TY - JOUR
T1 - Wilderness emergency medical services
T2 - The experiences at Sequoia and Kings Canyon National Parks
AU - Johnson, Jeffrey
AU - Maertins, Mark
AU - Shalit, Marc
AU - Bierbaum, Tucker J.
AU - Goldman, Douglas E.
AU - Lowe, Robert A.
N1 - Funding Information:
From the Department of Emergency Medicine Valley Medical Center of Fresno; and the Central Valley Medical Education Program, University of California, San Francisco, School of Medicinet. Manuscript received September 12,199O; accepted November 11, 1990. Supported in part by a grant from the Valley Medical Center Medical Research Committee. Address reprint requests to Dr Lowe, Division of Emergency Medicine, Box 0208, UCSF School of Medicine, San Francisco, CA 94143-0208. Key Words: Emergency medical services, emergency medical technicians, wilderness, rural health. Copyright 0 1991 by W.B. Saunders Company 0735-6757/91/0903-0002$500/O
PY - 1991/5
Y1 - 1991/5
N2 - This article describes the National Park Service wilderness emergency medical services (EMS) system, as implemented at Sequola-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 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.
AB - This article describes the National Park Service wilderness emergency medical services (EMS) system, as implemented at Sequola-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 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.
KW - Emergency medical services
KW - emergency medical technicians
KW - rural health
KW - wilderness
UR - http://www.scopus.com/inward/record.url?scp=0025761353&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025761353&partnerID=8YFLogxK
U2 - 10.1016/0735-6757(91)90078-X
DO - 10.1016/0735-6757(91)90078-X
M3 - Article
C2 - 2018588
AN - SCOPUS:0025761353
SN - 0735-6757
VL - 9
SP - 211
EP - 216
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 3
ER -