The development and current status of wilderness prehospital emergency care in the United States

A Review of Emergency Medical Services Events in US National Parks From 2007 to 2011

“…Although our data and past studies do not settle the debate of utility versus cost of advanced cardiac life support certification for park-medics, it does indicate that the number of cardiac arrests may not be negligible, particularly in so-called frontcountry areas of parks, where EMS events may more closely mimic those in an urban environment, with a older and less healthy population. 5,22 Fatalities in the NPS were more common in the regions previously discussed as having higher EMS events. The IMR and PWR reported the highest number of total fatalities, and the AKR reported the highest incidence of fatalities with nearly 5 times the national average.…”

“…This utilization varies from park to park based on geographical location, proximity to local EMS systems, and individual park need. [5][6][7] The parkmedic program was developed in 1977 by the NPS in response to the growing need for improved EMS for its steadily growing number of visitors. Parkmedics are rangers with advanced EMT training that allows them to perform venipuncture, administer intravenous fluids and medications, use advanced techniques in cardiopulmonary resuscitation, and airway management, and use advanced SAR techniques such as technical evacuations and helicopter rescue.…”

“…Parkmedics are rangers with advanced EMT training that allows them to perform venipuncture, administer intravenous fluids and medications, use advanced techniques in cardiopulmonary resuscitation, and airway management, and use advanced SAR techniques such as technical evacuations and helicopter rescue. 5,8 The NPS, its rangers, and its parkmedics cover the EMS for a large number and variety of visitors over a significant square mileage of often remote wilderness. Increasing numbers of people participating in wilderness activities is assumed to increase the frequency of wilderness injuries, but few studies have examined this on a national scale.…”

Successful resuscitation from sea water drowning.

“…Some authors give particular emphasis to 'field' resuscitation (Samuelson et al, 1982;Stewart, 1989;Bowman, 1990) yet these messages are not reaching 'front-line' rescuers. Should we tolerate this situation in the 1990s?…”

Perspectives on being a wilderness physician: is wilderness medicine more than a special body of knowledge?

“…Ten years ago in this publication, I listed the ways in which wilderness prehospital emergency care differs from urban prehospital emergency care. 2 Most of these guidelines apply equally well to wilderness medical care.…”