Snow sports injuries demanding hospital medical attention in an andorran ski area

4th to 10th August 20134th to 10th August 2013

BARILOCHE ARGENTINABARILOCHE ARGENTINA

SnowSnow sportssports injuriesinjuries demandingdemanding hospitalhospital medicalmedical attentionattention inin anan

andorranandorran skiski area. area. ObservationalObservational studystudy overover 7 seasons7 seasons

EscodaEscoda AlegretAlegret B., EscodaB., Escoda SalesSales J., AlduncinJ., Alduncin GutierrezGutierrez I.,I., CastroCastro DigonDigon I.,I., GonzalezGonzalez CarranzaCarranza S.,S., GuirroGuirro CastellnouCastellnou P.,P., PereiraPereira BritoBrito D.,D., ToshevToshev P. P.

Centre Centre MèdicMèdic PasPas dede lala CasaGrauCasaGrau Roig.Roig. GrandvaliraGrandvalira SkiSki Area.Area. ANDORRAANDORRA www.cmpas.comwww.cmpas.com [email protected] [email protected]

http://www.cmpas.com/

From time to time media talk about From time to time media talk about snowsports injuries, usually when death or snowsports injuries, usually when death or

severe injuries occur but...severe injuries occur but...

the majority of snowsports injuries seen in a the majority of snowsports injuries seen in a resort medical center are mild or moderateresort medical center are mild or moderate

20th congress of the International Society for Skiing Safety in association with SITEMSH 20th congress of the International Society for Skiing Safety in association with SITEMSH Bariloche August 4th to 10th 2013Bariloche August 4th to 10th 2013

the severity of injuries is stable along the the severity of injuries is stable along the yearsyears

AIS score (97 % of injured are grade I or II) AIS score (97 % of injured are grade I or II) time to heal (75% less than 1 month to heal) time to heal (75% less than 1 month to heal)


Medical Center in Pas de la CasaGrau Roig Medical Center in Pas de la CasaGrau Roig has attended during 7 seasons (20052006 has attended during 7 seasons (20052006 to 20112012) 23426 snowsports injuries to 20112012) 23426 snowsports injuries

(avg 3347/season)(avg 3347/season)


the average injury rate over this period is 5,86 the average injury rate over this period is 5,86 inj/1000 skier dayinj/1000 skier day

of witch 4% (937) were transfered to the of witch 4% (937) were transfered to the nearest hospitalnearest hospital


even if the frequency of severe injuries is low, even if the frequency of severe injuries is low, its important to consider this injuries as its important to consider this injuries as they are a challenge in our daily practicethey are a challenge in our daily practice


Taking this 7 seasons medical records we Taking this 7 seasons medical records we looked closer at the pacients neading looked closer at the pacients neading

hospital treatment, considering diferent hospital treatment, considering diferent itemsitems


Type of injury:Type of injury:32% are head injuries, mainly concussions32% are head injuries, mainly concussions35% injuries of the limbs35% injuries of the limbs33% injuries of the thorax, abdomen, spine, 33% injuries of the thorax, abdomen, spine,

pelvis and femurpelvis and femur


Type of transportType of transport

90% ambulance90% ambulance7% medicalized ambulance7% medicalized ambulance3% helicopter 3% helicopter


BecomingBecoming

60% quit the hospital before the 6th hour60% quit the hospital before the 6th hour30% stay in hospital30% stay in hospital10% only are transfered to other hospitals10% only are transfered to other hospitals


An equiped medical center in a ski resort clears and treats and important amount of

injuriesBut some patients need:

observationfurther investigationsspecialized treatment

20th congress of the International Society for Skiing Safety in association with SITEMSH 20th congress of the International Society for Skiing Safety in association with SITEMSH

Bariloche August 4th to 10th 2013Bariloche August 4th to 10th 2013

What can be done in this medical center will What can be done in this medical center will depend on:depend on:

EQUIPMENT:EQUIPMENT: Drugs, perfusion, fluids, orotracheal Drugs, perfusion, fluids, orotracheal

intubation, oxygen, cardiac monitor / DFintubation, oxygen, cardiac monitor / DFX RAY ...X RAY ...



And what's more important:And what's more important:

STAFFSTAFF


Part of the patients sent to the hospital could Part of the patients sent to the hospital could probably be managed in the ski resort probably be managed in the ski resort

medical centermedical centerEx:Ex:

Concussions could be kept in observation but Concussions could be kept in observation but that means a proper space and maybe a that means a proper space and maybe a

bigger staffbigger staff


Part of the patients sent to the hospital could Part of the patients sent to the hospital could probably be managed in the ski resort probably be managed in the ski resort

medical centermedical centerEx:Ex:

Ecografy would be helpfull in an abdomen Ecografy would be helpfull in an abdomen trauma but you must rely on your skills, trauma but you must rely on your skills, and... won't you need a blood analysis...and... won't you need a blood analysis...



In our case the nearest hospital is just 32km In our case the nearest hospital is just 32km away, probably the transferts rate is the away, probably the transferts rate is the right one, the efforts we could made in right one, the efforts we could made in

order to reduce it are not justified. order to reduce it are not justified. The effort must probably be made in the The effort must probably be made in the

communication with the hospital, communication with the hospital, establishing common protocols.establishing common protocols.



Improving the management of this injuries Improving the management of this injuries demands more coordination.demands more coordination.


GRACIAS !!!!!GRACIAS !!!!!

www.cmpas.comwww.cmpas.cominfo@cmpasinfo@cmpas

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Health & Medicine

Snow sports injuries demanding hospital medical attention in an andorran ski area