Morbidity and Mortality in US National Parks: A Review of National Emergency Medical Services Workload from 2007 to 2009

Abstract

Objective.-Lift-accessed downhill mountain biking has grown exponentially in popularity over the past decade. The sport, while offering participants access to a vast amount of terrain, also requires navigating steep and technical terrain at high speeds, posing significant risk of injury to the rider. A limited understanding of these risks impedes both medical management as well as industry-appropriate protective equipment development. The objective of this study was to describe the frequency and type of injuries sustained by downhill mountain bikers utilizing such lift-accessed bike parks.Methods.-A retrospective chart review was performed at one resort's urgent care facility for all patients seeking medical treatment for injuries sustained while riding in the neighboring mountain bike park during the 2009 season.Results.-Of 898 identified cases, 86% (772) were male and the median age was 26 years (range 7-66). Of these patients, 19.4% (174) required transport off the mountain by the park's bike patrol while another 8.4% (75) arrived by emergency medical services. There were 1759 specific injury diagnoses identified, including 420 fractures in 382 patients (42.5%). Upper extremity fractures included 109 wrists, 122 shoulders, 37 elbows, and 49 hands/fingers. There were 31 lower extremity fractures and 19 spine fractures (one with paralysis). In addition, 27 patients were suspected to have internal abdominal trauma and 11.2% (101) had a concussion or more severe intracranial injury. Though 90.5% (813) of patients were discharged, 8.5% (76) required transfer to a higher level of care facility.Conclusions.-Mountain bikers riding at this resort incurred a considerable number of injuries with significant morbidity during the 2009 riding season. Though exposure information was unavailable, these findings demonstrate the serious risks associated with this sport and highlight the need for continued research into appropriate safety equipment and risk avoidance measures.