• Janna Baker and Mary Pat McKay.
• Department of Emergency Medicine, The George Washington University Medical Faculty Associates, Washington, DC 20037, USA. jbaker@mfa.gwu.edu
• Prehosp Emerg Care. 2010 Apr 1;14(2):182-6.

BackgroundWilderness activities continue to be popular in the United States, but may lead to both direct injuries and exacerbations or complications from chronic diseases. Appropriate response planning requires information on the type and location of emergency medical services (EMS) activations in large outdoor areas with many visitors.ObjectivesTo describe EMS calls in Shenandoah National Park in Virginia and explore the resultant implications for EMS resources and staging, medical provider training, and potential public health interventions in similar wilderness recreation areas.MethodsA retrospective, descriptive review was conducted of all park EMS activations in Shenandoah National Park from 2003 to 2007.ResultsThere were 335 EMS activations within the park over the study period. Both call volume and call rate increased during the study period. There were 197 calls (58.8%) for injuries and 138 (41.2%) for illnesses. Weakness/dizziness was the most frequent illness complaint, and lower extremity injury was the most frequent injury. Those with illnesses were more likely to be seen by EMS at a lodge, tended to be female, and were more likely to require emergency transportation to a hospital. Chronic medical problems were reported for twice as many of the illness patients as for those who were injured.ConclusionsEMS runs in Shenandoah are increasing and the majority of calls from 2003 to 2007 were for injuries. A notable number of patients with both injuries and illnesses reported chronic medical conditions. These data may be used to help with EMS support availability planning, provider education, and safety planning within the park, and provide baseline data for future public-safety interventions.

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