Obstacle, adventure and endurance competitions in challenging or remote settings are increasing in popularity. A literature search indicates a dearth of evidence-based research on the organisation of medical care for wilderness competitions. The organisation of medical care for each event is best tailored to specific race components, participant characteristics, geography, risk assessments, legal requirements, and the availability of both local and outside resources. Considering the health risks and logistical complexities inherent in these events, there is a compelling need for guiding principles that bridge the fields of wilderness medicine and sports medicine in providing a framework for the organisation of medical care delivery during wilderness and remote obstacle, adventure and endurance competitions. This narrative review, authored by experts in wilderness and operational medicine, provides such a framework. The primary goal is to assist organisers and medical providers in planning for sporting events in which participants are in situations or locations that exceed the capacity of local emergency medical services resources.
- Prehospital Care
- Major Incident / Planning
- Remote And Rural Medicine
- Environmental Medicine
- Wilderness Medicine
- Mass Gathering Medicine
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Contributors The author group includes leaders of the Appalachian Center for Wilderness Medicine and the Wilderness Medical Society, and all those listed have contributed substantially. LL-J spearheaded this effort by developing the concept, organising this group and coordinating in-person meetings, conference calls and electronic communications. Individual sections were authored as follows: Abstract, Methods and Conclusion: RB; Introduction, Defining WEM: TC and CAD; Medical problems: MJC; Certification, Scope of practice: SCH and JMS. Logistics: equipment, fuel/fluids, medical tents: DSY; communication, orientation, documentation, transportation, integration with EMS: LL-J and LJJ; removing unsafe participants: RB. Medicolegal considerations: SG. Postevent QA: LL-J. LL-J and RB brought the various sections together into a cohesive multidisciplinary work that represents the group’s collective recommendations.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.