Rock Climbing Emergencies in the Austrian Alps: Injury Patterns, Risk Analysis and Preventive Measures

Rock falls while high-altitude mountaineering - More often in the last years? Evidence from the Swiss alps

Objectives

One risk while high-altitude mountaineering despite falls or stranding are rock falls. Due to the climatic change such events might have become potentially more common yielding to the research question to elucidate rock falls while high-altitude mountaineering in the Alps of Switzerland.

Design

A retrospective analysis was conducted from the central registry of the Swiss Alpine Club (SAC) during the observational period from 2009 to 2020.

Results

A total of 266 cases of rock falls was detected during an observational period yielding to in average 22.2 ± 7 emergency cases per year. No increase nor decrease of the number of cases over time (R2 = 0.0019) was detected. The average age of a victim was 50.2 ± 18.6 years. The mean of the NACA-Score (NACA = National Advisory Committee for Aeronautics) was 2.7 ± 1.4 implying a moderate injury, however not life threatening. The NACA-Score slightly decreased over time indicating that emergencies have become less severe (R2 = 0.1379). The injury pattern was relatively equal distributed between upper and lower extremity.

Conclusions

The slight decrease in the severity of the events might be a consequence of increasing security standards over the observational period. The fact that the average victim of an emergency action was around 50 years, might indicate that stone falls are a constant risk as it can be suggested that alpinists with this age are more risk averse than younger alpinists. As findings were analyzed in a retrospective design, a quasi-prospective design might be helpful while directly analyzing emergencies after occurrence with interviews of involved persons. These hints could be used constructively in order to improve security recommendations.

Change in grip strength, hang time, and knot tying speed after 24 hours of endurance rock climbing

Background

Non-professional climbers are increasingly attempting long routes in a single day. Many suffer injury or rely on search and rescue teams when they become too fatigued to finish. Predicting fatigue is difficult, and existing studies have only studied climbers over durations less than an hour, while many outdoor multipitch climbs require more than an hour of climbing.

Objectives

To determine how strength, endurance, and dexterity reflect fatigue after 24 h of continuous climbing.

Methods

Volunteer competitors completed measurements of grip strength, static hang time to failure, and time to tie a figure-eight follow-through knot. Measurements were taken during the registration period before the competition and again within an hour after the competition ended. Measurements were compared using the paired t-test. Subgroup analysis was applied to competitors by division. Linear regression was applied to determine the relationship between vertical feet climbed and the number of routes climbed during the competition on each metric.

Results

Thirty-six total climbers (average age 29.4 years old) completed pre- and post-competition measurements. After 24 h of climbing (n = 36), mean grip strength decreased by 14.3-15 lbs or 14.7%-15.1% (p < 0.001) and static hang time decreased by 54.2 s or 71.2% (p < 0.001). There was no significant change in time to tie a figure-eight-follow-through knot. Grip strength and hang time decreases were significant in climbers with outdoor redpoints of 5.10a and above. Hang time decreased by 5.4 s per 1,000 vertical feet climbed (p = 0.044).

Conclusion

Climbers can expect to experience a 14.7%-15.1% decrease in grip strength and 71.2% decrease in static hang time after 24 h of continuous climbing. These changes may make it difficult to climb consistently over a long objective, and climbers can use these measures at home to train for longer climbing routes. Future studies on shorter climbing intervals can help determine rates of decline in performance measures.

Deathly Accidents While High-Altitude Mountaineering in the Swiss Alps-An Observational Analysis from 2009 to 2021

BACKGROUND

High-altitude mountaineering has become more and more popular. While many enjoy the beauty of the highest parts of Switzerland, there are considerable risks, which can even result in death. This study analyzed fatal events while high-altitude mountaineering in the Swiss Alps.

MATERIALS AND METHODS

In this study, cases of emergencies while high-altitude mountaineering in the Swiss Alps were analyzed in the period from 2009 to 2021 from the Swiss Alpine Club (SAC) emergency registry. Fatal emergencies were identified and analyzed in detail.

