title: Epidemiological and medical aspects of canyoning rescue operations.
abstract: OBJECTIVE
  To describe the characteristics of canyoning rescue operations (CRO), type and severity of injuries or illnesses, and on-site medical procedures.
  
  
  METHODS
  A retrospective analysis of all CRO data from an emergency medical rescue team in Aragon, Spain, between 1 August 1999 and 31 July 2009.
  
  
  RESULTS
  A total of 520 patients were identified, with a male to female ratio of 1.4. The median age was 32 years (range 10-73 years). The median time from the emergency call to admission to an acute care facility (or evacuation for uninjured patients) was 90 min (range 10-860 min). In 329 (63.3%) cases technical skills or ability in the terrain with some grade of difficulty was required. Accessibility of the incident site was associated with type of rescue (p<0.0001), where patients in incident sites with moderate to extremely difficult access were more often rescued by ground rescue alone or supported by air rescue than by air rescue alone. 419 (80.6%) patients had trauma-related injuries. The most common injuries involved the lower extremities (74%). The percentage of patients with a NACA score ≥4 was higher for medical/environmental illnesses than traumatic injuries (p<0.0001), despite that the total number was smaller. 175 (33.7%) patients received analgesics. 370 (71.2%) patients required splinting/immobilization. Major life-saving medical interventions were rarely performed on-site.
  
  
  CONCLUSIONS
  The length and exposure to environmental factors validates the importance of emergency physicians and paramedics in CRO. Physicians and paramedics should be familiar with Pre-hospital Trauma Life Support, medical procedures related to environmental, topographical and logistical conditions, and helicopter rescue operations including winch operations.
authors: Cerdanya Hospital, Camino de Ur 31, 17520 Puigcerdà, Spain; Faculty of Medicine, Girona University, Emili Grahit 77, 17071 Girona, Spain. Electronic address: inigosoteras@yahoo.es.
authors: Inigo
authors: I
authors: Soteras
authors: Cerdanya Hospital, Camino de Ur 31, 17520 Puigcerdà, Spain; Faculty of Medicine, Girona University, Emili Grahit 77, 17071 Girona, Spain.
authors: Enric
authors: E
authors: Subirats
authors: EURAC Institute of Mountain Emergency Medicine, Viale Druso 1, 39100 Bolzano, Italy.
authors: Giacomo
authors: G
authors: Strapazzon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017732:Air Ambulances; D002648:Child; D004632:Emergency Medical Services; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009051:Mountaineering; D017410:Practice Guidelines as Topic; D018635:Rescue Work; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*
keywords: Canyoning; Emergency medical services; Epidemiology; Hypothermia; Mountain medicine; Search and rescue; Trauma