International Alpine Trauma Registry

The following Case Report Form and inclusion / exclusion criteria where defined by the expert panel for the Alpine Trauma Register.

1. INCLUSION & EXLUSION CRITERIA

INCLUSION CRITERIA

• A pre – hospital NACA-Score ≥ IV • A New Severity Score (ISS) > 15 • The accident must occur in extra urban, mountain, alpine or remote areas, not readily accessible by regular Emergency Medical Service.

EXCLUSION CRITERIA

• Patient should be excluded if they are already in upon arrival of rescue team at the scene • Patient who suffer drowning are not included • patients should be excluded if the burn represents the predominant injury or if the patient is treated in a specialized burn unit

OPTIONAL EXCLUSION CRITERIA

• Under specified circumstances accidents how occur on ski slopes can be excluded from the data collection. If a reporting hospital is going to choose this option, it will last for the whole of the study. Also the project coordinator of the Alpine Trauma Register must be informed

2. CASE REPORT FORM

Automatically recorded information A Patient ID Automaticly generatet ID

B Hospital Hospital ID / Hospital transfer history C Logged in as: LDM-User-Name CRF

HEADER D Last modified by: LDM-User-Name E Last modification on: Date / Time

Patient´s record & case history Patient´s date of • 1 Date of birth birth • Male • 2 Gender Female • Unkown

• ASA 1 • ASA 2 • ASA 3 Patient data Patient • 3 ASA classification ASA 4 • ASA 5 • ASA 6 • Unknown

• Date Date & time of • 5 Time accident • Unknown

• Date Date & time of • 6 first emergency Time • Unkown

call

• Freeride / Backcountry • Skiing/Snowboarding • Skitouring • Sledging • Snowshoeing • Riding a snowmobile • Hiking • Climbing 7 Type of activity • Mountainbiking Accident characteristics Accident • Canyoning • Rafting / Wildwater kayaking • Paragliding • Hang-gliding • Working in wilderness /mountain area • Other (should be sprecified) • Unknown • Fall (inc. height in meter) to specify: o low energy fall o high energy fall • Buried by avalanche to specify: o Patient was buried partial or Patient was buried completely Mechanism of o 8 • injury Crash • Collide with to specify: o other person o object • Trapped by an object • Unknown

• Easy • Exposed, steep Terrain victim was 9 found • Belaying rescue team necessary Extreme • Unknown

• Blunt Dominating type • 10 Penetrating of injury • Unknown

• No • Yes to specify: Cardiac arrest 11 during rescue o Patient died mission o Return of spontaneous cirrulation • Unknown

• Date Arrival of the first • 12 rescue service at Time scene • Unknown Responsive /involved • 13 Plain Text Mountain rescue service • Air support • Terrestrial rescue • Terrestrial rescue with technical evacuation

Mission 14 characteristics Every answer should be specified • Helicopter (inc. Name) • Fixed wing (inc. Name) • Unknown Rescue Mission Rescue

Pre-hospital • Value in mm Hg If exact value is missing: Systolic blood 15 pressure • RTS categories • Unknown

• Value in /min If exact value is missing: 16 Respiratory rate • RTS categories • Unknown

• Value in C° or fahrenheit

If exact value is missing: Vital data Vital • Normal body temperature • Mild hypothermia Patient core • Moderate hypothermia 17 temperature • Severe hypothermia • Profound hypothermia • Unknown

They way of measurement should be specified!

