Wilderness emergency medical services: the experiences at Sequoia and Kings Canyon National Parks.
This article describes the National Park Service wilderness emergency medical services (EMS) system, as implemented at Sequoia-Kings Canyon National Park. EMS records on all 434 patients in the period from August 1, 1986, to July 31, 1987, were reviewed. Most patients had minor problems. Overall, 77% of patients contacting the EMS system were released at the scene, and base hospital contact was made in only 28% of cases. However, there were three deaths, 44 (10%) patients who received advanced life support, and 292 (67%) patients who received basic life support. Seven patients who received advanced life support were released without transport. Decisions regarding scope of practice in a low-volume, wilderness EMS system are complicated by long transport times and problems with skills maintenance. Differences between the times and problems with skills maintenance. Differences between the patients treated by a wilderness system and those seen in most urban systems may make it appropriate to release a greater portion of patients without ambulance transport. In a system with long response and transport times, use of personnel with different training than in the urban setting becomes necessary.
Johnson
J
J
Department of Emergency Medicine, Valley Medical Center, Fresno, CA.
Maertins
M
M
Shalit
M
M
Bierbaum
T J
TJ
Goldman
D E
DE
Lowe
R A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004630:Emergencies / Q000453:epidemiology; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000628:therapy; D007223:Infant; D008020:Life Support Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011998:Recreation; D012151:Resuscitation / Q000706:statistics & numerical data; D012423:Rural Health / Q000706:statistics & numerical data*; D013997:Time Factors; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy