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Medical Incidents and Evacuations on Wilderness Expeditions for the Northwest Outward Bound School.
Wilderness Environ Med. 2018 Dec; 29(4):479-487.WE

Abstract

INTRODUCTION

Outdoor education (OE) expeditions travel far from definitive care and have unique epidemiology. Most OE expedition studies have examined a single organization and results may not generalize. This study examines the injuries, illnesses, medical evacuations, and nonmedical incidents of the Northwest Outward Bound School (NWOBS) to broaden our understanding and demonstrate commonalities within the field.

METHODS

This retrospective database review examined incidents and evacuations on NWOBS expeditions from June 1, 2014 through October 31, 2016. Incident rates, evacuation rates, and incident type frequencies were calculated. Frequencies of incidents during different expedition time periods were compared with a 1-sample χ2 test. The odds ratio that each type of incident would require evacuation was calculated and compared with other incident types using Fisher exact test.

RESULTS

The study period included 59,058 program days, 277 incidents, 143 medical incidents, 75 medical evacuations, and no fatalities. Injuries occurred at a rate of 1.64 per 1000 program days and illnesses at a rate of 0.78 per 1000 program days. The most common injuries were strains, sprains, and trauma or infection of the skin and soft tissue. Most injuries occurred while backpacking, hiking, or moving around camp. The most common illnesses were nausea, vomiting, diarrhea, abdominal pain, asthma, respiratory infections, and urinary tract infections. The medical incidents with the highest odds of evacuation were fractures, urinary tract infections, abdominal pain, and asthma.

CONCLUSIONS

Results from the NWOBS database are consistent with those from other expeditionary OE programs. These findings should guide risk-management strategies and staff medical training.

Authors+Show Affiliations

Oregon Health & Science University, Portland, OR (Mr Wells). Electronic address: forrestcwells@gmail.com.Department of Emergency Medicine, Oregon Health & Science University, Portland, OR (Dr Warden).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30309827

Citation

Wells, Forrest C., and Craig R. Warden. "Medical Incidents and Evacuations On Wilderness Expeditions for the Northwest Outward Bound School." Wilderness & Environmental Medicine, vol. 29, no. 4, 2018, pp. 479-487.
Wells FC, Warden CR. Medical Incidents and Evacuations on Wilderness Expeditions for the Northwest Outward Bound School. Wilderness Environ Med. 2018;29(4):479-487.
Wells, F. C., & Warden, C. R. (2018). Medical Incidents and Evacuations on Wilderness Expeditions for the Northwest Outward Bound School. Wilderness & Environmental Medicine, 29(4), 479-487. https://doi.org/10.1016/j.wem.2018.07.004
Wells FC, Warden CR. Medical Incidents and Evacuations On Wilderness Expeditions for the Northwest Outward Bound School. Wilderness Environ Med. 2018;29(4):479-487. PubMed PMID: 30309827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medical Incidents and Evacuations on Wilderness Expeditions for the Northwest Outward Bound School. AU - Wells,Forrest C, AU - Warden,Craig R, Y1 - 2018/10/09/ PY - 2018/01/05/received PY - 2018/07/12/revised PY - 2018/07/12/accepted PY - 2018/10/13/pubmed PY - 2019/5/11/medline PY - 2018/10/13/entrez KW - epidemiology KW - evacuation KW - first aid KW - illness KW - injury KW - wilderness medicine SP - 479 EP - 487 JF - Wilderness & environmental medicine JO - Wilderness Environ Med VL - 29 IS - 4 N2 - INTRODUCTION: Outdoor education (OE) expeditions travel far from definitive care and have unique epidemiology. Most OE expedition studies have examined a single organization and results may not generalize. This study examines the injuries, illnesses, medical evacuations, and nonmedical incidents of the Northwest Outward Bound School (NWOBS) to broaden our understanding and demonstrate commonalities within the field. METHODS: This retrospective database review examined incidents and evacuations on NWOBS expeditions from June 1, 2014 through October 31, 2016. Incident rates, evacuation rates, and incident type frequencies were calculated. Frequencies of incidents during different expedition time periods were compared with a 1-sample χ2 test. The odds ratio that each type of incident would require evacuation was calculated and compared with other incident types using Fisher exact test. RESULTS: The study period included 59,058 program days, 277 incidents, 143 medical incidents, 75 medical evacuations, and no fatalities. Injuries occurred at a rate of 1.64 per 1000 program days and illnesses at a rate of 0.78 per 1000 program days. The most common injuries were strains, sprains, and trauma or infection of the skin and soft tissue. Most injuries occurred while backpacking, hiking, or moving around camp. The most common illnesses were nausea, vomiting, diarrhea, abdominal pain, asthma, respiratory infections, and urinary tract infections. The medical incidents with the highest odds of evacuation were fractures, urinary tract infections, abdominal pain, and asthma. CONCLUSIONS: Results from the NWOBS database are consistent with those from other expeditionary OE programs. These findings should guide risk-management strategies and staff medical training. SN - 1545-1534 UR - https://www.unboundmedicine.com/medline/citation/30309827/Medical_Incidents_and_Evacuations_on_Wilderness_Expeditions_for_the_Northwest_Outward_Bound_School_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1080-6032(18)30124-8 DB - PRIME DP - Unbound Medicine ER -