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Elsayed RS, Pham A, Chitibomma N, Yates M, Barrera K, Atchison MJ, Gorski TF. Contemporary Outcomes and Patterns of Injury Associated With Parachuting Accidents. Am Surg 2024; 90:2501-2505. [PMID: 38661105 DOI: 10.1177/00031348241248809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Skydiving is an increasingly popular recreational activity in the United States and worldwide. While it is considered a high-risk sport, the United States Parachute Association reported a fatality of .28 per 100 000 jumps in 2022. Although mortality rates are low, the true rate of survivable injuries is unknown. Injuries requiring hospitalization are not uncommon and may be underreported in the literature. Anticipating these injuries and analyzing short-term outcomes following parachuting accidents would be useful for the development of mitigation strategies and to increase the safety of jumpers. METHODS A retrospective cohort review of 126 consecutive patients presenting to a Level II Trauma Center after skydiving accidents between 2016 and 2023. Patient baseline characteristics, patterns of injury, surgical procedures, and in-hospital outcomes were reviewed. RESULTS A total of 126 patients were included. One hundred and seventeen patients (93%) presented immediately following the accident, 65 (51.6%) were trauma activations, and 14 (11.1%) patients experienced loss of consciousness. Fractures of the lower extremity occurred in 57 (45%), fractures of the spine 48 (38%), upper extremity 13 (10%), pelvis 11 (9%). Of the spinal injuries, 10 injuries occurred in the cervical spine, 16 thoracic, 22 lumbar, 5 sacral, and 3 coccygeal spine. Eleven patients (9%) suffered multilevel spine injuries. Mean injury severity score was 7 (range 0-75). A third of patients required at least 1 surgical procedure (n = 43, 34%). Median length stay was 2 days (IQR 1, 5). Of patients who survived to our trauma center, there were two mortalities, both due to catastrophic intracranial hemorrhage. DISCUSSION Although the 30-day mortality rate for patient who presented to our trauma center is low, it can bear significant risks including major injury. The most common injuries were lower extremity and spinal in origin with a third of patients overall requiring at least one operation.
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Affiliation(s)
| | - Avian Pham
- Department of Surgery, Southwest Healthcare, Temecula, CA, USA
| | | | - Macey Yates
- Department of Emergency Medicine, Southwest Healthcare, Temecula, CA, USA
| | - Kaylene Barrera
- Department of Surgery, Southwest Healthcare, Temecula, CA, USA
| | | | - Titio F Gorski
- Department of Surgery, Southwest Healthcare, Temecula, CA, USA
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McNeil DG, Fell M, Loi NM, Chambers TP, Cosh SM. Exploring jump experience, risk perception, anxiety and self-confidence in skydiving: A mixed methods approach. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 73:102649. [PMID: 38663571 DOI: 10.1016/j.psychsport.2024.102649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 04/30/2024]
Abstract
Skydivers are required to interpret person-context characteristics to overcome inherent internal challenges (i.e., fear and anxiety) and external challenges (i.e., equipment malfunctions) to successfully perform. Research suggests that as skydiving experience increases, skydivers' self-confidence in their actions increases, while their perception of risk and anxiety decreases. However, there is a lack of research investigating the influence of experience and considerations of performance in extreme sports. This study examined the influence of skydiving experience on the interpretation of risk perception, anxiety and self-confidence. Participants comprised 503 experienced Australian skydivers (Mage = 40.10, SDage = 12.40; 79.5 % male). Using a mixed methods approach, skydivers completed measures of risk perceptions, anxiety, and self-confidence related to skydiving, as well as open-ended questions on their skydiving experiences. The findings indicated that increases in jumping experience led to greater self-confidence, and self-confidence mediated the relationship between all elements of jumping experience and cognitive and somatic anxiety associated with skydiving. Thematic analysis reinforced that skydivers understood the inherent risks associated with skydiving, and that skydivers adopted positive strategies that promoted self-confidence and mastery to perform successfully, while also managing their interpretations of risk and associated anxiety that potentially exists. Further research is needed to better understand the interpretation of person-context situations in extreme sports and recognize the important affordances for performance.
