Review maps emergency care barriers for transient populations in mountain regions

A scoping review published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine examined emergency healthcare access for transient and mobile populations in mountainous environments. Researchers searched six databases and search platforms, with two reviewers independently screening records. Of 737 records identified, 23 sources were included, covering tourists, climbers, pilgrims, migrants, disaster-affected populations, and mass-gathering participants.

Common barriers included difficult terrain, limited roads, variable weather, altitude-related operational constraints, communication limitations, and insufficient emergency medical capacity. Tourism, pilgrimage, and sporting events generated predictable surges that frequently strained local resources. Delays extended from incident recognition and system activation through responder access, field care, evacuation, interfacility transfer, and definitive care. Reported facilitators included helicopter emergency medical services, on-site clinics, specialized mountain rescue systems, telemedicine, drones, and geospatial planning tools.

The findings support planning across the entire care pathway rather than addressing transport alone, with provision for terrain, weather, altitude, and predictable demand. However, the review mapped heterogeneous evidence descriptively rather than establishing intervention effectiveness. The authors called for standardized access measures, geospatial modeling, and further evaluation of interventions. They reported no specific funding or competing interests.