Changes in injury patterns and severity in a helicopter air-rescue system over a 6-year period.
ABSTRACT To study the influence of current trends in alpine sports on the frequency and types of injuries handled by a helicopter-based emergency medical system (HEMS) in a wilderness mountain region.
A retrospective review of medical reports at a single emergency helicopter port (Christophorus-1 air rescue) in Innsbruck, Austria, was conducted for comparison between two 3-year periods (1998-2000 and 2001-2003).
Comparing the two 3-year periods, the proportion of leisure-time injuries leading to HEMS activation increased, whereas the frequency of life-threatening injuries significantly declined (P = .001). There was significant increase in injuries during mountain hiking and rock climbing (P = .002), during swimming (P = .013), and in avalanches (P = .019). Most injuries (70.1%) were recorded for skiers, and 68.3% involved tourists. During the investigation period, the high National Advisory Committee of Aeronautics scores showed a decreasing trend, whereas Glasgow Coma Scale scores and low National Advisory Committee of Aeronautics scores tended to increase (P = .048).
For the HEMS in this study, there has been an increasing number of calls for help from persons involved in outdoor leisure activities. As the number of life-threatening injuries declines, HEMSs more frequently serve as means of rescue rather than as providers of emergency treatment.
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ABSTRACT: We sought to study the epidemiologic and medical aspects of alpine helicopter rescue operations involving the winching of an emergency physician to the victim. We retrospectively reviewed the medical and operational reports of a single helicopter-based emergency medical service. Data from 1 January 2003 to 31 December 2008 were analysed. A total of 921 patients were identified, with a male:female ratio of 2:1. There were 56 (6%) patients aged 15 or under. The median time from emergency call to helicopter take-off was 7 min (IQR = 5-10 min). 840 (91%) patients suffered from trauma-related injuries, with falls from heights during sports activities the most frequent event. The most common injuries involved the legs (246 or 27%), head (175 or 19%), upper limbs (117 or 13%), spine (108 or 12%), and femur (66 or 7%). Only 81 (9%) victims suffered from a medical emergency, but these cases were, when compared to the trauma victims, significantly more severe according to the NACA index (p<0.001). Overall, 246 (27%) patients had a severe injury or illness, namely, a potential or overt vital threat (NACA score between 4 and 6). A total of 478 (52%) patients required administration of major analgesics: fentanyl (443 patients or 48%), ketamine (42 patients or 5%) or morphine (7 patients or 1%). The mean dose of fentanyl was 188 micrograms (range 25-750, SD 127). Major medical interventions such as administration of vasoactive drugs, intravenous perfusions of more than 1000 ml of fluids, ventilation or intubation were performed on 39 (4%) patients. The severity of the patients' injuries or illnesses along with the high proportion of medical procedures performed directly on-site validates emergency physician winching for advanced life support procedures and analgesia.Injury 07/2011; 43(9):1377-80. · 1.93 Impact Factor
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ABSTRACT: To profile casualties of UK remote and rural sport and recreation rescued by Mountain Rescue Teams (MRTs). Anonymised data regarding non-fatal casualties recorded from 1 January 2002 to 31 December 2006 were retrieved from the Mountain Rescue Committees of Scotland and England and Wales. Across the UK there were 6814 incidents involving 7995 people, including 550 fatal incidents. 3398 injured or ill casualties were assisted by rescue teams. Half of those rescued (50.7%) had no medical problems. 3152 casualty reports were available for analysis (Scotland 743, England and Wales 2409). The ages of those assisted ranged from 3 to 104 years, with a male predominance (60.8%). Hillwalking accounted for 75% of mountain rescues. More casualties were injured than ill (77.2% vs 10.4%). The injury reported most often was fracture (58.6%) and the lower extremity was most commonly injured (53%). Multiple injuries were relatively uncommon. The rescue scenarios in England and Wales and in Scotland were broadly similar. MRTs administered medication to more casualties in England and Wales (39.4% vs 14.5%). Helicopters assisted a greater proportion of casualties in Scotland (56.9% vs 40.5%). Volunteer rescue teams assisted a wide range of casualties including some with serious multiple injuries. The nature of casualty rescues undertaken in Scotland was similar to that in England and Wales. The results have implications for UK-wide rescue team training, medical professionals receiving casualties and for outdoor education safety initiatives.Emergency Medicine Journal 04/2010; 27(4):309-12. · 1.65 Impact Factor
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ABSTRACT: We aimed to examine the epidemiological characteristics and injury patterns of pediatric trauma in helicopter emergency medical service (HEMS) caused by sports/outdoor activities in alpine environment. This retrospective cohort study analyzed 912 primary HEMS missions for pediatric trauma (0-14 years of age) in Austrian Alps between 1 January 2006 and 30 June 2007. Children were stratified by age into toddlers (3-5 years), children in early (6-9 years), and late school age (10-14 years). The majority of pediatric sports-related trauma in alpine environment was caused by skiing (82.1%; n=749). Pediatric patients were predominately in late school age and boys (72.8%, n=664 and 61.0%, n=556, respectively) and a minority (16.0%, n=146) was severely injured. Overall, fracture (47.0%, n=429), contusion (17.9%, n=163), and traumatic brain injury (17.0%, n=155) were the most common prehospital diagnoses. The most frequent pattern of injury was related to the head/face and spine (36.3%, n=331). The knowledge about epidemiological characteristics of HEMS use for injured children in alpine environment may be essential for training requirements of HEMS crews and operational considerations of HEMS providers. The incidence of head and spinal injuries requires support for initiatives to promote helmet wear and appropriate risk behavior amongst skiers and snowboarders.High altitude medicine & biology 06/2012; 13(2):112-7. · 1.58 Impact Factor