Embarking in the Backcountry: Traumatic Injuries Sustained in the Boundary Waters Canoe Area

IntroductionThe Boundary Waters Canoe Area (BWCA) is a backcountry recreation area. This study aimed to characterize injuries sustained in the BWCA.MethodsA single reviewer completed a retrospective chart review of trauma admissions to Essentia Health from January 1, 2014 to February 25, 2023. Patients were included if their injury was documented to have occurred in the BWCA and they had not opted out of research.ResultsEighteen patients were found to have sustained injury in the BWCA. Most were adult males (78%), White (89%), and nonsmokers (94%). Most patients had no alcohol (83.3%) or drug (94.4%) use related to the injury. Seven patients self-extricated out to the BWCA, 6 were transported by ground Emergency Medical Services, and 5 required flight extrication. Median time from notification of injury to Emergency Medical Services arrival was 64 min. Time from notification of injury to hospital arrival was a median of 131 min. Falls were the main mechanism of injury (61%), followed by strike injury (22%) and water injury (17%). A few patients required lifesaving interventions (eg, prehospital intubations, needle thoracostomy, and blood transfusion). Twelve patients required a procedure (eg, <5 chest tubes and 10 surgeries). All 18 patients were alive at discharge.ConclusionThe most common injuries sustained in the BWCA were from falls, strikes, and water injuries. In collaboration with forest ranger stations, we plan to provide this information to backpackers to assist in their preparation for backcountry emergencies.