Bowie W S, Hunt T K, Allen H A
West J Med. 1988 Aug;149(2):172-7.
This study was presented in part at the annual meeting of the Wilderness Medical Society at Aspen, Colorado, in August 1986 and at "Mountain Medicine 1987," Leavenworth, Washington, in November 1987. We questioned 220 injured rock climbers or their partners seen consecutively at the Yosemite (California) Medical Clinic over 3 (1/2) years regarding details of their accidents. Injury type and location were extracted from medical records and severity quantified. The National Park Service rescued 27% of the climbers. Injured climbers were characteristically male (88%) and experienced (mean 5.9 years) and typically fell while leading climbs (66%). Among 451 injuries, 50% were to the skin or subcutaneous tissues, while 28% involved the lower extremity and were predominantly fractures. In terms of each climber's most severe injury (n = 220), 45% involved the lower extremities (30% from the ankle alone). Head injury or hypothermia caused 12 of 13 fatalities, showing the lowest case-fatality rate reported to date among injured climbers (6%). Rescue personnel successfully managed airways in victims of head injuries, anticipated and treated complications of hypothermia, and stabilized fractures. Victims requiring immediate extensive surgical intervention or blood transfusion usually died before rescue could be effected.
本研究的部分内容曾于1986年8月在科罗拉多州阿斯彭举行的荒野医学会年会上以及1987年11月在华盛顿州莱文沃思举行的“1987年山地医学会议”上发表。我们对在3年半时间里连续在约塞米蒂（加利福尼亚州）医疗诊所就诊的220名受伤攀岩者或其同伴就其事故细节进行了询问。从医疗记录中提取损伤类型和部位，并对严重程度进行量化。国家公园管理局营救了27%的攀岩者。受伤的攀岩者以男性为主（88%）且经验丰富（平均5.9年），通常在领攀时坠落（66%）。在451处损伤中，50%为皮肤或皮下组织损伤，而28%累及下肢且主要为骨折。就每位攀岩者最严重的损伤（n = 220）而言，45%累及下肢（仅踝关节损伤就占30%）。头部损伤或体温过低导致了13例死亡中的12例，这是迄今为止报告的受伤攀岩者中最低的病死率（6%）。救援人员成功地处理了头部受伤受害者的气道问题，预见到并治疗了体温过低的并发症，还固定了骨折部位。需要立即进行广泛手术干预或输血的受害者通常在救援实施前就死亡了。