RESULTS

In total, 5020 emergency cases were analyzed, and among them 303 deathly events where detected. Of the fatal emergencies, 261 cases (86.1%) were male and 42 (13.9%) were female. The average age was 53.2 ± 19.1 years. More than half of the emergencies were on a route to a classic four-thousander. Fatal events were most common on the Matterhorn, with 40 cases (13.2%); on the Mönch, with 18 cases (5.9%); and on the Piz Bernina, with 10 cases (3.3%). In 245 of the fatal emergencies (80.9%), a fall was the cause. The second most prominent cause was rockfalls, with 16 cases (5.3%), followed by stranding, with 10 cases (3.3%), and avalanches, with 9 cases (3%). Illnesses and crevasse accidents counted together for less than 5% of the fatal cases. Almost two-thirds of fatal falls occurred while descending. Concerning nationality, 30% were from Switzerland and more than three-fourths of victims were from the countries of the Alps.

DISCUSSION

We found that falls were the most common cause of fatal emergencies in the Swiss Alps. Concerning the fact that most of these emergencies occurred during descents, fatigue and inadequate focus (forgetting the risks of the descent after successfully reaching the peak) are potential reasons for the fatal events. This potentially resulted from a lack of acclimatization, insufficient physical fitness, and inadequate tour planning. Since most victims were from the countries of the Alps, training tours may be possible as a recommended preparation for more difficult four-thousander peaks.

Injuries in alpine summer sports - types, frequency and prevention: a systematic review

Introduction

Summer alpine sports, including mountain biking, hiking and airborne pursuits, have experienced a recent surge in popularity. Accordingly, trauma associated with these activities has increased. There is a scarcity of literature exploring clinical aspects surrounding injuries. Specifically, no single article provides a general overview, as individual studies tend to focus on one particular sport. In the present study, we performed a systematic literature review to summarize existing knowledge and explore the potential for prevention and clinical decision making in this group.

Method

Literature searches were performed using the PubMed and Scopus database for the most commonly ventured sports associated with injury: mountain biking, climbing, airborne sports, paragliding, and base jumping. From this search, studies were identified for qualitative and quantitative analyses. These searches were done according to PRISMA guidelines for systematic reviews. Studies were then analyzed regarding epidemiology of injuries, relevant anatomical considerations and prevention strategies were discussed.

Results

A broad spectrum of injury sites and mechanisms are seen in mountain biking, climbing or airborne sports. Mountain biking related injuries commonly involve the upper extremity, with fractures of the clavicle being the most common injury, followed by fractures of the hand and wrist. Scaphoid fractures remain of paramount importance in a differential diagnosis, given their often subtle clinical and radiological appearance. Paragliding, skydiving, and base jumping particularly affect transition areas of the spine, such as the thoracolumbar and the spinopelvic regions. Lower limb injuries were seen in equal frequency to spinal injuries. Regarding relative risk, mountain biking has the lowest risk for injuries, followed by climbing and airborne sports. Male alpinists are reported to be more susceptible to injuries than female alpinists. Generally, the literature surrounding hiking and water-related mountain sports is insufficient, and further work is required to elucidate injury mechanisms and effective preventative measures. A helmet seems to decrease the likelihood of face and head injuries in mountain sports and be a meaningful preventive measurement.

Injuries in outdoor climbing: a retrospective single-centre cohort study at a level 1 emergency department in Switzerland

Objectives

Outdoor rock climbing has become popular in recent years. However, few data have been published on climbing accidents in Switzerland, even though the Swiss Alps are a major climbing resort.To analyse data on accidents related to outdoor climbing treated in the Emergency Department (ED) of University Hospital Bern, Switzerland.

Methods

A retrospective database search for accidents related to outdoor climbing was conducted in the clinical reporting system E.care of the ED of University Hospital Bern for the period April 2012-December 2018.

Results

78 patients were treated after an accident related to outdoor climbing, which accounted for 1 per 3571 (0.028%) of all ED visits during this period. Mean age was 35.8±10.4 years. 76% of patients were male. Falls were the most common mechanism of injury (64%), followed by rock or ice falling on the climber (21%). Injuries affected multiple body regions (38%) or only the lower limbs (22%). Most injuries were fractures (68%). Mean ISS was 7.5 (1-38), and grade 3 UIAA MedCom injuries were most common (45%). 11 cases of polytrauma occurred and one fatality. 44 patients needed inpatient admission. Mean duration of inpatient stay was 7 days. Mean costs per patient were 12 283 CHF.

