Reishus Allan D
Emergency Department, The Memorial Hospital, 785 Russell St, Craig, CO 81625, USA.
Wilderness Environ Med. 2007 Spring;18(1):20-5. doi: 10.1580/06-weme-or-014r1.1.
The purpose of this study was to characterize big game hunter visits to a rural hospital's emergency department (ED). Using data collected on fatalities, injuries, and illnesses over a 9-year period, trends were noted and comparisons made to ED visits of alpine skiers, swimmers, and bicyclists. Out-of-hospital hunter fatalities reported by the county coroner's office were also reviewed. Cautionary advice is offered for potential big game hunters and their health care providers.
Self-identified hunters were noted in the ED log of a rural Colorado hospital from 1997 to 2005, and injury or illness and outcome were recorded. Additional out-of-hospital mortality data were obtained from the county coroner's office. The estimated total number of big game hunters in the hospital's service area and their average days of hunting were reported by the Colorado Division of Wildlife. The frequencies of hunters' illnesses, injuries, and deaths were calculated.
A total of 725 ED visits--an average of 80 per year--were recorded. Nearly all visits were in the prime hunting months of September to November. Twenty-seven percent of the hunter ED patients were Colorado residents, and 73% were from out of state. Forty-five percent of the visits were for trauma, 31% for medical illnesses, and 24% were labeled "other." The most common medical visits (105) were for cardiac signs and symptoms, and all of the ED deaths (4) were attributed to cardiac causes. The most common trauma diagnosis was laceration (151), the majority (113) of which came from accidental knife injuries, usually while the hunter was field dressing big game animals. Gunshot wounds (4, < 1%) were rare. Horse-related injuries to hunters declined while motor vehicle- and all-terrain vehicle (ATV)-related injuries increased. The five out-of-hospital deaths were cardiac related (3), motor vehicle related (1), and firearm related (1).
Fatal outcomes in big game hunters most commonly resulted from cardiac diseases. Gunshot injuries and mortalities were very low in this population. Knife injuries were common. Hunters and their health care providers should consider a thorough cardiac evaluation prior to big game hunts. Hunter safety instructors should consider teaching aspects of safe knife use. Consideration should be given to requiring and improving ATV driver education.
本研究旨在描述大型猎物猎人前往一家乡村医院急诊科（ED）就诊的情况。利用9年期间收集的关于死亡、受伤和疾病的数据，记录了相关趋势，并与高山滑雪者、游泳者和骑自行车者的急诊科就诊情况进行了比较。还查阅了县验尸官办公室报告的院外猎人死亡情况。为潜在的大型猎物猎人和他们的医疗服务提供者提供了警示建议。
在科罗拉多州一家乡村医院1997年至2005年的急诊科日志中记录了自认为是猎人的患者，并记录了损伤或疾病情况及结果。从县验尸官办公室获得了额外的院外死亡数据。科罗拉多野生动物部门报告了医院服务区内大型猎物猎人的估计总数及其平均狩猎天数。计算了猎人疾病、受伤和死亡的频率。
共记录了725次急诊科就诊——平均每年80次。几乎所有就诊都发生在9月至11月的主要狩猎月份。27%的猎人急诊科患者是科罗拉多州居民，73%来自其他州。45%的就诊是因创伤，31%是因内科疾病就诊，24%被归类为“其他”。最常见的内科就诊（105次）是因心脏症状，所有4例急诊科死亡均归因于心脏原因。最常见的创伤诊断是撕裂伤（151例），其中大多数（共113例）是意外刀伤，通常是猎人在野外处理大型猎物时发生的。枪伤（4例，<1%）很少见。猎人与马相关的损伤减少，而与机动车和全地形车（ATV）相关的损伤增加。5例院外死亡与心脏相关（3例）、机动车相关（1例）和枪支相关（1例）。
大型猎物猎人的致命结局最常见的原因是心脏病。该人群中枪伤和死亡率很低。刀伤很常见。猎人和他们的医疗服务提供者在大型猎物狩猎前应考虑进行全面的心脏评估。猎人安全指导员应考虑教授安全使用刀具方面的知识。应考虑要求并改进全地形车驾驶员教育。
