To describe the epidemiology of wilderness search and rescue in a region with easily accessible, heavily used wilderness areas. We conducted a retrospective review of New Hampshire Fish and Game Department wilderness search-and-rescue reports between January 1999 and December 2001. The study group consisted of all the subjects of the New Hampshire Fish and Game Department search and rescue in the state of New Hampshire during the study period. Demographics, types of incidents, type and location of injuries, environmental factors, fatalities, and use of medical services for all the subjects were analyzed. Three hundred twenty-one incidents involving 457 subjects were analyzed. The mean age of the subjects in the incidents was 35.6 years, with 64.5% men and 35.4% women; 73% of the subjects resided in New Hampshire and Massachusetts. At the time of the incident, 57.3% of the subjects were hiking. Injuries precipitated 39.3% of the rescues, whereas lost and missing persons accounted for 41.4%. Fractures accounted for 33.7% of the reported injuries; 49.7% of the injuries were to the lower extremities. Sixty-four of the subjects (14%) died; 32.8% drowned, and 23.4% died from cardiac events. Volunteers were used in 53.3% of the rescues, a rescuer was injured in 2.5% of the incidents, and at least 36.4% of the subjects were transported to a hospital. The most prevalent demographic group requiring search-and-rescue efforts in New Hampshire was men aged 30 to 40 years who were hiking and who resided within a 4-hour drive of the area where they encountered difficulty. To decrease the number of people involved in most search and rescue, efforts should be focused on preventing wilderness users from getting lost and preventing lower extremity musculoskeletal injuries. Wilderness deaths may be prevented by focusing attention on cardiac health in wilderness users older than 50 years and on water safety.
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