Conclusions

Accidents related to outdoor climbing accounted for a small number of patients seen in the University ED Bern. Further research should be on a nationwide basis, with collection of specific climbing data like use of a helmet and experience of climbing to inform injury prevention strategies. This should shed further light on this topic, as would a prospective study using the International Alpine Trauma Register.

Patterns of traumatic outdoor rock-climbing injuries in Sweden between 2008 and 2019

Purpose

Injury prevalence patterns for climbers have been presented in several papers but results are heterogenous largely due to a mix of included climbing disciplines and injury mechanisms. This study describes the distribution and pattern of acute traumatic climbing injuries sustained during outdoor climbing in Sweden.

Methods

Patients that experienced a climbing related traumatic injury during outdoor climbing between 2008 and 2019 and who submitted a self-reported questionnaire to the Swedish Climbing Association were included in the study. Medical records were retrieved, and the International Climbing and Mountaineering Federation injury classification system was used for injury presentation.

Results

Thirty-eight patients were included in the study. Seven (18%) injuries occurred during traditional climbing, 13 (34%) during sport climbing and 9 (24%) during bouldering. Varying with climbing discipline, 84–100% injuries were caused by falls. Injuries of the foot and ankle accounted for 72–100% of the injuries. Fractures were the most common injury (60%) followed by sprains (17%) and contusions (10%).

Conclusions

Traumatic injuries sustained during outdoor climbing in Sweden were predominantly caused by falls and affected the lower extremities in all major outdoor climbing disciplines. Rope management errors as a cause of injury were common in sport climbing and in activity surrounding the climbing, indicating there is room for injury-preventing measures.

A randomised controlled trial on effectiveness and feasibility of sport climbing in Parkinson's disease

Physical activity is of prime importance in non-pharmacological Parkinson's disease (PD) treatment. The current study examines the effectiveness and feasibility of sport climbing in PD patients in a single-centre, randomised controlled, semi-blind trial. A total of 48 PD patients without experience in climbing (average age 64 ± 8 years, Hoehn & Yahr stage 2-3) were assigned either to participate in a 12-week sport climbing course (SC) or to attend an unsupervised physical training group (UT). The primary outcome was the improvement of symptoms on the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS-III). Sport climbing was associated with a significant reduction of the MDS-UPDRS-III (-12.9 points; 95% CI -15.9 to -9.8), while no significant improvement was to be found in the UT (-3.0 points; 95% CI -6.0 to 0.1). Bradykinesia, rigidity and tremor subscales significantly improved in SC, but not in the unsupervised control group. In terms of feasibility, the study showed a 99% adherence of participants to climbing sessions and a drop-out rate of only 8%. No adverse events occurred. This trial provides class III evidence that sport climbing is highly effective and feasible in mildly to moderately affected PD patients.

Growth of Rescues in Natural Areas during the First Summer of COVID-19 Pandemic in Catalonia

This article analyzes the impact of the end of the COVID-19 lockdown on the number of rescues in natural areas in Catalonia (Spain) during July and August 2020. We compared the figures for 2020 with those corresponding to the same period in 2016–2019, including their temporal and spatial distributions. Our findings show that the number of rescues undertaken by the Catalan Fire Department in July and August 2020 increased significantly compared to the same summer period in the four previous years (+39.7%). The daily averages increased for both weekends and weekdays in 2020, with 7.5 and 3.9 rescues per day, respectively. The greatest increase corresponded to rescue operations conducted at low altitudes (up to 500 m ASL) and areas with no specific protection status near to populated places. Natural areas were perceived safer than, for example, coastal destinations in terms of the risk of COVID-19 contagion, and they experienced a growth in visitors during the first summer of the pandemic. One consequence of this was an increase in emergency service activity to rescue people in natural areas. This research adds new evidence of the multiple indirect effects of the reconfiguration of mobilities in the context of the COVID-19 pandemic. Our findings could be of interest to emergency service managers, managers of protected natural areas, and public authorities.