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Abstract
BackgroundInjuries from skiing and snowboarding became a major challenge for emergency care providers in Switzerland. In the alpine setting, early assessment of injury and health status is essential for the initiation of adequate means of care and transport. Nevertheless, validated standardized protocols for on-slope triage are missing. This article can assist in understanding the characteristics of injured winter sportsmen and exigencies for future on-slope triage protocols.MethodsSix-year review of trauma cases in a tertiary trauma centre. Consecutive inclusion of all injured skiers and snowboarders aged >15 (total sample) years with predefined, severe injury to the head, spine, chest, pelvis or abdomen (study sample) presenting at or being transferred to the study hospital. Descriptive analysis of age, gender and injury pattern.ResultsAmongst 729 subjects (total sample) injured from skiing or snowboarding, 401 (55%, 54% of skiers and 58% of snowboarders) suffered from isolated limb injury. Amongst the remaining 328 subjects (study sample), the majority (78%) presented with monotrauma. In the study sample, injury to the head (52%) and spine (43%) was more frequent than injury to the chest (21%), pelvis (8%), and abdomen (5%). The three most frequent injury combinations were head/spine (10% of study sample), head/thorax (9%), and spine/thorax (6%). Fisher's exact test demonstrated an association for injury combinations of head/thorax (p < 0.001), head/abdomen (p = 0.019), and thorax/abdomen (p < 0.001).ConclusionThe data presented and the findings from previous investigations indicate the need for development of dedicated on-slope triage protocols. Future research must address the validity and practicality of diagnostic on-slope tests for rapid decision making by both professional and lay first responders. Thus, large-scale and detailed injury surveillance is the future research priority.
Highlights
Injuries from skiing and snowboarding became a major challenge for emergency care providers in Switzerland
A six-year review of all consecutive serious injury cases of skiers and snowboarders documented in the hospitalbased trauma data base (Qualicare Office, Medical Database Software, Qualicare AG, Bern, Switzerland) of a tertiary trauma centre in Switzerland (University Hospital Bern, Emergency Department) was performed
A total of 401 (55%) suffered from isolated limb injury with snowboarders being more likely to suffer from isolated limb injury (n = 312, 54% versus n = 89, 58%), not significant (p > 0.05)
Summary
Injuries from skiing and snowboarding became a major challenge for emergency care providers in Switzerland. Validated standardized protocols for on-slope triage are missing. The popularity of alpine skiing and snowboarding has significantly increased over the last decades. The hostile and outdoor alpine setting demands comprehensive resources in terms of skills, knowledge, technology and infrastructure. Standardized algorithms in prehospital and in-hospital care of the injured are discussed controversial [13,14,15,16,17,18,19,20,21]. Absence of dedicated standardized algorithms was previously associated with inadequate transfer patterns, increased morbidity, and transfer costs [19,20,21]. To the best knowledge of the authors, dedicated on-slope triage protocols do not exist and evidence for the effectiveness and efficiency of comparable algorithms is missing
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