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Affiliation(s)
- Dominic G McNeil
- Institute of Health and Wellbeing, Federation University Australia. Victoria, Australia.
| | - Michael Fell
- School of Psychology, University of New England, New South Wales, Australia
| | - Natasha M Loi
- School of Psychology, University of New England, New South Wales, Australia
| | | | - Suzanne M Cosh
- School of Psychology, University of New England, New South Wales, Australia
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Damhuis M, van der Wal R, Frielink H, Nijveldt R, Ten Brinke J, Tan E. The ground is the limit: epidemiology of skydiving accidents over 25 years and in 2.1 million jumps in the Netherlands with sub-analysis of injuries reported by medical professionals in the past five years. World J Emerg Surg 2024; 19:7. [PMID: 38419090 PMCID: PMC10900578 DOI: 10.1186/s13017-024-00535-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Skydiving is the fastest nonmotorized sport; and consequently is not without risk. In the last decades, skydiving has become considerably safer but injuries and fatalities still occur. Incidents are reported to and administered by the Royal Netherlands Aeronautical Association (KNVvL). From 1995 to 2020, 2715 incidents were reported; of which 1503 resulted in injury and 26 in fatality. There is a need for more information available on the particular type, severity, and factors which contribute to skydiving-related injuries worldwide. This study aims to investigate patterns in occurrence rates, examine demographic and skydiving-related factors linked to injuries, and analyze the types and severity of injuries relating to these contributing factors. METHODS The Dutch KNVvL database - covering more than 25 years of data - was examined for contributing factors. An analysis of the severity and types of injury resulting from incidents over the last five years were matched with a search of hospital databases. RESULTS The rate of injuries pattern increases starting from 2016, with novice jumpers having the highest risk of injury. Most injuries occur during the landing phase. The lower extremities and the spine are most affected, with fractures being the most prevalent type of injury. More than half of the patients were admitted to hospital, with 10% requiring surgery, resulting in months of rehabilitation. CONCLUSION This study is the first in the Netherlands, and only the second worldwide to analyze technical incident databases in combination with data from medical information systems. Skydiving accidents of experienced jumpers should be considered as 'high-energy trauma,' therefore treatment should follow standard trauma guidelines. In less experienced skydivers, it is critical to conduct a secondary survey to assess the extremities adequately. Clinicians should also pay attention to friction burns that can arise due to friction between the skin and skydive equipment, a phenomenom that is already known in road traffic accidents.
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Affiliation(s)
- Michiel Damhuis
- Division of Trauma Surgery, Department of Surgery, Radboud University Medical Center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands.
| | - Raymond van der Wal
- Department of Anesthesiology, Radboud University Medical Center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Harriet Frielink
- Division of Trauma Surgery, Department of Surgery, Radboud University Medical Center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Robert Nijveldt
- Division of Trauma Surgery, Department of Surgery, ISALA Hospital, P.O. Box 10400, Zwolle, 8025 AB, The Netherlands
| | - Joost Ten Brinke
- Division of Trauma Surgery, Department of Surgery, Gelre Hospital, P.O. Box 9014, Apeldoorn, 7334 DZ, The Netherlands
| | - Edward Tan
- Division of Trauma Surgery, Department of Surgery, Radboud University Medical Center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
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Barthel C, Halvachizadeh S, Gamble JG, Pape HC, Rauer T. Recreational Skydiving-Really That Dangerous? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1254. [PMID: 36674008 PMCID: PMC9859333 DOI: 10.3390/ijerph20021254] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Skydiving have gained mainstream popularity over the past decades. However, limited data exist on the injury risk or type associated with skydiving. This systematic review evaluated the injuries and fatalities of civilian skydivers. A PRISMA-guided literature search was performed in MEDLINE, Web of Science, Cochrane Library, and Embase using the following MeSH terms: "skydiving" or "parachute" alone or in combination with "injury" or "trauma" was performed including all studies through June 2022 in both English and German. Additionally, injury reports from the German, American, and British Parachute Associations were reviewed. Of the 277 articles matching the selected search terms, 10 original articles and 34 non-scientific reports from various skydiving associations were included. More than 62 million jumps were evaluated, with an average of 3,200,000 jumps per year, which showed an average injury rate of 0.044% and an average fatality rate of 0.0011%. The most common injuries sustained by recreational skydivers involved the lumbar spine and lower extremities. Injuries were most commonly reported during the landing sequence. With modern equipment and training methods, fatalities occur in less than 1 per 100,000 cases, and serious injuries requiring hospitalization in less than 2 per 10,000 cases. This puts the assessment of skydiving as a high-risk sport into perspective.
