PT - JOURNAL ARTICLE AU - Linda Laskowski-Jones AU - Michael J Caudell AU - Seth C Hawkins AU - Lawrence J Jones AU - Chelsea A Dymond AU - Tracy Cushing AU - Sanjey Gupta AU - David S Young AU - Jennifer M Starling AU - Richard Bounds TI - Extreme event medicine: considerations for the organisation of out-of-hospital care during obstacle, adventure and endurance competitions AID - 10.1136/emermed-2017-206695 DP - 2017 Oct 01 TA - Emergency Medicine Journal PG - 680--685 VI - 34 IP - 10 4099 - http://emj.bmj.com/content/34/10/680.short 4100 - http://emj.bmj.com/content/34/10/680.full SO - Emerg Med J2017 Oct 01; 34 AB - 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.