Top

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Published in:

Open Access 01-12-2011 | Case report

Survival following a vertical free fall from 300 feet: The crucial role of body position to impact surface

Authors: Sebastian Weckbach, Michael A Flierl, Michael Blei, Clay Cothren Burlew, Ernest E Moore, Philip F Stahel

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2011

Abstract

We report the case of a 28-year old rock climber who survived an "unsurvivable" injury consisting of a vertical free fall from 300 feet onto a solid rock surface. The trauma mechanism and injury kinetics are analyzed, with a particular focus on the relevance of body positioning to ground surface at the time of impact. The role of early patient transfer to a level 1 trauma center, and "damage control" management protocols for avoiding delayed morbidity and mortality in this critically injured patient are discussed.

Available only for authorised users

Richter D, Hahn MP, Ostermann PA, Ekkernkamp A, Muhr G: Vertical deceleration injuries: a comparative study of the injury patterns of 101 patients after accidental and intentional high falls. Injury. 1996, 27 (9): 655-659. 10.1016/S0020-1383(96)00083-6.CrossRefPubMed

Bragg S: Vertical deceleration: falls from height. J Emerg Nurs. 2007, 33 (4): 377-378. 10.1016/j.jen.2007.04.017.CrossRefPubMed

American College of Surgeons Committee on Trauma: Resources for optimal care of the injured patient. 2006, Chicago, IL: American College of Surgeons

Lapostolle F, Gere C, Borron SW, Petrovic T, Dallemagne F, Beruben A, Lapandry C, Adnet F: Prognostic factors in victims of falls from height. Crit Care Med. 2005, 33 (6): 1239-1242. 10.1097/01.CCM.0000164564.11989.C3.CrossRefPubMed

Stahel PF, Moore EE, Schreier SL, Flierl MA, Kashuk JL: Transfusion strategies in postinjury coagulopathy. Curr Opin Anaesthesiol. 2009, 22 (2): 289-298. 10.1097/ACO.0b013e32832678ed.CrossRefPubMed

Kashuk JL, Moore EE, Sawyer M, Le T, Johnson J, Biffl WL, Barnett C, Stahel PF, Silliman CC, Sauaia A, Banerjee A: Postinjury coagulopathy management: goal directed resuscitation via POC thrombelastography. Ann Surg. 2010, 251 (4): 604-614. 10.1097/SLA.0b013e3181d3599c.CrossRefPubMed

Stahel PF, Smith WR, Moore EE: Current trends in resuscitation strategy for the multiply injured patient. Injury. 2009, 40 (Suppl 4): S27-35.CrossRefPubMed

Flierl MA, Stoneback JW, Beauchamp KM, Hak DJ, Morgan SJ, Smith WR, Stahel PF: Femur shaft fracture fixation in head-injured patients - when is the right time?. J Orthop Trauma. 2010, 24: 107-114. 10.1097/BOT.0b013e3181b6bdfc.CrossRefPubMed

Stahel PF, Flierl MA, Moore EE, Smith WR, Beauchamp KM, Dwyer A: Advocating "spine damage control" as a safe and effective treatment modality for unstable thoracolumbar fractures in polytrauma patients: a hypothesis. J Trauma Manag Outcomes. 2009, 3: 6-10.1186/1752-2897-3-6.PubMedCentralCrossRefPubMed

10.

Hasenboehler EA, Stahel PF, Williams A, Smith WR, Newman JT, Symonds DL, Morgan SJ: Prevalence of sacral dysmorphia in a prospective trauma population: Implications for a "safe" surgical corridor for sacro-iliac screw placement. Patient Saf Surg. 2011, 5: 8-10.1186/1754-9493-5-8.PubMedCentralCrossRefPubMed

11.

Haschtmann D, Stahel PF, Heyde CE: Management of a multiple trauma patient with extensive instability of the lumbar spine as a result of a bilateral facet dislocation and multiple complete vertebral burst fractures. J Trauma. 2009, 66 (3): 922-930. 10.1097/01.ta.0000215415.87801.fc.CrossRefPubMed

12.

Kossmann T, Payne B, Stahel PF, Trentz O: Traumatic paraplegia: surgical measures [German]. Swiss Med Wkly. 2000, 130: 816-828.

13.

Kossmann T, Jacobi D, Trentz O: The use of a retractor system for open, minimal invasive reconstruction of the anterior column of the thoracic and lumbar spine. Eur Spine J. 2001, 10 (5): 396-402. 10.1007/s005860100330.PubMedCentralCrossRefPubMed

14.

Gerdes EM, Hafner JW, Aldag JC: Injury patterns and safety practices of rock climbers. J Trauma. 2006, 61 (6): 1517-1525. 10.1097/01.ta.0000209402.40864.b2.CrossRefPubMed

15.

Stahel PF, Heyde CE, Flierl MA, Wilkerson JA: Head and neck injuries. Medicine for Mountaneering. Edited by: Wilkerson JA, Moore EE, Zafren K. 2010, Seattle, WA: The Mountaneers Books, 86-95. Volume 6

16.

Sauaia A, Moore EE, Johnson JL, Ciesla DJ, Biffl WL, Banerjee A: Validation of postinjury multiple organ failure scores. Shock. 2009, 31 (5): 438-447. 10.1097/SHK.0b013e31818ba4c6.PubMedCentralCrossRefPubMed

17.

Keel M, Trentz O: Pathophysiology of polytrauma. Injury. 2005, 36 (6): 691-709. 10.1016/j.injury.2004.12.037.CrossRefPubMed

18.

Stahel PF, Smith WR, Moore EE: Role of biological modifiers regulating the immune response after trauma. Injury. 2007, 38 (12): 1409-1422. 10.1016/j.injury.2007.09.023.CrossRefPubMed

19.

Burlew Cothren C, Moore EE, Smith WR, Johnson JL, Biffl WL, Barnett CC, Stahel PF: Preperitoneal pelvic packing/external fixation with secondary angioembolization: optimal care for life-threatening hemorrhage from unstable pelvic fractures. J Am Coll Surg. 2011, 212: 628-637. 10.1016/j.jamcollsurg.2010.12.020.CrossRef

20.

Osborn PM, Smith WR, Moore EE, Cothren CC, Morgan SJ, Williams AE, Stahel PF: Direct retroperitoneal pelvic packing vs. pelvic angiography: a comparison of two management protocols for hemodynamically unstable pelvic fractures. Injury. 2009, 40: 54-60. 10.1016/j.injury.2008.08.038.CrossRefPubMed

Title: Survival following a vertical free fall from 300 feet: The crucial role of body position to impact surface
Authors: Sebastian Weckbach
Michael A Flierl
Michael Blei
Clay Cothren Burlew
Ernest E Moore
Philip F Stahel
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2011
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/1757-7241-19-63

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Survival following a vertical free fall from 300 feet: The crucial role of body position to impact surface

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2011

A national survey on temporary and delayed abdominal closure in Norwegian hospitals

Unanswered questions in the use of blood component therapy in trauma

Feasibility of written instructions in airway management training of laryngeal tube

First aid skill retention of first responders within the workplace

Assessment of the effects and limitations of the 1998 to 2008 Abbreviated Injury Scale map using a large population-based dataset

Effects of first aid training in the kindergarten - a pilot study