Hasler Rebecca M, Schmucker Uli, Evangelopoulos Dimitrios S, Hirschberg Ron E, Zimmermann Heinz, Exadaktylos Aristomenis K
Dept. of Emergency Medicine, University of Bern, Inselspital, Bern, Switzerland.
Dept. of Trauma and Reconstructive Surgery, University of Greifswald, Greifswald, Germany.
J Trauma Manag Outcomes. 2011 Apr 26;5(1):5. doi: 10.1186/1752-2897-5-5.
Injuries 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.
Six-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.
Amongst 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).
The 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.
滑雪和单板滑雪造成的损伤成为瑞士急救人员面临的一项重大挑战。在高山环境中，对损伤和健康状况进行早期评估对于启动适当的护理和转运手段至关重要。然而，目前缺少经过验证的标准化斜坡分诊方案。本文有助于了解受伤冬季运动员的特征以及未来斜坡分诊方案的迫切需求。
对一家三级创伤中心的创伤病例进行为期六年的回顾。连续纳入所有年龄大于15岁（总样本）、头部、脊柱、胸部、骨盆或腹部有预先定义的严重损伤的受伤滑雪者和单板滑雪者（研究样本），这些患者在研究医院就诊或被转诊至该医院。对年龄、性别和损伤模式进行描述性分析。
在729名因滑雪或单板滑雪受伤的受试者（总样本）中，401人（55%，滑雪者中的54%和单板滑雪者中的58%）遭受孤立性肢体损伤。在其余328名受试者（研究样本）中，大多数（78%）为单一创伤。在研究样本中，头部损伤（52%）和脊柱损伤（43%）比胸部损伤（21%）、骨盆损伤（8%）和腹部损伤（5%）更常见。三种最常见的损伤组合是头部/脊柱（研究样本的10%）、头部/胸部（9%）和脊柱/胸部（6%）。费舍尔精确检验显示头部/胸部（p < 0.001）、头部/腹部（p = 0.019）和胸部/腹部（p < 与损伤组合之间存在关联。
所呈现的数据以及先前调查的结果表明需要制定专门的斜坡分诊方案。未来的研究必须解决斜坡诊断测试对于专业和非专业急救人员快速决策的有效性和实用性。因此，大规模和详细的损伤监测是未来的研究重点。
