A Review of Wilderness Patient Transport – A British Columbian Perspective
British Columbia is a mountainous province known for wilderness adventure. In B.C., transport of patients injured in the wilderness is conducted by a network of agencies including British Columbia Emergency Health Services, the Canadian Armed Forces, and 80 volunteer Search and Rescue teams. A survey of current literature has been conducted via PubMed search to create a narrative review of subjects relevant to wilderness transport, with a focus on areas of potential improvement.
Transport is carried out either by air or ground resources and the decision to use one or the other is based on the patient’s condition and factors at the scene. Even when one method is preferred, the other will likely be involved as well; it is important for both air and ground resources to work together to give the patient the greatest benefit. The time needed for transport is heavily dependent upon the distance from the site of dispatch to the patient, the environment, and the patient’s condition. In B.C., helicopter access to the patient may be through landing, Helicopter External Transport Systems, or winching. The combination of these three methods seen in B.C. is similar to that in the UK. Rescue helicopters in B.C. are staffed by paramedics and, while other systems use physicians, there is no convincing literature that one is superior to the other.
Overall B.C.’s system of wilderness transport is comparable to other jurisdictions, but the field would benefit from a more robust body of research.