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General Medical Considerations for the Wilderness Adventurer: Medical Conditions That May Worsen With or Present Challenges to Coping With Wilderness Exposure

Cushing, Tracy A. MD, MPH*; Roberts, William O. MD, MS; Hackett, Peter*,‡; Dexter, William W. MD§; Brent, Jeff S. MD; Young, Craig C. MD; Fudge, Jessie R. MD**; Hawkins, Seth C. MD††; DeLoughery, Thomas G. MD‡‡; Thomas, Benjamin J. MD§§; Tabin, Geoffrey C. MD§§; Jacoby, Leah E. MD¶¶; Asplund, Chad A. MD, MPH‖‖

Clinical Journal of Sport Medicine: September 2015 - Volume 25 - Issue 5 - p 396–403
doi: 10.1097/JSM.0000000000000229
Care of the Wilderness Athlete

Abstract: Participation in wilderness and adventure sports is on the rise, and as such, practitioners will see more athletes seeking clearance to participate in these events. The purpose of this article is to describe specific medical conditions that may worsen or present challenges to the athlete in a wilderness environment.

*Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado;

Department of Family Medicine and Community Health, University of Minnesota, St. Paul, Minnesota;

Department of Emergency Medicine, Institute for Altitude Medicine, Telluride, Colorado;

§Department of Family Medicine, Tufts University School of Medicine, Boston, Massachusetts;

Department of Sports Medicine, The Vancouver Clinic, Vancouver, Washington;

Department of Orthopedics/Community & Family Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;

**Department of Family Medicine, Group Health Cooperative, Everett, Washington;

††Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina;

‡‡Departments of Medicine, Pediatrics and Pathology, Oregon Health and Science University, Portland, Oregon;

§§Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah;

¶¶Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado; and

‖‖Department of Family Medicine, Georgia Regents University, Augusta, Georgia.

Corresponding Author: Tracy A. Cushing, MD, MPH, Mail Stop B 12 Leprino Building, 12401 E 17th Ave Room 763, Aurora, CO 80045 (

The authors report no conflicts of interest.

This article appears in a “Care of the Wilderness and Adventure Athlete” special issue, jointly published by Clinical Journal of Sport Medicine and Wilderness & Environmental Medicine.

Received February 25, 2015

Accepted June 12, 2015

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