Content uploaded by Kenneth V Iserson
Author content
All content in this area was uploaded by Kenneth V Iserson
Content may be subject to copyright.
352
Information
Injuries
to
Search
and
Rescue
Volunteers
A
30-Year
Experience
KENNETH
V.
ISERSON,
MD,
MBA
Tucson
SEARCH
AND
RESCUE
is
a
vital
component
of
a
rural
and
wilderness
emergency
medical
system.
Yet
it
differs
from
the
normal
component
of
the
emergency
medical
system
in
the
complex
logistics
often
needed
to
effect
a
rescue,
the
often
hostile
environment
in
which
teams
operate,
and
the
unique
physical
conditioning
and
training
needed
by
rescue
per-
sonnel.
To
a
limited
extent,
injuries
and
illnesses
requiring
inter-
vention
by
wilderness
search
and
rescue
personnel
have
been
documented.
1'2
Little
is
known,
however,
about
the
injuries
sustained
during
both
operations
and
training
by
search
and
rescue
personnel
themselves.
To
learn
more
about
such
inju-
ries,
a
local
search
and
rescue
operation
was
studied.
The
Southern
Arizona
Rescue
Association
(SARA)
is
a
com-
pletely
volunteer
search
and
rescue
organization
that
has
been
operating,
at
the
request
of
local
law
enforcement,
forest
service,
and
fire
department
officials,
in
southern
Ari-
zona
for
30
years.
Its
scope
of
activity
includes
mountain
and
desert
searches,
technical
rescues
and
evacuations,
cave
and
mine
rescues,
and
river
rescues.
Averaging
60
to
80
opera-
tions
a
year,
field
time
for
personnel
during
operations
ap-
proximates
110,000
hours
over
the
organization's
30-year
existence.
An
additional
30,000
hours
have
been
spent
in
field
training.
The
organization
consistently
has
between
40
and
60
men
and
women
actively
involved
at
any
one
time.
The
average
age
of
members
is
31
years,
with
a
minimum
age
of
16
years.3
Methods
Injuries
or
acute
illnesses
in
the
field
that
required
a
physi-
cian's
attention
or
evacuation
of
SARA
rescue
personnel
were
culled
both
from
available
organizational
and
govern-
mental
records
and
from
the
memories
of
members
who
have
been
active
throughout
the
organization's
existence.
These
three
sources
were
used
to
cross-check
the
validity
and
com-
pleteness
of
the
data.
The
time
lost
from
field
activities,
if
rescue
personnel
needed
to
leave
the
field,
plus
time
lost
from
work
because
of
injuries,
were
totaled.
The
total
time
members
of
this
rescue
organization
have
spent
in
the
field
during
the
organization's
existence
was
extrapolated
to
full-
time-equivalent
positions
as
is
done
for
other
job
classifica-
tions
by
the
United
States
Occupational
Safety
and
Health
Administration.4
(Iserson
KV:
Injuries
to
search
and
rescue
volunteers-A
30-year
experi-
ence.WestJ
Med
1989Sep;
151:352-353)
From
the
Southern
Arizona
Rescue
Association
and
the
Section
of
Emergency
Medicine,
University
of
Arizona
College
of
Medicine,
Ibcson.
Reprint
requests
to
Kenneth
V.
Iserson,
MD,
MBA,
Section
of
Emergency
Medicine,
University
of
Arizona
College
of
Medicine,
1501
N
Campbell
Ave,
lIbcson,
AZ
85724.
Results
Musculoskeletal
injuries
were
the
most
common
type
of
injury
that
SARA
members
suffered
over
the
years
(Table
1).
These
included
two
fractures,
a
disrupted
knee,
a
shoulder
dislocation,
and
sprains
requiring
emergency
department
evaluation.
There
were
many
more
minor
sprains
and
strains
for
which
no
assistance
was
needed.
This
category
included
the
only
injuries
for
which
time
was
lost
from
work
or
res-
cues.
Other
injuries
and
illnesses
included
one
near
drowning
(evaluated
and
released
from
the
emergency
department),
one
case
of
hypothermia,
a
scorpion
sting,
a
chipped
tooth,
and
an
acute
exacerbation
of
multiple
sclerosis.
There
were
numerous
close
encounters
with
cactus,
although
these
never
required
medical
care.
There
were
no
deaths.
The
time
lost
from
field
activities,
if
rescue
personnel
needed
to
leave
the
field,
plus
time
lost
from
work
because of
injuries
totaled
360
hours.
