Even if head injuries are not among the most common injuries in snow sportsit's still an issue that matters, epidemiology can help us to go further in its prevention

1. 4th tto 10tth Augustt 2013
BARIILOCHE ­­ARGENTIINA

2. SIITEMSH WORKSHOP 2::
MANAGEMENT OF HEAD INJURIES
Epiidemiological aspects of head
iinjjuriies iin a skii resortt
Escoda Alegret B., Escoda Sales J., Alduncin Gutierrez I., Castro Digon I.,
Gonzalez Carranza S., Guirro Castellnou P., Pereira Brito D., Toshev P.
Centre Mèèdic Pas de la Casa­­Grau
Roig. Grandvalira Ski Area.
ANDORRA www.cmpas.com info@cmpas.com

3. Andorra
IItt iis a mountainous country,, wiitth
70000 iinhabiittantts lliiviing iin 462
square km
wiitth more tthan10 peaks ranged
bettween 2900mtt and 3000mt high
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

4. 20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

5. Andorra
2 off tthe 3 biiggestt skii areas iin tthe
Pyrenees, Valllnord and GrandValira
wiitth 1,,800,,000 skiier­­days/
season
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

6. SNOW SPORTS IINJURIIES IIN
ANDORRA
we have olld regiistters begiiniing
in the seventies that are nott
sttandardiized,, iin paper fforms,,
with no control groups
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

7. SNOW SPORTS IINJURIIES IIN
ANDORRA
effffortts have been made tto iimprove tthe datta
collllecttiion
ffor tthe llastt 10 seasons ttheres iis a uniique
dattabase resullttiing ffrom tthe work off tthe skii
pattrolls,, tthe resortts mediicall centters and tthe
hospiittall
ALL THE DATA ON SNOW SPORT IINJURIIES
ARE COLLECTED IIN A UNIIQUE DATABASE
wiitth 140,,000 recorded iinjj..
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

8. SNOW SPORTS IINJURIIES IIN
ANDORRA
Thiis datta base giives us good generall
iinfformation, complletted by control
groups (unfforttunattelly nott ffor allll tthe
seasons),, butt when studying precise
iissues iitt has some lliimiitts
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

9. Head injuries in snowsports
Injuried region
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

10. Head injuries in snowsports
Type of injury
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

11. head injuries evolution
% of overall injuries
6
6
6
5
4
3
2
1
2001/2002 2002/2003 2003/2004 2004/2005 2005/2006 2006/2007 2007/2008 2008/2009
5
5
4
4
3
HEAD INJURIES
sub-title
sub-title
sub-title
INJURIES
INJURIES
TOTAL 3
TOTAL 0
HEAD INJURIES
SEASON
% OVER TOTAL INJURIES

12. head injuries evolution
Injuries /1000 skier days

13. SNOW SPORTS IINJURIIES IIN
ANDORRA
Concerned about this particular issue
we began iin our centter
to enrich data collection iin head
iinjjuriies ffrom 2010­­2011
butt no on­­deep
analysis has been
made yett
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

14. Head iinjjuriies iin snowsportts
The enriiched datta collllecttiion aboutt
head iinjjuries began in season 2010­­2011
and no on­­deep
analysis has been
made yett
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

15. Head iinjjuriies iin snowsportts
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

16. Head iinjjuries in snowsports
22//33 wweerree ttrraannssffeerreedd ttoo tthhee llooccaall
hhoossppiittaall
tthhee ootthheerr wweerree ggiivveenn aann aaddvviiccee ffoorrmm
aanndd ttoolldd ttoo ccoonnssuulltt aaggaaiinn iiff wwoorrsseenniinngg
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

17. Head iinjjuries in snowsports
IInn ppaacciieennttss sseenntt ttoo hhoossppiittaall
4400%% hhaadd aa CCTT SSccaann
9900%% ssttaaiidd lleessss tthhaann 2244hh iinn tthhee hhoossppiittaall
66 %% wweerree ttrraannssffeerreedd ffrroomm tthhee llooccaall hhoossppiittaall ttoo
lleevveell 33 hhoossppiittaall ((BBaarrcceelloonnaa oorr TToouulloouussee))
20th congress of the International Society for Skiing Safety in association with SITEMSH
Bariloche August 4th to 10th 2013

18. Evolution of helmet use
% of injuried wearing helmet

19. Evolution of helmet use
Among children helmet use is largely majoritary:
- Children coming with their schools, ski clubs,
and other organized structures (either from
Andorra or other countries), have as
mandatory the use of safety helmet, so 100 %
are normally wearing helmet
- For those who come individually with their
parents lower ski pass prices are aplied when
wearing helmets
- Helmets are easily found in rental shops
UNHELMETED CHILD ARE EXTREMELY
UNCOMON

20. CChhiilldd aanndd hheeaadd iinnjjuurriieess
CChhiillddrreenn aarree mmoorree eexxppoosseedd ttoo hheeaadd
iinnjjuurriieess tthhaann oollddeerr sskkiieerr
//ssnnoowwbbooaarrddeerrss,, wwee hhaavvee nnoo pprreecciissee
ddaattaa oonn tthhiiss aaggee ggrroouupp..
MMoorree ssttuuddiieess aarree nneeeeddeedd ttoo ccoonnffiirrmm
tthhee mmaassssiivvee uussee ooff hheellmmeettss aanndd iittss
bbeenneeffiittss

21. CCoonnssiiddeerraattiioonnss oonn hheellmmeettss
IIn a prreviiouss ssttudy
We diid nott ffiind decrreasse iin tthe % off
pattiienttss neediing hosspiittallarry ttrreattmentt,,
whiille hellmett usse iiss expandiing
The mosstt dangerrouss iinjjurriiess ussualllly
assssociiatte sseverrall llocalliizattiionss,, arre ussualllly
caussed by hiigh sspeed colllliissiionss,, and ttherre iiss
no eviidence tthatt tthey coulld be prreventted by
hellmett usse..

22. Considerations on helmets
Making helmet use mandatory in
children seems reasonable; helmet use
in adults should result of good
information including talking about
risk taking behaviors.

23. CCoonnssiiddeerraattiioonnss oonn hheellmmeettss
PPrreevviioouuss ssttuuddiieess ffrroomm ootthheerr aauutthhoorrss
sshhooww tthhaatt hheellmmeett uussee rreedduucceess
sseevveerriittyy aanndd iinncciiddeennccee ooff hheeaadd
iinnjjuurriieess..
EExxttrreemmeellyy sseevveerree hheeaadd iinnjjuurriieess,,
rreessuullttiinngg ffrroomm hhiigghh ssppeeeedd ccoolllliissiioonnss,,
ccaannnnoott bbee pprreevveenntteedd bbyy hheellmmeett uussee..

24. CCOONNCCLLUUSSIIOONN
studies are time demanding, but
­they
can help doing snowsports safer
­they
can help us improving what is
done in medical centers
Prospective, multicentre, coordinated
studies are necessary in order to
improve our understanding of snow
sport's injuries and their possible
prevention policies

25. GRACIIAS !!!!!!!!!!
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