Recommendations to Prevent and Manage Snowboarder Injuries in the FIS Snowboard World Cup
Total Page：16
File Type：pdf, Size：1020Kb
대한응급의학회지 제 27 권 제 1 호 � 원저� Volume 27, Number 1, February, 2016 Trauma Recommendations to Prevent and Manage Snowboarder Injuries in the FIS Snowboard World Cup Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Busan Baik Hospital, College of Medicine, Inje University, Busan1, Haeundae Paik Hospital, College of Medicine, Inje University, Busan2, Republic of Korea Kyoung Wan Ko, M.D.1, Tae Hoon Kim, M.D.1, Kyoung Chul Cha, M.D., Yong Sung Cha, M.D., Kyung Hye Park, M.D.2, Kyung Hoon Sun, M.D.2, Hyun Kim, M.D., Sung Oh Hwang, M.D., Kang Hyun Lee, M.D. Purpose: Snowboarding accidents may cause severe Key Words: Skiing, Wounds and injuries, Prevention, Medical injury due to the advanced skills required of Olympic ath- staff, Environment letes and the faster speed compared to many other sports. The aim of this study was to describe environmental char- acteristics of snowboarding injuries and to determine the Article Summary level of medical support using injury analysis. What is already known from the previous study Methods: A descriptive epidemiology study was conducted The frequency and severity of snowboard injuries are con- with collection of data from the Fe´de´ ration Internationale de centrated in SBX, PGS, and PSL compared with other com- Ski (FIS) Snowboard Competition from January 14 to 24 in petitions. 2009. Data from the Competition Operation Committee records, medical records and competition regulations were What is new in the current study selected for analysis. The time taken for emergency medical personnel to reach Results: In this study, 31/524 competitors reported injuries, an injured athlete after injury varied by competition. predominantly sprains and contusions (21 cases), including Weather and slope conditions as environmental factors eight fractures. Analysis of the physical distribution of these appeared to have an impact on injury frequency. injuries indicated ten injuries of an upper extremity (32%), seven of a lower extremity (23%), six in the head/neck region (19%), and five spinal injuries (16%). The majority (23/31) of these injuries occurred during the snowboard Introduction cross (SBX) events. Environmental factors including the The popularity of snowboarding has increased drasti- course visibility and slope conditions impacted the frequen- cally in a short period of time, in part because it is recog- cy of injury during the competition. In addition, the arrival nized as a dynamic and easy-to-learn sport. As a result of times of medical teams were longer for the SBX events this increasing popularity, the Fe´de´ration Internationale (260±92 sec) than for the Parallel Giant Slalom (202±54 sec) and other snowboarding events (<60 sec). de Ski (FIS) organized the Snowboard World Cup. In Conclusion: The frequency and severity of injuries were addition, snowboarding was first recognized as an highest in the SBX competition. For injury prevention, we Olympic sport at the Nagano Winter Olympics in 1998. recommend increased focus on safety on the SBX course, One consequence of the growth and popularity of snow- consideration of weather and other environmental condi- boarding has been an increased risk of associated injuries tions, and a rapid emergency medical support response for and injury severity. Olympic snowboarders may experi- injury management. ence severe injuries due to the advanced technical require- ments and high speeds, which are faster than many other sports1,2). A Winter Olympic Sports Association report 책임저자: 이 강 현 강원도 원주시 일산로 20 indicated that there was a more than five-fold difference in 연세원주의대 응급의학과 the number of snowboard injuries compared with alpine Tel: 033) 741-1612, Fax: 033) 742-3030 skiing3-8). There are many reports in the literature on the E-mail: [email protected] epidemiology (e.g., gender, age, and class), injury pat- 접수일: 2015년 8월 18일, 1차 교정일: 2015년 8월 18일 terns, injury types, and biomechanics of snowboarding 게재승인일: 2015년 10월 26일 92 Kyoung Wan Ko et al.: Recommendations to Prevent and Manage Snowboarder Injuries in the FIS Snowboard World Cup / 93 injuries and several associated risk factors2-5,9-11). Several or required transfer to a hospital. Visits with the team physi- authors have suggested various solutions to reduce the cian were not included in this study. Medical records for risk of injury and to achieve fewer incidents from unex- injured athletes included the following information: (1) age pected falls or uncontrolled landings after jumps or colli- and gender, (2) competition category and accident mecha- sion with another person or object4,12-15). nism, (3) type and location of the injury, (4) injury severity As previously mentioned, there are many studies score (ISS), and (5) arrival time of the medical team. focused on individual characteristics of snowboard Medical support for each competition consisted of one injury (e.g., injury patterns, injury types, and biomechan- medical team