Category 1 Continuing Medical Education credit for physicians is available to Wilderness Medical Society members for this article. Go to http://wms.org/cme/cme.asp?whatarticle=1811 to access the instructions and test questions.
Objective.—The purpose of this study was to characterize big game hunter visits to a rural hospital's emergency department (ED). Using data collected on fatalities, injuries, and illnesses over a 9-year period, trends were noted and comparisons made to ED visits of alpine skiers, swimmers, and bicyclists. Out-of-hospital hunter fatalities reported by the county coroner's office were also reviewed. Cautionary advice is offered for potential big game hunters and their health care providers.
Methods.—Self-identified hunters were noted in the ED log of a rural Colorado hospital from 1997 to 2005, and injury or illness and outcome were recorded. Additional out-of-hospital mortality data were obtained from the county coroner's office. The estimated total number of big game hunters in the hospital's service area and their average days of hunting were reported by the Colorado Division of Wildlife. The frequencies of hunters' illnesses, injuries, and deaths were calculated.
Results.—A total of 725 ED visits—an average of 80 per year—were recorded. Nearly all visits were in the prime hunting months of September to November. Twenty-seven percent of the hunter ED patients were Colorado residents, and 73% were from out of state. Forty-five percent of the visits were for trauma, 31% for medical illnesses, and 24% were labeled “other.” The most common medical visits (105) were for cardiac signs and symptoms, and all of the ED deaths (4) were attributed to cardiac causes. The most common trauma diagnosis was laceration (151), the majority (113) of which came from accidental knife injuries, usually while the hunter was field dressing big game animals. Gunshot wounds (4, <1%) were rare. Horse-related injuries to hunters declined while motor vehicle– and all-terrain vehicle (ATV)–related injuries increased. The five out-of-hospital deaths were cardiac related (3), motor vehicle related (1), and firearm related (1).
Conclusions.—Fatal outcomes in big game hunters most commonly resulted from cardiac diseases. Gunshot injuries and mortalities were very low in this population. Knife injuries were common. Hunters and their health care providers should consider a thorough cardiac evaluation prior to big game hunts. Hunter safety instructors should consider teaching aspects of safe knife use. Consideration should be given to requiring and improving ATV driver education.
