Collins Dylan, Crickmer Michael, Brolly Kayla, Abrams Daniel, Ritchie Alec, Milsom William
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Wilderness Environ Med. 2023 Mar;34(1):55-62. doi: 10.1016/j.wem.2022.11.004. Epub 2023 Jan 28.
Little is known about the epidemiology of emergency medical search and rescue incidents globally. The purpose of this study was to describe the epidemiology of emergency medical search and rescue incidents in the North Shore Mountains of Vancouver, British Columbia, Canada.
This was a retrospective review and descriptive analysis of search and rescue incident reports created by North Shore Rescue over a 25 y period from 1995 to 2019, inclusive. Incident reports were screened for inclusion against a priori criteria defining a medical callout. The National Advisory Committee of Aeronautics (NACA) severity score was used as a method to grade medical acuity of included subjects.
We included 906 subjects. Their median age was 35 y (interquartile range, 24-53), and 65% of subjects were men. Forty-one percent (n=371) of subjects were classified as non-trauma and 54% (n=489) as trauma. The top 3 activities were hiking (53%), biking (10%), and snow sports (10%). Forty-nine percent of incidents were classified as having a NACA score of ≥3. For subjects with trauma, the top 3 body regions were lower limb (52%), head (18%), and torso (12%). For subjects with non-traumatic conditions, the top 3 causes were mental health crises (25%), exposure (25%), and cardiovascular incidents (11%).
Half of the incidents were serious enough to require medical assessment at a hospital (NACA score ≥3). Given this medical acuity, there is a need for evidence-based guidelines and core training competencies for mountain medical search and rescue. Standardized core data sets and outcomes are needed to monitor quality of care over time.
全球范围内，人们对紧急医疗搜索与救援事件的流行病学了解甚少。本研究旨在描述加拿大不列颠哥伦比亚省温哥华北岸山脉紧急医疗搜索与救援事件的流行病学情况。
这是一项回顾性研究及描述性分析，对北岸救援组织在1995年至2019年（含）的25年期间创建的搜索与救援事件报告进行分析。根据定义医疗出诊的先验标准对事件报告进行筛选以纳入研究。采用美国国家航空咨询委员会（NACA）严重程度评分法对纳入研究对象的医疗 acuity 进行分级。
我们纳入了906名研究对象。他们的年龄中位数为35岁（四分位间距为24 - 53岁），65%的研究对象为男性。41%（n = 371）的研究对象被归类为非创伤性病例，54%（n = 489）为创伤性病例。前三项活动分别是徒步旅行（53%）、骑自行车（10%）和冰雪运动（10%）。49%的事件被归类为NACA评分为≥3。对于创伤性病例，前三个身体部位是下肢（52%）、头部（18%）和躯干（12%）。对于非创伤性病例，前三大病因是心理健康危机（25%）、暴露（25%）和心血管事件（11%）。
一半的事件严重到需要在医院进行医疗评估（NACA评分≥3）。鉴于这种医疗 acuity，需要基于证据的指南和山地医疗搜索与救援的核心培训能力。需要标准化的核心数据集和结果来长期监测医疗质量。
