Forrester Joseph D, Holstege Christopher P
Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA.
Wilderness Environ Med. 2009 Winter;20(4):318-26. doi: 10.1580/1080-6032-020.004.0318.
There have been no studies to date exploring the nature of injuries and illness experienced by individuals in a National Park in the southeastern United States. The purpose of this study was to determine the incidence of such illnesses and injuries to visitors in Shenandoah National Park.
This study was a retrospective review of the case incident reports from Shenandoah National Park from 2003 to 2007. Data obtained included age, sex, time and date report was received, medical symptoms, trauma type, location of injury, mechanism of injury, level of care, time to patient, time to disposition, disposition type, location, and activity at time of event.
There were 159 total cases, corresponding to a reported incident rate of 2.7 persons reported injured or ill per 100 000 visitors to Shenandoah National Park. A total of 23.3% of all reported injuries occurred in persons less than 18 years of age. The most common reported adult injury was soft tissue injury, with the most common anatomical location being the distal lower extremity. The most common activity in which adults were involved at the time of the injury was hiking. Of the pediatric trauma cases, the most common mechanism of injury was a fall. Of the adult medical illnesses, the most common complaint was chest pain.
The pattern of adult and pediatric trauma is consistent among several geographically different National Parks in the United States and represents an injury pattern that all wilderness/outdoor care providers need to be competent to treat. Among adult visitors, the most common medical complaint was chest pain, a complaint more prevalent at Shenandoah National Park compared to other parks. Knowing that trauma injury patterns are relatively similar to those of other parks but that medical illness is more locale specific can help health care providers tailor their resource allotment and health management protocols.
迄今为止，尚无研究探讨美国东南部一个国家公园内个人所经历的伤病性质。本研究的目的是确定谢南多厄国家公园游客此类伤病的发生率。
本研究是对谢南多厄国家公园2003年至2007年的病例事件报告进行的回顾性分析。获得的数据包括年龄、性别、报告接收时间和日期、医学症状、创伤类型、受伤部位、受伤机制、护理级别、到达患者的时间、处置时间、处置类型、地点以及事件发生时的活动。
共有159例病例，对应报告的发生率为每10万名谢南多厄国家公园游客中有2.7人报告受伤或患病。所有报告的伤害中，23.3%发生在18岁以下的人群中。报告的最常见成人伤害是软组织损伤，最常见的解剖部位是下肢远端。成人受伤时最常参与的活动是徒步旅行。在儿科创伤病例中，最常见的受伤机制是跌倒。在成人内科疾病中，最常见的主诉是胸痛。
美国几个地理位置不同的国家公园中，成人和儿科创伤模式是一致的，代表了所有野外/户外护理提供者都需要有能力治疗的伤害模式。在成年游客中，最常见的内科主诉是胸痛，与其他公园相比，谢南多厄国家公园的这种主诉更为普遍。了解创伤伤害模式与其他公园相对相似，但内科疾病更具地域特异性，有助于医疗保健提供者调整其资源分配和健康管理方案。
