Mountain casualties in

SnowdoniaDr. Rhiannon Talbot FY1, Ysbyty GwyneddDr. Zoë Smith FY2 Emergency Medicine Royal Infirmary EdinburghDr. Linda Dykes Consultant in Emergency Medicine Ysbyty Gwynedd

Ysbyty Gwynedd is a DGH located in North Wales, the catchment area of which includes Snowdonia National Park.

Conclusions Approximately 80 patients per year are recovered from the mountains to the ED by SAR and MRTs. Over one third are >50 years, and more likely to be suffering pre-existing disease. By far the largest group of casualties in this series were injured hill-walkers. Lower limb injuries were the most common mountain injury, consistent with previous studies. 1 in 6 mountain casualties required rescue due to medical problems. The incidence of fatalities in this group was twice that of trauma victims.

Results Sex: Two-thirds of casualties were male.

Age: One third of casualties were ≤ 25 years; one third 26-49 and the remainder >50 years. The youngest casualty was 3 years (hypothermia) and the oldest 86 years (angina).

Trauma: 172/206 (83.5%) of casualties had sustained injuries. All cases involving major trauma were evacuated by helicopter.

Non-trauma: 34/206 (16.5%) casualties required rescue due to medical conditions including myocardial infarction, hypothermia, exhaustion, and respiratory complaints.

ReferencesMountain Rescue Council (2001). Mountain and cave rescue: the handbook of the mountain rescue council. Mountain Rescue Council: UKHearns, S. (2003). The Scottish mountain rescue casualty study. Emerg Med J. 20; 281-284 Guly, H.R. (1996). Medical aspects of the work of a moor land rescue team. Br J Sports Med. 30(3); 260-263Kerr, G.W. (1998). Scottish mountain rescue casualties in 1994 and 1995: an analysis. Prehospital Immed Care. 2; 206-208Saito, S. et al. (2002). Physical condition among middle altitude trekkers in an ageing society. Am J Emer Med. 20(4); 291-294

Lower limb, 101

Head, 31

Upper limb, 35

Chest, 5

Pelvis, 2Face, 13

Internal, 1

Spine, 23

11234

1213

26144

Light aircraftMountain biking

AbseilingSnow/ice climbing

Paragliding/pentingLocal incident

Rock scramblingRock climbing

Hill walking

MethodMountain rescues resulting in attendance at our ED over a 42-month period (Jan 2004–July 2007) were identified using records of the North Wales Mountain Rescue Association (MRTs) and RAF 22 Squadron SAR. The resulting database was cross-referenced with ED records. 281 casualties were rescued during the study period. Full records (including ED records) were available for 206/281 (73%).

This retrospective study examined the characteristics of injured and ill casualties brought to the Emergency Department (ED) following rescue by Mountain Rescue Teams (MRTs) and RAF Search and Rescue (SAR) teams.

Fatalities: 22 fatalities; 11 of which were brought to the ED, the remainder dead at the scene. 9% of all trauma rescues and 18% of medical/non-trauma rescues involved fatalities.

156

28

16 (9%)

6 (18%)

0

50

100

150

200

Trauma Non-trauma/Medical

No. of casualties

FatalNon-fatal

Figure 1. Site of injury in trauma casualties

Figure 2. Activity at time of rescue (n=206)