The
calculated
rate
of
lost
workday
injuries
for
SARA
members
over
its
30-year
existence
can
be
extrapolated
to
60
days
per
year
per
100
full-time-equivalent
workers.
Discussion
The
rate
of
lost
workday
injuries
experienced
by
Southern
Arizona
Rescue
Association
members
is
similar
to
the
63
lost
workdays
per
year
per
100
full-time
workers
found
in
health
service
personnel
and
notably
less
than
the
117
lost
workdays
per
year
per
100
full-time
fire
service
personnel
(Table
2).4
TABLE
1.-In/uries
to
Search
and
Rescue
blunteers*
Musculoskeletal
Other
Injuries
Tibiofibular
fracturet
Finger
laceration
Knee
disruptiont
Chipped
tooth
Finger
fracture
Scorpion
sting
Shoulder
dislocation
Near
drowning
Ankle
sprain
Hypothermia
Knee
sprain
ilnesses
Multiple
sclerosis
*AD
injuries
listed
occurred
once.
tLost
workday
injuries.
TABLE
2.-Comparison
of
Lost
Workdays
by
Occupation
Lost
Workdays
per
Year
per
10W
Occupation
Full-time
Personnel*
Mining
.................
145
Construction
................
129
Fire
protection
................
117t
Transportation,
public
services
.....
...
107
Agriculture,
forestry,
fishing
......
....
91
Manufacturing
................
80
Health
services
................
63
SARA
members
................
60
Wholesale,
retail
trade
..............
51
Finance,
insurance,
real
estate
.......
..
15
Legal
services
................
7
SARA=Southern
Arizona
Rescue
Association
*1985
statistics
rounded
to
nearest
whole
number
(from
Bowmanl).
tExtrapolated
from
other
information.
THE
WESTERN
JOURNAL
OF
MEDICINE
*
SEPTEMBER
1989
*
151
*
3
It
is
difficult
to
directly
extrapolate
the
SARA
experience
with
the
injuries
of
team
members
in
other
search-and-rescue
groups.
There
are
several
reasons
for
this.
First,
each
search-and-rescue
organization
operates
within
a
unique
en-
vironment
and
organizational
structure.
The
Southern
Ari-
zona
Rescue
Association
operates
in
a
setting
where
about
70%
of
the
calls
are
in
a
relatively
warm
or
hot
environment.
Many
of
its
evacuations
are
on
scree
slopes-loose
rocky
debris-rather
than
solid
rock,
and
more
than
half
of
the
operations
take
place
partially
or
completely
after
dark.
Field
operations
are
organized
under
a
modification
of
the
Incident
Command
System
used
by
the
US
Forest
Service.'
Second,
the
sheer
amount
of
activity
of
this
volunteer
group,
as
well
as
the
longevity
of
its
members-the
average
length
of
service
of
active
members
is
eight
years-gives
SARA
oper-
ations,
in
many
respects,
a
more
professional
than
volunteer
appearance.
Third,
an
ingrained
part
of
training
and
opera-
tions
is
that
the
safety
of
rescue
personnel
comes
first.
This
is
constantly
emphasized
and
is
routinely
reinforced
during
op-
erations,
postoperation
debriefings,
and
formal
group
dis-
cussions
of
operations.6
Finally,
helicopters
are
only
rarely
used
to
transport
SARA
personnel.
Most
operations
are
con-
ducted
on
foot.
Search
and
rescue
is
undoubtedly
an
exciting
part
of
the
emergency
medical
system.
Yet
the
experience
of
the
Southern
Arizona
Rescue
Association
suggests
that
volun-
teer
search-and-rescue
activities,
while
continuing
to
be
ef-
fective,
need
not
be
unusually
dangerous.
REFERENCES
1.
Bowman
W:
Search
and
rescue
data-based
first
aid.
Wilderness
Med
1987;
4:
12-13
2.
Mitchell
BL:
A
Summary
of
the
National
Association
for
Search
and
Rescue
Data
Collection
and
Analysis
Program
for
1980-1985.
Washington,
DC,
NASAR,
1985
3.
Iserson
KV:
Incidence
of
snakebites
in
wilderness
rescue.
JAMA
1988;
260:1405
4.
Accident
Facts
1987.
Chicago,
Ill,
National
Safety
Council,
1987,
pp
30-41
5.
US
National
Fire
Academy:
Incident
Command
System
and
Structural
Fire
Fighting.
Emmitsburg,
Md,
National
Emergency
Training
Center,
1984
6.
Southern
Arizona
Rescue
Association
Training
Manual,
Revised.
Tucson,
Ariz,
SARA,
1988
353
