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For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity participation. Disabled and special needs athletes benefit from careful pre-event planning for the potential medical issues and equipment modifications that may affect their health in wilderness environments. Issues that demand special consideration for female adventurers include pregnancy, contraceptive use, menses, and ferritin levels at altitude. A careful preparticipation evaluation that factors in unique, population- specific risks will help special populations stay healthy and safe on wilderness adventures. The PubMed and SportDiscus databases were searched in 2014 using both MeSH terms and text words and include peer-reviewed English language articles from 1977 to 2014. Additional information was accessed from Web-based sources to produce this narrative review on preparticipation evaluation for special populations undertaking wilderness adventures. Key words include children, adolescent, pediatric, seniors, elderly, disabled, special needs, female, athlete, preparticipiation examination, wilderness medicine, and sports. <\/jats:p>","DOI":"10.1016\/j.wem.2015.09.010","type":"journal-article","created":{"date-parts":[[2015,11,26]],"date-time":"2015-11-26T10:30:12Z","timestamp":1448533812000},"page":"76-91","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Wilderness Preparticipation Evaluation and Considerations for Special Populations"],"prefix":"10.1177","volume":"26","author":[{"given":"Elizabeth","family":"Joy","sequence":"first","affiliation":[{"name":"Clinical Outcomes Research, Intermountain Healthcare, Salt Lake City, Utah (Dr Joy)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Van Baak","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Colorado, Denver, Colorado (Dr Van Baak)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine L.","family":"Dec","sequence":"additional","affiliation":[{"name":"CJW Sports Medicine, Richmond, Virginia (Dr Dec)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Semakula","sequence":"additional","affiliation":[{"name":"Anne Arundel Medical Center, Orthopedic and Sports Medicine Center, Annapolis, Maryland (Dr Semakula)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashlea D.","family":"Cardin","sequence":"additional","affiliation":[{"name":"Missouri State University, Springfield, Missouri (Dr Cardin)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Lemery","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Colorado, Aurora, Colorado (Drs Lemery and Yaron)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George C.","family":"Wortley","sequence":"additional","affiliation":[{"name":"Big Island Family Medicine Center, Lynchburg, Virginia (Dr Wortley)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Yaron","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Colorado, Aurora, Colorado (Drs Lemery and Yaron)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Madden","sequence":"additional","affiliation":[{"name":"Longs Peak Sports Medicine, Longmont, Colorado (Dr Madden)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,12,1]]},"reference":[{"key":"bibr1-j.wem.2015.09.010","unstructured":"American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine. 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