K. S. Romanowski2, E. S. Salcedo1, J. M. Galante1, C. S. Cocanour1 1University Of California – Davis,Division Of Trauma And Acute Care Surgery,Sacramento, CA, USA 2University Of Iowa,Division Of Acute Care Surgery,Iowa City, IA, USA
Introduction: California and the Western United States are in the midst of a severe drought that has been intensifying for the last four years. With lower water levels in the lakes and rivers, a new mechanism of injury has emerged. Patients are sustaining serious injuries and are doing so with a much higher incidence than previously seen. Patients are presenting with injuries sustained while using rope swings in areas previously with safe water levels.
Methods: Following IRB approval, a retrospective chart review of all admitted trauma patients seen following rope swing accidents during the summers (July to September) of 2013 and 2014 was performed. Data collected included: demographics (age, gender), injury characteristics (ISS, types of injuries), outcomes (length of stay, surgical procedures), and discharge disposition. Values are expressed as mean ± SD.
Results: During summer of 2013, only 2 patients presented with injuries following falls from rope swings. In summer of 2014, 13 patients presented with injuries sustained while using rope swings. This represented a 650% increase from the previous year. The mean age of patients was 28.9±14.2 (range 10-56) years. Eight patients were women (61.5%). Patients fell from a mean height of 14.3±6.3 (6-25) feet. Only 2 patients (15.4%) had a loss of consciousness and all patients presented with a Glasgow Coma Scale (GCS) of 15. The mean ISS was 9.17±6.5 (1-25). These 13 patients sustained 22 injuries. The most frequent injuries were: pelvic fractures (3 patients), lumbar spine fractures (3 patients) and concussions (2 patients). They required a mean of 1±0.96 (0-3) procedures. The mean length of stay was 5.46±4.0 (1-15) days and 11 patients (84.6%) were discharged home from the hospital. One patient went to a skilled nursing facility and one patient left against medical advice. Eight patients (61.5%) required durable medical equipment at the time of discharge. One patient was readmitted for cellulitis.
Conclusion: As the drought intensifies and water levels get lower, there has been a surge in patients presenting with injuries that were sustained using rope swings. The patients are presenting with serious, potentially life-threatening injuries that often require surgical procedures and inpatient hospital stays. Additionally the majority of these patients require durable medical equipment at discharge. All of this produces significant societal cost. The public must be made aware of the dangers of rope swings and those that are located in areas with severely low water levels or dangerous conditions should be removed.