Original Contributions
Serious winter sport injuries in children and adolescents requiring hospitalization,☆☆

This study was presented at American Academy of Pediatrics annual fall meeting (Injury Prevention Section) in San Francisco, CA, November, 2001.
https://doi.org/10.1053/ajem.2003.50032Get rights and content

Abstract

To describe the epidemiology of serious winter sports-related injuries resulting in hospitalization in children and adolescents, we prospectively collected and analyzed records of all winter sports-related injuries requiring hospitalization at our respective institutions from 1996 to 2000. We identified 101 patients with a mean age of 10.7 years, of whom 68% were male and 32% female. Skiers accounted for 71% and snowboarders 26% of injuries; 3% of injuries were snowmobile-or luge-related. Leading mechanisms of injury were ground level falls (50%), crashes into trees, (18%), and falls from ski lift (13%). Approximately 26% of the patients met criteria for trauma-team activation. Leading diagnoses were head injury (20%), femur fracture (18%), and concussion (11%). Five patients required admission to the intensive care unit. The median injury severity score (ISS) was 7; 8% of patients had an ISS score > 15. Abbreviated Injury Scale-1990 scores of ≥ 3 were noted in 34% of the patients. We conclude that Injuries sustained through participation in winter sports may be severe, especially in the case of injuries involving the head. Injury-prevention strategies should focus on head injuries. (Am J Emerg Med 2003;21:95-99. Copyright 2003, Elsevier Science (USA). All rights reserved.)

Section snippets

Case 1

During a ski lesson, an 11-year-old male skier collided with a tree at high speed. He suffered immediate loss of consciousness. A nearby emergency medical technician responded, using basic life-support techniques while maintaining cervical spine precautions. Bag-valve-mask (BVM) ventilation was initiated. The patient's Glasgow Coma Scale (GCS) score was 3, his pupils were normally reactive, and his vital signs were stable. Following rapid-sequence intubation, the patient was transported by

Methods

PCMC is a level-one trauma center and the only designated pediatric facility for an area encompassing 7 major winter specialty resorts. All patient records of injuries sustained through participation in a winter sport and requiring inpatient hospitalization were collected prospectively and extracted for retrospective analysis. Data were collected from 1996 to 2000. We defined winter sports as skiing, snowboarding, snowmobiling, or lugeing. All children presenting to PCMC for evaluation for

Results

A total of 101 patients were enrolled in the study. The mean age of the patients was 10.7 years, with an age range of 4 to 17 years. Males constituted 68% of the patient population (Table 2). Most of the patients (71%) were skiers. Snowboarders constituted 26% of the patients, subjects with snowmobile-related injuries constituted 3%, and 1 patient was injured while on a luge. As shown in Table 2, there were no observed gender-related differences in types of sports-related injury, but there

Discussion

This study describes serious injuries sustained through participation in winter sports exclusively in a pediatric and adolescent population, and helps to clarify the epidemiology of this public health problem. Almost one third of patients requiring hospitalization suffered head injuries. This population of patients also had high AIS values and ISS scores, and long hospital stays. We found that none of the patients with serious head injuries used protective safety equipment such as a skiing

Conclusion

Injuries sustained through participation in winter sports may be associated with significant morbidity and possibly with mortality in children and adolescents. Injury-prevention strategies for these groups should focus on head injuries and helmet use.

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    Address reprints requests to: Elisabeth Guenther Skokan, MD, MPH, Division of Pediatric Emergency Medicine, Primary Children's Medical Center, 100 No. Medical Drive, Salt Lake City, UT, 84113. Email: [email protected]

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