title: Epidemiology of Search and Rescue in Baxter State Park: Dangers of Descent and Fatigue.
abstract: OBJECTIVE
  The purpose of this study was to determine the epidemiology of injury in Baxter State Park, Maine, and to better tailor search and rescue (SAR) resources, personnel, and training to acute needs in the park.
  
  
  METHODS
  We conducted a retrospective review of all SAR incident reports in Baxter State Park from July 1992 through June 2014. For each event, demographics, location, time, activity before the incident, incident details, and evacuation means were recorded and analyzed.
  
  
  RESULTS
  In all, 754 incidents of SAR or medical need were identified. Mean age was 38.9 years; mean age for subjects with fatigue as the primary complaint was 48.7 years. A majority (60.5%) of victims were male. Nineteen fatalities occurred during the study. Traumatic injuries precipitated 51% of SAR incidents, and an additional 30% were initiated for late or lost parties. Slips or falls while hiking were the most common causes of injury (67%), with the lower extremity being the most common injury site (31%). When applicable, 84.4% of acute need occurred while descending, as opposed to ascending, a mountain. Fatigue was the most commonly reported medical emergency, causative in 66% of medical SAR events.
  
  
  CONCLUSIONS
  Fatigue is a major factor in SAR events, both as a discreet cause and as a contributor to other injuries. Search and rescue need is more likely to occur during mountain descent, and lower extremity injuries are the most common etiology. Efforts should be focused on training rescuers in lower extremity and fatigue treatment, and more rescuers should be available when many are descending.
authors.affiliation: Tufts University School of Medicine, Boston, MA (Drs Sholl and Strout; Mr Welter).
authors.forename: Chris R
authors.initials: CR
authors.lastname: Welter
authors.affiliation: Department of Emergency Medicine, Maine Medical Center, Portland, ME (Drs Sholl and Strout).
authors.forename: J Matthew
authors.initials: JM
authors.lastname: Sholl
authors.affiliation: Department of Emergency Medicine, Maine Medical Center, Portland, ME (Drs Sholl and Strout). Electronic address: strout@mmc.org.
authors.forename: Tania D
authors.initials: TD
authors.lastname: Strout
authors.affiliation: Baxter State Park, Millinocket, ME (Mr Woodard).
authors.forename: Ben
authors.initials: B
authors.lastname: Woodard
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008281:Maine / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D000068316:Parks, Recreational / Q000706:statistics & numerical data; D018635:Rescue Work / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult
keywords: epidemiology; recreation; wilderness medicine