title: Injury patterns at Isle Royale National Park: an epidemiologic review of injuries and illnesses sustained in a remote environment.
abstract: OBJECTIVE
  Isle Royale National Park is a remote island in northern Lake Superior that attracts 16,000 visitors annually. The epidemiology of injuries and illnesses sustained by Isle Royale׳s visitors has not been previously studied. The purpose of this study is to examine these data and evaluate them for injury patterns.
  
  
  METHODS
  This is a retrospective observational study examining the epidemiology of injuries and illnesses sustained during the period from 2008 to 2012. Incident reports completed by park rangers were reviewed and the data sorted according to time of year, time of day, type of medical encounter, and whether the patient was stable, unstable, or required transport.
  
  
  RESULTS
  Two hundred and seventy patient care reports were obtained from the National Park Service. Sixty-four percent of encounters occurred in July and August, and most patients sought care in the afternoon. Care was provided by park rangers, the majority of whom were trained to the level of emergency medical technician. Fifty-eight percent of cases were trauma related, and 20% of all cases were evacuated.
  
  
  CONCLUSIONS
  The majority of incidents were trauma related. The majority of the rangers on the island are trained to the level of emergency medical technician-B and appear to offer appropriate care to the island's many visitors, utilizing the National Park Service treatment protocols and comprehensive medical kits. In addition, access to advanced medical care is readily available by air and water evacuation.
authors.affiliation: Colorado Permanente Medical Group, Department of Emergency Medicine, Saint Joseph Hospital, Denver, CO (Dr Saxon). Electronic address: kdsaxon@gmail.com.
authors.forename: Kathleen D
authors.initials: KD
authors.lastname: Saxon
authors.affiliation: Department of Emergency Medicine, University of New Mexico, Albuquerque, NM (Dr White).
authors.forename: Jenna M B
authors.initials: JM
authors.lastname: White
authors.affiliation: Department of Emergency Medicine, University of Michigan, Ann Arbor, MI (Drs Eddy, Albertus, and Bassin).
authors.forename: Mary M
authors.initials: MM
authors.lastname: Eddy
authors.affiliation: Department of Emergency Medicine, University of Michigan, Ann Arbor, MI (Drs Eddy, Albertus, and Bassin).
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Albertus
authors.affiliation: Department of Emergency Medicine, University of Michigan, Ann Arbor, MI (Drs Eddy, Albertus, and Bassin).
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Bassin
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D000068316:Parks, Recreational; D012189:Retrospective Studies; D012621:Seasons; D013997:Time Factors; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology
keywords: Isle Royale National Park; epidemiology