• Giacomo Strapazzon, Oliver Reisten, Fabien Argenone, Ken Zafren, Greg Zen-Ruffinen, Gordon L Larsen, and Inigo Soteras.
• Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy; Corpo Nazionale Soccorso Alpino e Speleologico, National Medical School (CNSAS SNaMed), Milan, Italy (Dr Strapazzon); International Commission of Mountain Emergency Medicine (ICAR MEDCOM), Kloten, Switzerland (Drs Strapazzon, Reisten, Zafren, Zen-Ruffinen, and Soteras). Electronic address: giacomo.strapazzon@eurac.edu.
• Wilderness Environ Med. 2018 Jun 1; 29 (2): 252-265.

AbstractCanyoning is a recreational activity that has increased in popularity in the last decade in Europe and North America, resulting in up to 40% of the total search and rescue costs in some geographic locations. The International Commission for Mountain Emergency Medicine convened an expert panel to develop recommendations for on-site management and transport of patients in canyoning incidents. The goal of the current review is to provide guidance to healthcare providers and canyoning rescue professionals about best practices for rescue and medical treatment through the evaluation of the existing best evidence, focusing on the unique combination of remoteness, water exposure, limited on-site patient management options, and technically challenging terrain. Recommendations are graded on the basis of quality of supporting evidence according to the classification scheme of the American College of Chest Physicians.Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

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