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Affiliation(s)
- Christiane Barthel
- Department of Trauma Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Sacha Halvachizadeh
- Department of Trauma Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
| | | | - Hans-Christoph Pape
- Department of Trauma Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Thomas Rauer
- Department of Trauma Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
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Cronin R, Winston DC. Parachute Deaths in Southern Arizona. Acad Forensic Pathol 2017; 7:649-656. [PMID: 31240014 DOI: 10.23907/2017.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 11/07/2017] [Indexed: 11/12/2022]
Abstract
Introduction Parachuting is said to be a relatively safe activity. We sought to undertake a study to assess parachute-related deaths in our jurisdiction. Methods A retrospective study of parachute-related deaths in Southern Arizona was conducted by searching the Pima County Office of the Medical Examiner database between 2001 and 2016. This search revealed 24 deaths. Results The decedents ranged from 19 to 61 years of age, with a median age of 36 years. Twenty-two of the decedents were male. The racial breakdown was 22 white, one Asian, and one not recorded. The manner of death in all cases was classified as an accident. All deaths were due to multiple blunt force injuries and only one case was found to have no injuries to the head or neck. The most common circumstances were failure of chute deployment (seven), mid-air collisions (three), and becoming entangled with other parachutists (three). Six deaths occurred during military training. Four of the nonmilitary decedents were described as "experienced" parachutists and one case involved a tandem jump team with a survivor. Natural disease was found in four cases with three having moderate coronary artery atherosclerosis. Toxicology was performed in 21 of the deaths with three positive for cannabinoids, one positive for 7-aminoclonazepam, and one positive for 3, 4-methylenedioxymethamphetamine (MDMA). Discussion Parachuting is a relatively safe activity, with very few deaths. Investigation of these deaths should include a complete autopsy with toxicology as well as a thorough scene investigation and evaluation of the jumper's equipment.
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Affiliation(s)
| | - David C Winston
- Pima County Office of the Medical Examiner and University of Arizona Arizona Health Sciences Center
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Vidovic M, Rugai N. Are hook turns a major obstacle to safe skydiving? A study of skydiving fatalities in the United States from 1992 to 2005. Percept Mot Skills 2008; 105:795-802. [PMID: 18229535 DOI: 10.2466/pms.105.3.795-802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Landing errors account for most of the skydiving fatalities today in more experienced skydivers. The United States Parachute Association (USPA) states that this is due to a new generation of parachutes with higher wing loading. Using data on fatalities from 1992 to 2005 as reported by the USPA, hook turns were found to be a major cause of death but not significantly associated with higher wing loading. Fatalities caused by not having a functional parachute have decreased over the years, possibly due to introduction and widespread use of safety devices.
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Affiliation(s)
- Martina Vidovic
- Department of Economics, Bloomsburg University, Bloomsburg, PA 17815, USA.
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Soreide K, Ellingsen CL, Knutson V. How dangerous is BASE jumping? An analysis of adverse events in 20,850 jumps from the Kjerag Massif, Norway. ACTA ACUST UNITED AC 2007; 62:1113-7. [PMID: 17495709 DOI: 10.1097/01.ta.0000239815.73858.88] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Extreme sports, including BASE (building, antenna, span, earth) jumping, are rapidly increasing in popularity. Associated with risk for injuries and deaths, this activity may pose a burden on the emergency system. Hitherto, no reports exist on accidents and deaths associated with BASE jumping. METHODS We reviewed records of 20,850 BASE jumps from 1995 to 2005 at the Kjerag massif in Norway. Frequency of deaths, accidents, and involvement of helicopter and climbers in rescue are analyzed. Fatalities were scored for injury severity scores (Abbreviated Injury Scale score, Injury Severity Score, New Injury Severity Score) on autopsy. RESULTS During an 11-year period, a total of 20,850 jumps (median, 1,959; range, 400-3,000) resulted in 9 fatal (0.04% of all jumps; 1 in every 2,317 jumps) and 82 nonfatal accidents (0.4% of all jumps; 1 in every 254 jumps). Accidents increased with the number of jumps (r=0.66; p=0.007), but fatalities did not increase, nor did activation of helicopter or climbers in rescue (p>0.05). Helicopter activation (in one-third of accidents) in rescue correlated with number of accidents (r=0.76, p=0.007), but not climbers. Postmortem examination (n=7) of fatalities revealed multiple, severe injuries (Abbreviated Injury Scale score>or=3) sustained in several body regions (median, Injury Severity Score 75; range, 23-75). Most nonfatal accidents were related to ankle sprains/fracture, minor head concussion, or a bruised knee. CONCLUSION BASE jumping appears to hold a five- to eightfold increased risk of injury or death compared with that of skydiving. The number of accidents and helicopter activation increases with the annual number of jumps. Further analysis into the injury severity spectrum and associated hospital burden is required.
