LAUSR

Introduction: People are increasingly embarking on expeditions into remote wilderness environments and subjecting themselves to increased medical risk. Medical provisions for the management of anticipated injuries and illnesses must be selected carefully due to financial and size and weight constraints on expeditions. Literature suggests decisions surrounding medical resource provisioning are rarely made using evidence-based methods. Aim: The aim of this study was to evaluate the medical provisions taken on expeditions against the medical provisions recommended as best practice in published treatment protocols for the management of conditions encountered on expeditions. Methods: Firstly, a mixed methods study approach was used to develop a conceptual model linking injuries and illnesses with the medical resources (equipment and medications) recommended for their management. In the second part of the study, injuries and illnesses reported in four studies from the published literature were analyzed using the conceptual model. Results: Expected medical resources for the injury and illness burden were compared to the medical resources included in published equipment and medication lists. It was found that medical resources taken on expeditions were both significantly underequipped (p<0.01) compared with the list of provisions recommended by the treatment protocols, but also included a range of resources that were not indicated as part of best practice. Discussion: These findings suggest that unnecessary over-provisioning and under-provisioning risks are being assumed on expeditions. Further research supporting the development of a medical provision recommender system may provide a more evidence-informed method of matching medical resource requirements to anticipated injury and illness profiles on expeditions.