title: Emergency Medical Service in the US National Park Service: A Characterization and Two-Year Review, 2012-2013.
abstract: OBJECTIVE
  Visitors to US National Park Service (NPS) units have a unique set of needs in terms of emergency medical care. The purpose of this review is to quantify and characterize emergency medical services (EMS) activities in the NPS to elaborate on its unique aspects, establish trends, and benchmark these data against a sample of national EMS data.
  
  
  METHODS
  The EMS data for calendar years 2012 and 2013 were queried from national NPS reports.
  
  
  RESULTS
  The EMS responses totaled 40 calls per million visitors in 2012 and 34 calls per million visitors in 2013. Of those, 75% required a basic life support level of care. There were comparable incidences of transported EMS trauma calls (49%) and medical calls (51%). Of a total of 137 sudden cardiac arrest events, 65% of patients received defibrillation and 26% survived to hospital release. There were 262 total fatalities in 2012 and 238 in 2013, with traumatic fatalities occurring approximately twice as often as nontraumatic fatalities.
  
  
  CONCLUSIONS
  Across the country, the NPS responded to a large number of EMS calls each year, but with a relatively low frequency, considering the large number of visitors. This is a challenging setting in which to provide consistent EMS care throughout various NPS administered areas. The typical NPS EMS response provided basic life support level care to visitors with traumatic injuries. The NPS caregivers must be prepared, however, to respond to a varied and diverse range of EMS calls.
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD (Mr Lane). Electronic address: jeffrey.lane@som.umaryland.edu.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Lane
authors.affiliation: National Park Service, Washington, DC (Ms Taylor and Drs Smith and Wheeler).
authors.forename: Bonnaleigh
authors.initials: B
authors.lastname: Taylor
authors.affiliation: National Park Service, Washington, DC (Ms Taylor and Drs Smith and Wheeler); University of Washington School of Medicine, Seattle, WA (Dr Smith); St. John's Medical Center, Jackson, WY (Drs Smith and Wheeler).
authors.forename: William R
authors.initials: WR
authors.lastname: Smith
authors.affiliation: National Park Service, Washington, DC (Ms Taylor and Drs Smith and Wheeler); St. John's Medical Center, Jackson, WY (Drs Smith and Wheeler); University of Utah, Salt Lake City, UT (Dr Wheeler).
authors.forename: Albert R
authors.initials: AR
authors.lastname: Wheeler
mesh_terms: D002202:Capital Financing; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D004632:Emergency Medical Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D000068316:Parks, Recreational / Q000706:statistics & numerical data*; D018635:Rescue Work / Q000706:statistics & numerical data; D014481:United States; D055814:Wilderness; D000078329:Workforce; D014947:Wounds and Injuries / Q000453:epidemiology
keywords: National Park Service; automated external defibrillator; emergency medical services; rescue; sudden cardiac arrest; wilderness