Snow Sports Safety

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Snow Sports Safety

• Ben Constance, MS3
• UW School of Medicine

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Safety Topics

• Patient Education
• The Helmet Debate
• Common Injuries
• Patient Resources

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Safety Tips from NSP

• Use proper ski equipment
• Wear a helmet but only snow sports helmet
• Prepare for the weather (no cotton!)
• Get proper instruction
• Wear goggles
• Take a break
• Ski with a friend
• Respect your limits
• Follow the rules skier safety code

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The Helmet Debate

• Case control studies show helmets reduce head
  injury by 30-60
• May cause increased neck injury
• May not prevent fatality
• May bolster confidence, leading to increased
  injury
• Improper helmets may cause injury

(Hagel et al, Sulheim et al)
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US Consumer Product Safety Commission, 1999

• From 1993 ? 1997 ED visits declined from 114,400
  to 84,200
• Head injury percentage increased from 11.8 in
  1993 to 15 in 1997
• Kinds under 15y/o, head injuries 22 (4,950
  annually)
• 44 head injuries preventable by helmet, 53 in
  kids)
• Would reduce 11 deaths per year (in 1997)

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Helmet Use and Risk of Head Injuries in Alpine
Skiers and Snowboarders JAMA Feb 22, 2006

• Study by Steinar Sulheim, MD (et al)
• Head injuries 17.6 of snow injuries in US
• Helmet use showed 60 reduction of head injuries
  OR 0.40
• Snowboarders at higher risk compared to skiers
  OR 1.53
• Concluded helmet use prevented head injury

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Effectiveness of helmets in skiers and
snowboarders case-control crossover studyBMJ
Jan 2005

• Adjusted OR for helmet use for head injury
  prevention was OR 0.71 with a 29 reduction in
  head injury
• For those taken to ED with head injury, OR was
  0.44
• For those taken to ED with neck injury, OR was
  1.29
• Concluded helmets help to reduce head injury, but
  cannot rule out increased neck injury

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Summary of Helmet Recommendations

• Helmets have been shown to reduce head injuries
  in both snowboarders and skiers
• The effect of helmet use on neck injuries is
  indeterminate at this time and should be studies
  further
• Helmets should be approved for snow sports use
• Patients should limit activities to those they
  would feel comfortable doing without a helmet,
  and not increase risk level of activities while
  using a helmet

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Common Injury Types
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Alpine Ski Injuries
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Common Ski Trauma

• Skiers thumb
• Boot-top fracture
• UE/wrist injuries
• ACL/MCL/MM injuries

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Ski ACL injury

• Weight back
• Rotated knee
• Down uphill hand
• Places tension on ACL and medial meniscus
• One of most common skiing knee injuries
• Can be prevented by skier education

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Snowboard Injuries
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Common Snowboard Trauma

• Anterior shoulder dislocation
• Sacrococcygeal injury
• Wrist injury
• Head injury
• Terrain-park trauma
• High velocity impact
• Chest contusion
• Lacerations

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Snowboard wrist injuries
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Medical Considerations

• Dehydration
• Sunburn/Windburn
• Hypothermia
• Hyperthermia
• Intoxication
• Hypoglycemia
• (DM complications)

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Patient Resources

• National Ski Patrol
• www.nsp.org
• National Ski Area Association
• www.nsaa.org
• Lids on Kids campaign
• www.lidsonkids.org
• Heads-Up Skier Safety
• via www.nsaa.org
• Terrain Park Safety Smart Style
• www.terrainparksafety.org

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References

• Hagel, Bret E. et al. Effectiveness of helmets in
  skiers and snowboarders case-control crossover
  study. BMJ 2005330281-Jan 2005.
• National Ski Area Association. Facts About
  Skiing/Snowboarding Safety. March 2006.
• Sulgeim, Steinar MD. Et al. Helmet Use and Risk
  of Head Injuries in Alpine Skiers and
  Snowboarders. JAMA Feb 2006 295 (919-924).
• U.S. Consumer Product Safety Commission. Skiing
  Helmets, An Evaluation of the Potential to Reduce
  Head Injury. Washington D.C., January 1999.