Into the wild and on to the table: A Western Trauma Association multicenter analysis and comparison of wilderness falls in rock climbers and nonclimbers

Analyzing Injury Patterns in Climbing: A Comprehensive Study of Risk Factors

Climbing, a sport with increasing popularity, poses diverse risks and injury patterns across its various disciplines. This study evaluates the incidence and nature of climbing-related injuries, focusing on how different disciplines and climbers' personal characteristics affect these injuries. Data on injury incidence, severity, and consequences, as well as climbers' personal attributes, were collected through a questionnaire and analyzed using generalized linear models and generalized linear mixed models, Cochran-Armitage tests, and multivariate analysis. Our findings indicate a direct correlation between time spent on bouldering and lead climbing and increased injury frequency, while injury incidence decreases with time in traditional climbing. Interestingly, personal characteristics showed no significant impact on injury incidence or severity. However, distinct patterns emerged in individual disciplines regarding the recent injuries in which age and weight of climbers play a role. While the phase of occurrence and duration of consequences show no significant variation across disciplines, the intensity of the required treatment and causes of injury differ. This research provides insights into climbing injuries' complex nature, highlighting the need for tailored preventive strategies across climbing disciplines. It underscores the necessity for further investigation into the factors contributing to climbing injuries, advocating for more targeted injury prevention and safety measures in this evolving sport.

Wilderness Rescue of a Hiker with Multiple Trapped Limbs by a Combined Wilderness and Urban Rescue Team Using High-Pressure Airbags

We report on the case of a 28-y-old man with both legs and left arm trapped for nearly 6 h after falling and subsequently being trapped by a boulder during a hike in the wilderness. Extrication required equipment designed for urban environments and was operated by an unconventional team of rescue professionals. The patient experienced multiple right lower-extremity orthopedic injuries, acute kidney injury secondary to rhabdomyolysis, and bilateral segmental pulmonary emboli. In this article, we detail the extrication and review the treatment guidelines for crush injuries that focus on aggressive fluid resuscitation prior to and during extrication and medication administration only if hyperkalemia presents. Wilderness rescuers should plan for the use of unconventional rescue equipment in austere prolonged rescue scenarios.

Head Injuries in Rock Climbing: A Scoping Review

Rock climbing was recognized as a sport at the 2020 Tokyo Olympics. Despite its increasing participation, there is no knowledge synthesis of head injuries (HIs), defined as any injury to the head, associated with climbing, making it challenging for clinicians to provide evidence-based care. Our aim was to synthesize HI literature within rock climbing and identify knowledge gaps. Six databases (Medline, Embase, Sports Medicine & Education Index, SPORTDiscus, CINAHL, and Cochrane) were searched. Two reviewers screened 345 studies and 31 studies were selected for data abstraction. We found the quality of individual studies mainly "fair" to "good." Both HI and traumatic brain injury (TBI) had inconsistent definitions and categorization. The HIs represented between 0 to 36% of reported climbing injuries. Between 11 to 100% of HIs were TBIs, defined as an HI with permanent or temporary neurological sequelae. The most common causes of HIs were outdoor falls and falling objects. Climbing-specific factors associated with the causes were infrequently examined in the literature. Data sources of safety practices were incomplete. Overall, there was a lack of literature examining HIs, mechanisms of injury, and safety practices associated with climbing. To improve the tracking of HIs in climbing, we suggest the use of consistent reporting standards and the creation of a climbing injury surveillance system.

Review and Analysis of Mountaineering Accidents in the United States from 1947-2018

DeLoughery, Emma P. and Thomas G. DeLoughery. Review and Analysis of Mountaineering Accidents in the United States from 1947-2018. High Alt Med Biol. 23:114-118, 2022. Introduction: Given the popularity of mountaineering, it is important to better understand accidents related to this sport. We undertook this review of accidents to better understand the demographics and locations involved in mountaineering accidents over 71 years. Methods: Data collected from "Accidents in North American Mountaineering" booklets from 1947 to 2018 included the date, state and location of the accident, sex and age of the victim, type of accident, injuries sustained, and distance fallen if a fall occurred. If at least 10 accidents occurred in an individual state and/or location, these sites were separately analyzed. Results: From 1947 to 2018, 2,799 people were reported to be involved in mountaineering accidents, and 43% of these accidents resulted in death. Women were involved in 12% of cases. Falls were the most common accident (68% incidence, 45% fatal), followed by falling rock (7%, 26% fatal), avalanche (6%, 75% fatal), and falling into a crevasse (2%, 52% fatal). The average age of victims was 30 years. California had the most accidents (18%), followed by Washington (16%) and Alaska (15%). Denali had the greatest frequency of both accidents and deaths (11%, 8% of deaths), followed by Mount Rainier (6%, 7% of deaths) and Mount Hood (2%, 3% of deaths). Conclusions: Accident victims tend to be young and predominantly male, and the accidents themselves are most often falls. Avalanches were identified as an accident cause with a high fatality rate.