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Chapter 14

Snowsports and Mountain Biking

Emergencies

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Chapter 14: Snowsports and Mountain Biking Emergencies

Objectives (1 of 2)

• Describe injuries and illnesses caused by exposure to certain environmental conditions.

• Describe basic types of snowsports (fixed heel, free heel, snowboard, cross country, tubing) accidents and common injuries resulting from each accident type.

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Objectives (2 of 2)

• Describe the safety aspects of modern snowsports equipment.

• Describe methods of preventing accidents.• Describe common off-road bicycling injuries.

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Snowsports Injuries

• Overall injury rates have declined due to:

– More experienced participants

– Better instruction

– Better equipment

– Better trail grooming

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Fatalities

Accident Types Fatalities/Year (average)

Skiing and snowboarding

34

Lightning strikes 89

Bathtub falls 300

Auto accidents 42,000

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Snowsports Risk Factors

• Higher participant densities

• Time of day

• Lower 1/3 of race course

• Snow conditions

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Alpine Skiing Injuries

• Rates have steadily declined

• Relatively safe when compared with other outdoor recreational activities

• Mechanisms

– Rotational

– Nonrotational

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Alpine Skiing Injuries (1 of 4)

• Ankle – Boot-top fracture– Spiral fractures

• Knee – ACL sprains– MCL sprains – Phantom foot syndrome

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• Thigh, hip, and pelvis

– Contusions

– Lacerations

– Fractures (femur, pelvis)

• Hand

– Skier’s thumb

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• Upper extremity (nearly 11% of all injuries)– Dislocations

Humeral Acromioclavicular separations

– Fractures Clavicle Wrist (silver fork)

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• Overuse injuries

• Multiple body parts

• Head and chest

– Collisions with fixed objects

– Leading cause in fatalities

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Snowboarding Injuries

• Overall rate is only slightly higher than skiing

• Risks for beginners is nearly the same as for new skiers

• Riders sustain more injuries that require immediate medical attention

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Snowboarding Risks

• When compared to skiing:– Higher risk of upper

extremity injury – Twice the risk of fracture

• Males = ankle and lower leg injuries

• Females = wrist and knee injuries

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Snowboarding MOIs

• MOIs are different from those in skiing

• Generally due to impact

• Historically, less formal instruction

• Less familiarity with mountain environment

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Snowboarding Injury Types (1 of 4)

• Lower extremities – 60% fewer than skiers– “Air” leads to ACL injuries – Ankle injuries are common

Snowboarder’s ankle (talus fracture)

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• Abdominal, thoracic, and back – Risk of spinal injuries is the same as

for skiers – Injuries to the spleen are more

frequent – Blunt thoracic trauma is 2nd leading

cause in fatalities

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• Upper extremity – More than 50% of all riding injuries

– Wrist Young, females, beginners

– Hand, elbow, and shoulder Male, intermediate, expert

– FOOSH

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• Head

– Rare, but leading cause in fatalities

– Occurs usually with a fall backward Impact to occiput

– Collisions

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Telemark Injuries

• Third most popular winter sport at ski areas

• Newer high performance equipment has led to injuries similar to alpine skiing.

• Release bindings may decrease injury risks.

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Nordic Skiing

• Various types of gear and locales

– Featherweight skis and boots

– Traditional wax or waxless skis and heavier leather boots

– Parabolic skis and tall plastic boots

• 7 million nordic skiers in U.S.

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Nordic Skiing Injuries

• Injury rate is small, 0.5/1000 visits • Common types:

– Cold-related, ie, frostbite, hypothermia – Equal amounts of upper and lower

extremity injuries caused by falls– Overuse (Skier’s toe)– Eye (rare) – Avalanche (rare)

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Snowblade Injuries

• New trend • Easy to learn • Non-release bindings• Common types:

– Upper extremity injuries similar to snowboarders

– Boot-top and spiral tib/fib fractures

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Tubing Injuries

• New trend • No or limited steering• No braking • Common types:

– Head and spine – Fractures, isolated and multiple – Soft tissue

• Injuries result from collisions and rollovers

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Snowmobile Injuries• Common types:

– Lower extremity About 50% are fractures

– Spinal injuries Head and neck trauma Lower back pain

– Overuse injuries (Raynaud’s syndrome)

– Avalanche

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Snowmobile Risk Factors

• Multiple riders • Excessive speed • Alcohol and drug use • Improper equipment • Night riding • Unfamiliar or avalanche terrain • Jumping

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Mountain Biking

• Make up majority of bikes sold in U.S.

• Many ski areas promote activity.

• IMBA, NORBA, and NSP helped found the National Mountain Bike Patrol.

– Offers training in OEC, trail etiquette, and environmental issues

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Mountain Biking Injuries (1 of 2)

• 80% of riders will be injured • MOIs include high speed and steep terrain • Demographics of riders and injuries

– Males, late teens to late 30s – Multiple injuries tend to occur. – 25% require medical care. – 90% occur off-road. – Serious head injuries are rare.

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Mountain Biking Injuries (2 of 2)

• Common types:

– Abrasions, most frequent

– Contusions

– Lacerations

– Fractures, typically of the clavicle

• Often the injured will self-evacuate

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Injury Prevention (1 of 2)

• Maintain physical conditioning.

• Use and maintain good equipment.

• Use retention devices on the slopes.

• Ski or ride within your ability.

• Attune to your surroundings.

• Avoid intoxication.

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Injury Prevention (2 of 2)

• Maintain adequate nutrition. • When tired or cold, stop, rest, drink, and eat. • Dress appropriately. • Follow your Responsibility Code.• Carry survival equipment when skiing out of area. • Use high-quality eyewear. • If you choose to wear a helmet, assure that it fits

properly and is appropriate for the activity.