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Affiliation(s)
- Kjetil Soreide
- Acute Care Medicine Research Network, Department of Health Studies, University of Stavanger, and Department of Pathology, Stavanger University Hospital, Norway.
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Abstract
Between 2000 and 2004, 125 recreational parachuting fatalities were reported in the USA. Each was categorized using a previously reported taxonomy. While patterns of skydiving fatality were largely unchanged since the last such analysis of fatalities from 1993-1999, some variations were noted. As in previous analyses, most of the recent skydiving fatalities were the direct result of human error. Some examples of commonplace human error fatalities were turning low to the ground resulting in a hard landing, accidentally colliding with other skydivers resulting in entangled parachutes, and failure to deploy the reserve parachute correctly in the event of malfunctioning main parachute.
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Affiliation(s)
- Christian L Hart
- Department of Psychology, East Central University Ada, OK 74820, USA.
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VIDOVIC MARTINA. ARE HOOK TURNS A MAJOR OBSTACLE TO SAFE SKYDIVING? A STUDY OF SKYDIVING FATALITIES IN THE UNITED STATES FROM 1992 TO 2005. Percept Mot Skills 2007. [DOI: 10.2466/pms.105.7.795-802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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HART CHRISTIANL. AN ANALYSIS OF U.S. PARACHUTING FATALITIES: 2000-2004. Percept Mot Skills 2006. [DOI: 10.2466/pms.103.7.896-900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Westman A, Björnstig U. Fatalities in Swedish skydiving. ACCIDENT; ANALYSIS AND PREVENTION 2005; 37:1040-8. [PMID: 16039597 DOI: 10.1016/j.aap.2005.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2004] [Revised: 05/11/2005] [Accepted: 06/02/2005] [Indexed: 05/03/2023]
Abstract
Exact risk patterns in skydiving fatalities are not well known, but incomplete world injury data indicate that many are preventable. A comprehensive national material for Sweden of 37 skydiving fatalities 1964-2003 were reviewed to identify risk factors. In relation to jump volume, the period 1994-2003 had a fatality rate 11 times lower than 1964-1973. Student skydivers had the highest risk of fatal outcome, often caused by instability in freefall leading to unstable parachute activation with subsequent line entanglement, or parachute activation failure. Unintentional water landings also contributed to student fatality, with life jacket malfunctions, neglect to use life jackets, and automatic reserve parachute activation devices activated by water as aggravating factors. One-third of all fatalities had an inflated and operational parachute at some point prior to injury. A drastic worldwide increase in fatal landing incidents with fast wing parachutes during the 1990s did not occur in Sweden. Every fourth fatality caused by rapid deceleration against ground or water survived impact and died during transports or in hospitals. Rescue units and health care providers can improve management of skydiving incidents from knowledge about the incident and injury mechanisms we have described, and the skydiving community can target risk factors in preventive safety work.
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Affiliation(s)
- Anton Westman
- Department of Surgical and Perioperative Sciences, Division of Surgery, Umeå University, Sweden.
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Abstract
OBJECTIVES Parasports' comprise parachuting, skydiving, paragliding, parapenting, parascending, parasailing and hang-gliding, and may involve rapid deceleration on landing. The aims of this study were to determine the spectrum of parasport-related trauma presenting to Auckland City Hospital and to make recommendations to reduce further injury. METHODS The Auckland City Hospital Trauma Registry was used to identify all patients requiring admission with serious injury as a result of parasport incidents over an 8-year period. Demographic and injury-related data were then analysed. RESULTS Parachuting/skydiving was responsible for 66% of all serious parasport injuries and 96% of patients were men. Fractures of the lower limbs and lumbar spine were the predominant injuries. Misjudgement of landing speed and attitude resulting in injurious landing forces were the usual causes of injury. CONCLUSIONS The magnitude of serious parasport-related trauma is greater than that indicated by previous studies in New Zealand. Appropriate use of protective clothing and close attention to safe flight planning and landing techniques may reduce the injury rate without degrading the experience of flight.
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Affiliation(s)
- Grant R Christey
- Trauma Services, Auckland City Hospital, Grafton, Auckland, New Zealand.
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Affiliation(s)
- Danial E. Baker
- Drug Information Center, College of Pharmacy, Washington State University Spokane
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