The equestrian sport-related injury workload of a regional doctor-led air ambulance unit

Abstract

The Great Western Ambulance Service Air Support Unit (ASU) was established in July 2007. The helicopter carries a doctor, providing a Helicopter Emergency Medical Service (HEMS) model of care. Equestrian sport-related injuries account for 6.8% of the unit's total attended case load.Horse riding has a higher rate of severe injury than motorcycle racing and 45% of patients admitted with equestrian injuries require surgical intervention. Orthopaedic injuries to the extremities are commonest, superseding head injuries since the introduction of protective headwear. The majority of equestrian sport—related injuries occur in areas inaccessible to land crews.We conducted a retrospective analysis of the ASU mission database from July 2008 to December 2009 (18months) and identified 29 patients that were attended to by the ASU. The patient cohort had a female majority with an average age of 31.9. 10 Patients (34.5%) were under the age of 20. The ISS ranged from 1 to 75 (mean, 4.8; median, 1) and injuries to the extremities were commonest. The location of the accident was inaccessible to land ambulance in 55.2% of missions. The average mission time was over 2h. Doctors delivered more advanced (medical) interventions in 20.7% of missions.In 41.4% of missions, there were no such interventions performed by the attending doctor and no access to land ambulance. We therefore conclude that a large proportion of ASU dispatches were due to limited access rather than for the delivery of advanced interventions. However, our results support the opinion that horse riding carries some risk of serious injury and when employed appropriately, HEMS doctors on the ASU are a useful resource for a minority of equestrian sport-related injuries.