Yue Michael D T, Spivey David W, Gingold Daniel B, Sward Douglas G
University of Maryland School of Medicine, Baltimore, Maryland, USA.
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
World J Emerg Med. 2018;9(3):172-177. doi: 10.5847/wjem.j.1920-8642.2018.03.002.
The purpose of this study was to document the correlation between medical and wilderness training with levels of preparedness for acute mountain sickness (AMS), illness, and injury among backcountry hikers.
We conducted a cross-sectional, convenience survey in Rocky Mountain National Park in July and August 2015. The study group consisted of 380 hikers who completed a written survey that collected information about demographics, wilderness experience, altitude experience, hiking equipment, communications devices, and trip planning.
Factors such as wilderness training (wilderness first aid [WFA], wilderness first responder [WFR], or wilderness emergency medical technician [WEMT]), wilderness experience, and altitude experience all affected hikers' emergency preparedness. Respondents with medical training were more prepared to avoid or respond to AMS (62.3% vs. 34.3% [<0.001]). They were also more prepared to avoid or manage injury/illness than hikers without medical training (37.7% vs. 20.7% [=0.003]). Participants with wilderness training were more likely to be prepared to avoid or respond to AMS (52.3% vs. 36.8% [=0.025]) but not significantly more likely to be prepared to manage illness/injury (31.8% vs. 22.0% [<0.11]). Adjusting for experience, wilderness training, age, and gender, we found that medical training was associated with increased preparedness for AMS ( 2.72; 95% 1.51-4.91) and injury/illness ( 2.71; 95% 1.5-4.89).
Medically trained hikers were more likely to be prepared to avoid or manage AMS, medical emergencies, and injuries than their non-medically trained counterparts. Wilderness training increased hikers' preparedness for AMS but did not significantly alter preparedness for illness/injury.
本研究的目的是记录医学培训和野外训练与偏远地区徒步旅行者的急性高山病(AMS)、疾病及损伤的准备水平之间的相关性。
2015年7月和8月,我们在落基山国家公园进行了一项横断面便利性调查。研究组由380名徒步旅行者组成,他们完成了一份书面调查问卷,该问卷收集了有关人口统计学、野外经历、海拔经历、徒步装备、通讯设备及行程规划的信息。
诸如野外训练(野外急救[WFA]、野外急救员[WFR]或野外紧急医疗技术员[WEMT])、野外经历和海拔经历等因素均会影响徒步旅行者的应急准备情况。接受过医学培训的受访者更有准备避免或应对急性高山病(62.3%对34.3%[<0.001])。他们也比未接受医学培训的徒步旅行者更有准备避免或处理损伤/疾病(37.7%对20.7%[=0.003])。接受过野外训练的参与者更有可能有准备避免或应对急性高山病(52.3%对36.8%[=0.025]),但在处理疾病/损伤方面准备充分的可能性并未显著更高(31.8%对22.0%[<0.11])。在对经历、野外训练、年龄和性别进行校正后,我们发现医学培训与急性高山病(比值比[OR]=2.72;95%置信区间[CI]:1.51 - 4.91)以及损伤/疾病(OR = 2.71;95%CI:1.5 - 4.89)的准备增加相关。
与未接受医学培训的同行相比,接受过医学培训的徒步旅行者更有可能准备好避免或处理急性高山病、医疗紧急情况及损伤。野外训练提高了徒步旅行者对急性高山病的准备程度,但并未显著改变对疾病/损伤的准备程度。