On-site management of medical encounters during obstacle adventure course participation.

Obstacle adventure courses (OAC) are increasing in popularity. Although injuries are not uncommon, there is scant medical literature documenting the morbidity and mortality associated with these events. This manuscript describes a case series. Event demographics, medical coverage, and injuries/illnesses documented during four OAC events in British Columbia, Canada, are discussed - Tough Mudder™ (2012 and 2013) and Warrior Dash© (2011 and 2012). The patient presentation rate across all events ranged from 26.53 to 37.40 per 1,000 participants. Ambulance transfer rates were low (range = 0 to 5 per event day, 0% to 1.1% of patients seen). Although some illness presentations and injuries required a higher level of care, the majority of medical issues were related to musculoskeletal injuries of the lower limbs. Advanced knowledge about risks and patient presentations associated with participation in OAC may influence on-site staffing, deployment patterns, rescue equipment, and transfer to hospital planning for diagnostic imaging and definitive treatment.