• Automatical calculation of GCS by recording: o Eye component o Verbal component Glasgow Coma o Motor component 18 Scale If components are missing • Enter GCS

• Unknown

• NACA 0 • NACA I

Injury data Injury • NACA II • NACA III • 19 NACA-Score NACA IV • NACA V • NACA VI • NACA VII • Unkown

• Ketamine • Opioids • Other (the kind of analgesics should be specified) • Unknown

They way of infusion should be specified: Analgesics given • Intravenous cannula 20 during pre-hospital • Intraosseous needle care • Intranasal • Aspiration needle • EV • Other • Unkown

• Yes to specify: the type of airway management: o A tube in the trachea – drug assisted o A tube in the trachea – not drug assisted o A supraglottic airway adjunct that prevents speech – drug assisted 21 Intubation o A supraglottic airway adjunct that prevents speech – not drug assisted o Other (The kind of airway management should be specified^ • No • Unknown

• Thoracostomy • Coniotomy First emergency 22 surgical • None intervention • Unknown

• Level I. No Field Care • Level II. • Level III. Advanced Life Support - No Physician Present Highest level of 23 care • Level IV. Advanced Life Support - Physician Field Care • Level V. Analgesia Only • Unknown

• Level I. No Field Care • Level II. Basic Life Support • Level III. Advanced Life Support - No Physician Highest level of Present 24 care after • Level IV. Advanced Life Support - Physician Field evacuation Care • Level V. Analgesia Only • Unknown

• Yes to specify:

Type of solution: o Hypertonic solution o Hypotonic solution o Crystalloid solution o Other (The used solution should be specified) o Unknown

Amount of solution: Volumen 25 Should be recorded in ml replacement o

Way of infusion: o Intraosseous needle o Intravenous cannula o Other (The way of infusion should be specified) o Unknown • No • Unknown

In-hospital • Level I – • Level II – Large hospital Trauma care level • 26 at referring Level III – Small hospital hospital • Other (Trauma care level should be specified) • Unknown

• Transfer to higher trauma center within 24 hour Hospital transfer • 27 No transfer within 24 hours within 24 hours • No detail information about patient transfer

• Value in mm Hg If exact value is missing: • RTS categories • Unknown

Systolic blood If Patient was in general anasthesia, intubated or 28 pressure curarized on arrival at referring hospital the following should be specified • Insufficent • Spontaneously sufficent • Unknown

• Value in /min If exact value is missing: 29 Respiratory rate • RTS categories • Unknown

• Value in mmol/l • Not measured within the first hour after arrival in 30 Aterial Base Exess hospital • Unkown

International • Exact value 31 normalized ratio • Unknown INR Partial • Exact value 32 thromboplastin • Unknown time • Exact value in g% 33 Hemoglobin • Unknown

• Value in C° or fahrenheit

If exact value is missing: • Normal body temperature • Mild hypothermia • Moderate hypothermia • Severe hypothermia • Profound hypothermia • Unknown

Patient core They way of measurement should be specified: 34 temperature • Oesophageal • Nasopharyngeal • Rectal • Bladder • Tympanic membrane • Infra-red tympanic membrane thermometer • Blood • Muscle • Other (should be specified) • Unknown

• Pelvic bleeding control (radiological intervention or external pelvis packing) • Emergency surgery to control bleeding (e.g. abdominal, thoracic) 35 In-hospital care • Emergency intracranial surgery (except ICP) • Other (should be specified) • Unknown • None

• Yes Traumatic brain • 36 No injury • Unkown

Injury coding For every injury: • Body region based on AIS- Body regions • AIS severity score

• Injury was already recorded pre-hospital: o Yes 37 Injury coding o No o Not applicable

Injury coding Injury • Diagnosis details • Injury details

Outcome & survival status Survival status (at • Died in hospital discharge from • 38 Survived until discharge acute care • Unknown hospital) • Alive Survival status (30 • 38 Dead days after injury) • Unknown

• Good recovery • Moderate disability • Severe disability Glasgow Outcome 39 Scale • Persistent vegetative state • Death • Unkown

• Home • Rehabilitation Outcome & survival status survival & Outcome • Morgue • Another CCU, higher treatment level Discharge 40 • Another CCU, same level of care destination • Another intermediate or low care somatic hospital ward • Other • Unknown

Informed consent

• Yes, given • Informed consent No, not given • Patient was unable to give it consent Informed