manager, four site support doctors, one ics), but few studies have focused on environmental nurse, and six patrol personnel. A medical base camp characteristics (e.g., weather, temperature, slope condi- was established and staffed by the medical team manag- tions, and visibility)4,7,8,10). In addition, only a few studies er, one site support doctor, and one nurse. For each com- have focused on medical systems or medical support petition, the remaining three site-support doctors were efforts to minimize injury after the accident10,11). positioned at the starting point, an intermediate point, Based on this data, we assessed records to determine and the finish line, along with two patrol personnel for answers to the following: each doctor. The site-support doctors and patrols had (1) Is medical support optimal in consideration of the more than five years of experience providing medical high injury frequency and severity in snowboard support and with skiing. The study protocol was competitions? approved by institutional review board of Wonju College (2) Do environmental characteristics affect the injury of Medicine, Yonsei University (IRB No. YWMR-13-9- mechanism in snowboard competition? 055). Informed consent was confirmed by Competition Therefore, the purpose of this study was to (1) propose Operation Committee of FIS. optimal medical support during competition, including Statistically, the frequency of injury and number of expedited emergency medical treatment and (2) estimate injuries by gender were cross-tabulated for comparison environmental characteristics as risk factors. within each category, and the number of injured athletes was cross-tabulated among all participating athletes. One- way analysis of variance (ANOVA) was performed for Materials and Methods two method of ISS comparison with a subsequent follow- up test. The first method grouped data by category, and the This study collected data from the FIS Snowboard second grouped data into SBX and non-SBX. The data World Championships at one resort in Gangwon were then analyzed using a Chi-square test. In addition, t- Province, from January 14 to 24, 2009. A total of 524 test analysis was performed to verify the differences in athletes and more than 500 officials from 50 countries time until arrival of the medical team with regard to cate- participated in this competition. Women competed in gory. The environmental characteristics, including weather, four categories and men competed in five categories temperature, slope condition, and visibility, were assessed including Snowboard Cross (SBX), Parallel Giant as risk factors using multiple logistic regression with OR Slalom (PGS), Parallel Slalom (PSL), Half Pipe (HP), and 95% confidence interval (CI). Statistical analyses were and Big Air (BA) (women did not compete in the BA). conducted using SPSS for Windows (version 20K, SPSS The data was compiled from Competition Operation Inc., Chicago, IL, USA). Data were considered statistically Committee records, medical records, and competition significant when the P value was less than 0.05. regulations. The Competition Operation Committee records included the following information: (1) weather, temperature, and visibility on each day; (2) course infor- Results mation; (3) slope conditions; and (4) the state of obsta- cles for each competition. 1. Demographic Data Medical records were created for all injured athletes and included details on whether the athlete was treated on-site A total of 524 athletes participated in the FIS 94 / 대한응급의학회지: 제 27 권 제 1 호 2016 Snowboard World Championship in 2009, including 313 sprains and six contusions). Fractures were also more fre- male athletes (59.7%) performing in up to five events quent in the SBX, with five cases, followed by PGS and and 211 female athletes (40.3%) performing in up to four BA, with one and two cases, respectively (Fig. 1A). The events. The number of injured athletes was 23 (74.1%) most frequently injury site was an upper limb including in the SBX event significantly higher than that of other the wrist and hand, followed by eight cases of head or events (Table 1). Of the 31 injured athletes, on-site face injury, seven cases of lower limb including knee and examinations were performed on 22 athletes (20 male ankle injury, and six spine or hip cases (Fig. 1B). and two female), and nine athletes (seven male and two female) were subsequently transferred to a hospital fol- 3. Environmental characteristics lowing on-site emergency treatment. Decisions on whether the injured athletes should be transferred to a The weather and slope conditions appeared to have an hospital were made by the medical support team after an impact on injury frequency. During this event, the fre- on-site examination and emergency treatment of injuries. quency of injury was very high for SBX, which occurred The ISS of injured players for the SBX group was 2.08 over two days in the midst of bad visibility due to sleet, ±1.93 (mean±SD), which was not significantly differ- mist, and fog and under icy slope conditions.