epidemiological aspects of head injuries in a ski resort

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

BARILOCHE ARGENTINABARILOCHE ARGENTINA

SITEMSH WORKSHOP 2:SITEMSH WORKSHOP 2:MANAGEMENT OF HEAD INJURIESMANAGEMENT OF HEAD INJURIES

Epidemiological aspects of head Epidemiological aspects of head

injuries in a ski resort injuries in a ski resort

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/

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

AndorraAndorra

It is a mountainous country, with It is a mountainous country, with 70000 inhabitants living in 462 70000 inhabitants living in 462

square kmsquare kmwith more than10 peaks rangedwith more than10 peaks ranged

between 2900mt and 3000mt highbetween 2900mt and 3000mt high


AndorraAndorra

2 of the 3 biggest ski areas in the 2 of the 3 biggest ski areas in the Pyrenees, Vallnord and GrandValiraPyrenees, Vallnord and GrandValira with 1,800,000 skierdays/seasonwith 1,800,000 skierdays/season


SNOW SPORTS INJURIES INSNOW SPORTS INJURIES INANDORRAANDORRA

we have old registers beginingwe have old registers beginingin the seventies that are notin the seventies that are not

standardized, in paper forms,standardized, in paper forms, with no control groupswith no control groups



efforts have been made to improve the data efforts have been made to improve the data collection collection

for the last 10 seasons theres is a unique for the last 10 seasons theres is a unique database resulting from the work of the ski database resulting from the work of the ski patrols, the resorts medical centers and the patrols, the resorts medical centers and the

hospitalhospital ALL THE DATA ON SNOW SPORT INJURIESALL THE DATA ON SNOW SPORT INJURIES ARE COLLECTED IN A UNIQUE DATABASEARE COLLECTED IN A UNIQUE DATABASE

with 140,000 recorded inj. with 140,000 recorded inj.



This data base gives us good general This data base gives us good general information, completed by control information, completed by control

groups (unfortunately not for all the groups (unfortunately not for all the seasons), but when studying precise seasons), but when studying precise

issues it has some limitsissues it has some limits


Head injuries in snowsportsInjuried region


Head injuries in snowsportsType of injury

head injuries evolution% of overall injuries

2001/2002 2002/2003 2003/2004 2004/2005 2005/2006 2006/2007 2007/2008 2008/20090

1

2

3

4

5

6

HEAD INJURIESsub-titlesub-titlesub-title

SEASON

% O

VE

R T

OT

AL

IN

JUR

IES

2001/2002 2002/2003 2003/2004 2004/2005 2005/2006 2006/2007 2007/2008 2008/20090

1

2

3

4

5

6

HEAD INJURIESsub-titlesub-title

SEASON

% O

VE

R T

OT

AL

IN

JUR

IES

2001/2002 2002/2003 2003/2004 2004/2005 2005/2006 2006/2007 2007/2008 2008/20090

1

2

3

4

5

6

HEAD INJURIES

SEASON

% O

VE

R T

OT

AL

IN

JUR

IES

head injuries evolutionInjuries /1000 skier days



Concerned about this particular issue Concerned about this particular issue we began in our center we began in our center

to enrich data collection in head to enrich data collection in head injuries from 20102011injuries from 20102011

but no ondeep analysis has been but no ondeep analysis has been made yet made yet


Head injuries in snowsportsHead injuries in snowsports

The enriched data collection about The enriched data collection about head injuries began in season 2010head injuries began in season 2010

20112011and no ondeep analysis has been and no ondeep analysis has been

made yetmade yet



2/3 were transfered to the local 2/3 were transfered to the local hospital hospital the other were given an advice form the other were given an advice form and told to consult again if worseningand told to consult again if worsening


Head injuries in snowsportsHead injuries in snowsportsIn pacients sent to hospitalIn pacients sent to hospital

40% had a CT Scan40% had a CT Scan

90% staid less than 24h in the hospital90% staid less than 24h in the hospital

6 % were transfered from the local hospital to 6 % were transfered from the local hospital to level 3 hospital (Barcelona or Toulouse)level 3 hospital (Barcelona or Toulouse)

Evolution of helmet use% of injuried wearing helmet

Among children helmet use is largely majoritary:Among children helmet use is largely majoritary:- Children coming with their schools, ski clubs, Children coming with their schools, ski clubs,

and other organized structures (either from and other organized structures (either from Andorra or other countries), have as Andorra or other countries), have as mandatory the use of safety helmet, so 100 % mandatory the use of safety helmet, so 100 % are normally wearing helmetare normally wearing helmet

- For those who come individually with their For those who come individually with their parents lower ski pass prices are aplied when parents lower ski pass prices are aplied when wearing helmetswearing helmets

- Helmets are easily found in rental shopsHelmets are easily found in rental shops

UNHELMETED CHILD ARE EXTREMELY UNHELMETED CHILD ARE EXTREMELY UNCOMONUNCOMON

Evolution of helmet use

Children are more exposed to head Children are more exposed to head injuries than older skier injuries than older skier /snowboarders, we have no precise /snowboarders, we have no precise data on this age group.data on this age group.More studies are needed to confirm More studies are needed to confirm the massive use of helmets and its the massive use of helmets and its benefitsbenefits

Child and head injuriesChild and head injuries

In a previous studyIn a previous studyWe did not find decrease in the % of We did not find decrease in the % of patients needing hospitalary treatment, patients needing hospitalary treatment, while helmet use is expandingwhile helmet use is expandingThe most dangerous injuries usually The most dangerous injuries usually associate several localizations, are usually associate several localizations, are usually caused by high speed collisions, and there is caused by high speed collisions, and there is no evidence that they could be prevented by no evidence that they could be prevented by helmet use.helmet use.

Considerations on helmetsConsiderations on helmets

Making helmet use mandatory in children seems reasonable; helmet use in adults should result of good information including talking about risk taking behaviors.

Considerations on helmets

Previous studies from other authors Previous studies from other authors show that helmet use reduces show that helmet use reduces severity and incidence of head severity and incidence of head injuries.injuries.Extremely severe head injuries, Extremely severe head injuries, resulting from high speed collisions, resulting from high speed collisions, cannot be prevented by helmet use.cannot be prevented by helmet use.

Considerations on helmetsConsiderations on helmets

studies are time demanding, but they can help doing snowsports safer they can help us improving what is done in medical centers

Prospective, multicentre, coordinated studies are necessary in order to improve our understanding of snow sport's injuries and their possible prevention policies

CONCLUSIONCONCLUSION

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

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

http://www.cmpas.com/

epidemiological aspects of head injuries in a ski resort

Health & Medicine

sitemsh bariloche

skiing safety

international society

injuried peoplesubtitlesub

snow sport injuries

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