Abstract
Wilderness emergencies present unique problems in rescuer access and medical evacuation. An innovative prehospital care system utilizing United States Forest Service smokejumpers has evolved in north central Washington state. Trained primarily as airborne forest firefighters, smokejumpers have unique talents in rough terrain parachuting. Coordination between the North Cascades Smokejumper Base, a local primary care physician, and the nearby county sheriffs office has made the access, initial treatment and evacuation of wilderness patients possible. Utilizing data from the United States Forest Service Logbooks and personal records of the base manager, the rescue mission experience of North Cascades Smokejumper Base between 1957 and 1988 is presented. The urgency of patients rescued was high, with 18% being in the critical or fatal outcome category, and 67.5% of patients being classified as urgent. The majority of rescues (80.5%) were for trauma patients. An average of four smokejumpers per rescue was utilized. Medical evacuation was predominantly by helicopter; horseback, litter carry, hiking and ground ambulances were also used. Medical training of smokejumpers has improved since 1973 with Emergency Medical Technician training of selected smokejumpers.