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Trends in Skin and Soft Tissue-Related Injuries in NOLS Wilderness Expeditions from 1984 to 2012.
Wilderness Environ Med. 2017 Dec; 28(4):307-312.WE

Abstract

OBJECTIVE

Wilderness expeditions inevitably involve risk to participants. Understanding of expedition-related illnesses and injuries allows institutions and individuals to develop strategies to mitigate risk. We describe findings and trends in soft tissue injuries, the second-most common type of injury, among participants in the National Outdoor Leadership School expeditions from 1984 to 2012.

METHODS

Injuries and illnesses sustained by students and staff have been recorded continuously since 1984 in the extensive National Outdoor Leadership School database. We performed a retrospective analysis of incidence of soft tissue injuries in this population. Data before 1996 were standardized in order to make use of the entire dataset.

RESULTS

Of 9734 total reported incidents, 2151 (22%) were soft tissue related, 707 (33%) of which required evacuation. The sex distribution of incidents was similar to the sex distribution of participants. The largest incidence of soft tissue injuries occurred independent of activity (711 incidents, 33%). The most commonly associated activities were hiking (528 incidents, 25%), camping (301 incidents, 14%), and cooking (205 incidents, 10%). Over the study period, rates of injury declined overall and in every individual category except cooking.

CONCLUSIONS

Over this 28-year period, the incidence of soft tissue injuries associated with the most common activities decreased. Incidence of activity-independent injuries did not change significantly, but reported severity decreased. These data provide unique insights to help improve wilderness risk management for institutions and individuals and suggest areas in which educational efforts may further reduce risk.

Authors+Show Affiliations

Department of Emergency Medicine, Massachusetts General Hospital, Brigham and Women's Hospital, Boston, MA (Dr Stanford). Electronic address: drkstanford@gmail.com.Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA (Dr Phillips).Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (Dr Harris), the National Outdoor Leadership School (Mr Leemon, and Mr Schimelpfenig); and the Department of Medicine, Massachusetts General Hospital, Boston, MA (Dr Chang).Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (Dr Harris), the National Outdoor Leadership School (Mr Leemon, and Mr Schimelpfenig); and the Department of Medicine, Massachusetts General Hospital, Boston, MA (Dr Chang).Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (Dr Harris), the National Outdoor Leadership School (Mr Leemon, and Mr Schimelpfenig); and the Department of Medicine, Massachusetts General Hospital, Boston, MA (Dr Chang).Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (Dr Harris), the National Outdoor Leadership School (Mr Leemon, and Mr Schimelpfenig); and the Department of Medicine, Massachusetts General Hospital, Boston, MA (Dr Chang).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28882617

Citation

Stanford, Kimberly A., et al. "Trends in Skin and Soft Tissue-Related Injuries in NOLS Wilderness Expeditions From 1984 to 2012." Wilderness & Environmental Medicine, vol. 28, no. 4, 2017, pp. 307-312.
Stanford KA, Phillips L, Chang Y, et al. Trends in Skin and Soft Tissue-Related Injuries in NOLS Wilderness Expeditions from 1984 to 2012. Wilderness Environ Med. 2017;28(4):307-312.
Stanford, K. A., Phillips, L., Chang, Y., Leemon, D., Schimelpfenig, T., & Harris, N. S. (2017). Trends in Skin and Soft Tissue-Related Injuries in NOLS Wilderness Expeditions from 1984 to 2012. Wilderness & Environmental Medicine, 28(4), 307-312. https://doi.org/10.1016/j.wem.2017.06.005
Stanford KA, et al. Trends in Skin and Soft Tissue-Related Injuries in NOLS Wilderness Expeditions From 1984 to 2012. Wilderness Environ Med. 2017;28(4):307-312. PubMed PMID: 28882617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in Skin and Soft Tissue-Related Injuries in NOLS Wilderness Expeditions from 1984 to 2012. AU - Stanford,Kimberly A, AU - Phillips,Lara, AU - Chang,Yuchiao, AU - Leemon,Drew, AU - Schimelpfenig,Tod, AU - Harris,N Stuart, Y1 - 2017/09/04/ PY - 2016/11/26/received PY - 2017/06/15/revised PY - 2017/06/19/accepted PY - 2017/9/9/pubmed PY - 2018/6/21/medline PY - 2017/9/9/entrez KW - evacuation KW - expedition medicine KW - illness KW - infection KW - injury KW - wilderness medicine SP - 307 EP - 312 JF - Wilderness & environmental medicine JO - Wilderness Environ Med VL - 28 IS - 4 N2 - OBJECTIVE: Wilderness expeditions inevitably involve risk to participants. Understanding of expedition-related illnesses and injuries allows institutions and individuals to develop strategies to mitigate risk. We describe findings and trends in soft tissue injuries, the second-most common type of injury, among participants in the National Outdoor Leadership School expeditions from 1984 to 2012. METHODS: Injuries and illnesses sustained by students and staff have been recorded continuously since 1984 in the extensive National Outdoor Leadership School database. We performed a retrospective analysis of incidence of soft tissue injuries in this population. Data before 1996 were standardized in order to make use of the entire dataset. RESULTS: Of 9734 total reported incidents, 2151 (22%) were soft tissue related, 707 (33%) of which required evacuation. The sex distribution of incidents was similar to the sex distribution of participants. The largest incidence of soft tissue injuries occurred independent of activity (711 incidents, 33%). The most commonly associated activities were hiking (528 incidents, 25%), camping (301 incidents, 14%), and cooking (205 incidents, 10%). Over the study period, rates of injury declined overall and in every individual category except cooking. CONCLUSIONS: Over this 28-year period, the incidence of soft tissue injuries associated with the most common activities decreased. Incidence of activity-independent injuries did not change significantly, but reported severity decreased. These data provide unique insights to help improve wilderness risk management for institutions and individuals and suggest areas in which educational efforts may further reduce risk. SN - 1545-1534 UR - https://www.unboundmedicine.com/medline/citation/28882617/Trends_in_Skin_and_Soft_Tissue_Related_Injuries_in_NOLS_Wilderness_Expeditions_from_1984_to_2012_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1080-6032(17)30192-8 DB - PRIME DP - Unbound Medicine ER -