Avtor/Urednik		Mair, Peter; Lutz, Martin
Naslov		Padec pri varovanju s plezalno vrvjo: ali tip varnostnega pasu vpliva na vzorec in resnost poškodbe?
Prevedeni naslov		Climbing rope falls: does the type of harness influence pattern and severity of injury?
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 43, št. 3
Leto izdaje		2004
Obseg		str. 313-7
Jezik		eng
Abstrakt		Based on experimental data, it is widely believed that any extended climbing rope fall may cause life-threatening injuries when using a sit harness alone. This is mainly due to the danger of thoraco-lumbar spinal and visceral abdominal injuries secondary to hyperextension trauma, as well as the risk of a "head down" position during suspension. The aim of this retrospective study was to clarify whether the pattern of injury suggested by experimental data is indeed found in real life falls and whether the type of harness used contributes to morbidity and mortality in climbing accident victims. A total of 57 climbers with a history of a fall into the climbing rope were analysed, 41 using a sit harness alone and 16 using a combination of sit and chest harness. Neither a disruption of the thoraco-lumbar spinal nor abdominal visceral injuries secondary to hyperextension trauma were found in any of our victims using a sit harness alone, despite long falls up to 65 meters. The pattern and severity of injury were not different in climbers using a sit harness alone when compared to those using a combination of sit and chest harness. "Head first" position was common during the fall (33% of all cases), but without any correlation to the type of harness used. "Head down" position after the fall during suspension was less common and found only when no chest harness was used. There was a peak of life threatening injuries and multi-system-trauma cases in routes of low difficulty, the pattern of injury indicating rock contact during the fall as the underling mechanism responsible for these injuries. Taken together, we did not find any evidence that the type of harness used significantly influences the pattern or severity of injury in rock climbing accidents. Our data indicate that severe and life threatening injuries in rock climbing accidents are predominantly due to rock contact during the fall and are more common in routes of low difficulty.
Izvleček		Na podlagi eksperimentalnih podatkov je razširjeno prepričanje, da lahko vsak večji padec pri varovanju s plezalno vrvjo povzroči smrtno nevarne poškodbe, če plezalec uporablja le sedalni varnostni pas, predvsem zaradi nevarnosti poškodb prsne in ledvene hrbtenice in trebušnih organov pri hiperekstenzijski poškodbi, pa tudi zaradi tveganja, da bo plezalec obvisel v položaju z glavo navzdol. Cilj te retrospektivne študije je bil ugotoviti, ali vzorec poškodb, ki so ga pokazali eksperimentalni podatki, resnično najdemo pri dejanskih primerih nesreč in ali vrsta varnostnega pasu prispeva h obolevnosti in umrljivosti pri teh ponesrečencih. Analizirali smo skupaj 57 plezalcev, ki so v preteklosti padli v plezalno vrv. Od tega jih je 41 uporabljalo le sedalni varnostni pas, 16 pa kombinacijo sedalnega in prsnega varnostnega pasu. Pri nobenem od plezalcev, ki so uporabljali le sedalni pas, niso našli ne motenj na prsni in ne na ledveni hrbtenici, ne poškodb trebušnih organov zaradi hiperekstenzijske poškodbe, kljub dolgemu padcu do največ 65 metrov. Vzorec in resnost poškodb plezalcev, ki so uporabljali le sedalni pas, se nista razlikovala od tistih, ki so uporabljali kombinacijo sedalnega in prsnega varnostnega pasu. Položaj z glavo naprej je bil med takimi padci pogost (33% vseh primerov), vendar ni bilo nobenega ujemanja z vrsto pasu, ki ga je plezalec uporabljal. Visenje z glavo navzdol po padcu je bilo manj pogosto in je nastopalo le, če plezalec ni uporabljal prsnega varnostnega pasu. Opažali smo, da je največ primerov smrtno nevarnih poškodb in multisistemske poškodbe na lažjih plezalnih smereh, vzorec poškodb pa je kazal na udarec ob skalo med padcem kot osnovni mehanizem teh poškodb. Nismo torej našli nobenih znakov ali dokazov, da bi vrsta plezalnega pasu značilno vplivala na vzorec poškodb pri padcih med plezanjem. (Izvleček skrajšan pri 2000 znakih).
Deskriptorji		MOUNTAINEERING ACCIDENTAL FALLS PROTECTIVE DEVICES EMERGENCY MEDICAL SERVICES