Wilderness emergency medical services: the experiences at Sequoia and Kings Canyon National Parks

Am J Emerg Med. 1991 May;9(3):211-6. doi: 10.1016/0735-6757(91)90078-x.


This article describes the National Park Service wilderness emergency medical services (EMS) system, as implemented at Sequoia-Kings Canyon National Park. EMS records on all 434 patients in the period from August 1, 1986, to July 31, 1987, were reviewed. Most patients had minor problems. Overall, 77% of patients contacting the EMS system were released at the scene, and base hospital contact was made in only 28% of cases. However, there were three deaths, 44 (10%) patients who received advanced life support, and 292 (67%) patients who received basic life support. Seven patients who received advanced life support were released without transport. Decisions regarding scope of practice in a low-volume, wilderness EMS system are complicated by long transport times and problems with skills maintenance. Differences between the times and problems with skills maintenance. Differences between the patients treated by a wilderness system and those seen in most urban systems may make it appropriate to release a greater portion of patients without ambulance transport. In a system with long response and transport times, use of personnel with different training than in the urban setting becomes necessary.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • California / epidemiology
  • Child
  • Child, Preschool
  • Emergencies / epidemiology
  • Emergency Medical Services / organization & administration*
  • Emergency Medical Services / statistics & numerical data
  • Emergency Medical Technicians / statistics & numerical data
  • Female
  • Humans
  • Hypersensitivity / therapy
  • Infant
  • Life Support Care / statistics & numerical data
  • Male
  • Middle Aged
  • Recreation*
  • Resuscitation / statistics & numerical data
  • Rural Health / statistics & numerical data*
  • Time Factors
  • Transportation of Patients / statistics & numerical data
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / therapy