Unattended Hoist Extraction of an Intubated Patient From Mountainous Terrain

McDonough, Miles J.; Duncan, Richard O.; Brown, R. Lane; Luks, Andrew M.; Condino, Anna E.

doi:10.1016/j.amj.2020.01.006

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…Climbing TBI was between 11 and 100% of HI (Table 2). 4,5,7,23,26,29,32,33,37,38,45 The mTBI was between 11 and 50% of HI. 26,32,37 We found that self-reported mTBI rates were higher in survey studies.…”

Section: Resultsmentioning

confidence: 99%

“…2,26,37 There were also studies that did not differentiate HIs from TBI or minor injuries, such as a facial laceration. 2,3,10,24,25,27,30,32,38,39,41,44 However, if studies reported HI with major trauma, 27,30,38,39,44 high injury severity, 32,41 or loss of consciousness, 29,32,38 we categorized these injuries as TBIs because they fulfilled our definitions.…”

Section: Resultsmentioning

confidence: 99%

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Head Injuries in Rock Climbing: A Scoping Review

Yoon

Armstrong

Philippopoulos

et al. 2022

Wilderness & Environmental Medicine

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Head Injuries in Rock Climbing: A Scoping Review

Yoon

Armstrong

Philippopoulos

et al. 2022

Wilderness & Environmental Medicine

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“…Although acuity of illness and injury in the wilderness setting is typically low, examples of expanded medical protocols being implemented in the field by civilian SAR teams show that these interventions are feasible and can play an important role in stabilizing critically injured patients when transit times are prolonged. 11 Standardized expanded medical protocol models exist in both military and NPS wilderness settings and have been shown to save lives in the prehospital environment. 12 The TCCC model uses tourniquets, hemostatic agents, nasopharyngeal airways, analgesia, and antibiotics in the battlefield.…”

Section: Discussionmentioning

confidence: 99%

Search and Rescue in the Pacific West States

Ettinger

Long

Ganti

et al. 2022

Wilderness & Environmental Medicine

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Introduction-The training practices and the level of medical oversight of search and rescue (SAR) organizations in the US National Park Service (NPS) Pacific west region is not known.Methods-A database of SAR teams in the NPS Pacific west region was assembled using public sources. SAR team leaders received an electronic survey between May and December 2019. A descriptive analysis characterizing team size, technical and medical training protocols, and medical oversight was completed. Results are reported as median (interquartile range, range).Results-Of the 250 SAR teams contacted, 39% (n=97) completed our survey. Annual mission volume was 25 (10-50, 1-200). Team size was 30 members (22-58, 1-405). SAR teams most frequently trained in helicopter operations (77%), low-angle rope rescue (75%), and avalanche rescue (43%). Nearly all teams (99%) had members with some medical training: first aid or cardiopulmonary resuscitation (89%), emergency medical technicians (75%), registered nurses or midlevel providers (52%), and physicians (40%). SAR members administered field medical care (84%), often in coordination with EMS (77%). Medical direction was present on a minority of teams (45%), most frequently by a provider specialized in emergency medicine (68%). Expanded medical procedures were permitted on 21% of SAR teams.Conclusions-SAR teams across the NPS Pacific west region had composition and training standards similar to those surveyed previously in the US intermountain states. Healthcare professionals were present on most teams, typically as team members, not as medical directors. Few SAR teams use medical protocols in remote care environments.

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