Abstract
Objective
Outdoor recreation is growing in the United States with over 278 million annual visitors to areas controlled by the National Park Service (NPS). The National Park rangers oversee emergency medical needs in these parks. This study examines medical and traumatic emergencies throughout the National Parks over a 3-year period to better understand events rangers encounter, types of fatalities, and automated external defibrillator (AED) usage on a national scale.
Methods
This is a retrospective study of the Annual Emergency Medical Services Reports published by all 7 NPS regions from 2007 to 2009. At a regional and national level, the following were examined: traumatic vs medical vs first aid events, advanced life support vs basic life support, traumatic vs medical fatalities, cardiac events and outcomes, cardiac fatalities, and use of AEDs and outcomes.
Results
The national incidence of EMS events was 50 events per million visitors. Medical, traumatic, and first aid events composed 28%, 27%, and 46% of reports, respectively. Two percent of medical episodes were cardiac, of which 57% received AED treatment. Thirty-three percent of cardiac arrests survived to hospital release. Sixty-three percent of fatalities were traumatic in nature, while the remaining 37% were nontraumatic in nature. Regional differences were found for all variables.
Conclusions
To our knowledge, this is the first study to examine medical emergencies in the NPS on a national scale. There are equal numbers of medical and traumatic events. Automated external defibrillator use may be limited by access to AEDs. The number of cardiac arrests surviving to hospital discharge is higher than the national average. Regional variations in events probably reflect differences in terrain, common activities, and access to definitive care between regions. This data can assist the NPS in targeting the regions with the greatest number of incidents and fatalities for visitor prevention and education.