ID MyHorse

ISS, GCS, SBP, and LOS… How Do They Relate to Horseback Riding?

Your ISS (Injury Severity Score), SBP (Systolic Blood Pressure), GCS (Glasgow Coma Scale), and LOS (Length of Stay) are all measures of how broken you are if you are injured while riding or interacting with your horse. Recently, this article appeared in my Facebook newsfeed multiple times as it was shared amongst my many horse groups.

Mike McRae of ScienceAlert wrote, Horse Riding More Dangerous Than Skiis And Motorcycles, Injury Data Reveal. The article was written on October 16th, 2021 and the information was pulled from BMJ Journals Trauma Surgery and Acute Care Open, which describes itself as follows:

Trauma Surgery & Acute Care Open is the American Association for the Surgery of Trauma’s open access journal dedicated to the rapid publication of peer-reviewed, high-quality trauma and acute care research. Trauma Surgery & Acute Care Open provides an interdisciplinary forum for global issues in trauma and acute care surgery and is dedicated to covering epidemiological, educational, and socioeconomic facets of trauma management and injury prevention.

In my opinion, the main focus of the original article was to highlight how little attention is given to the very real dangers of playing around with horses. Rather than paraphrase the concerns raised by this study, let me share their own words with you:

Many public health initiatives have focused on making sure that participants wear helmets during bicycle and motorcycle riding.26 27 Furthermore, research funding has mirrored public interest as the National Football League pledged millions of dollars in grant funding to launch the Head Health campaign.28 They are hoping to define the brain injuries that occur during play29 and create new helmet prototypes that will protect the brains of athletes.

Interestingly, hospital admission risk from horseback riding is higher than football, auto and motorcycle racing, and skiing.32 Recently, some attention has been paid by equestrian sporting agencies to the use of protective equipment to prevent injuries, especially as it relates to concussion and brain injuries33 34; however, very few public health campaigns have focused on preventing injuries in riders using horses for leisure and work. This is in stark contrast to the popularity of riding these animals. We suggest that preventive measures and campaigns should be instituted to highlight safety practices.30 31

About a year ago, an ER doctor told me that wearing a safety vest was even more important than wearing a helmet! Crazy, right? Yet, this study confirms that more than a third (37%) of the reported injuries involved the thoracic region. Injuries to the extremities accounted for 26% of the total, with head injuries in third place at roughly 23%. Abdominal injuries were the least reported at about 13%.

Sadly, 320 people, roughly 1.3% of the study group, did not survive their injuries. Head and neck injuries caused 75% of those fatalities. Did you know that the lightweight Hit-Air vests that Alan and I wear have extensions that rise up to protect your cervical spine and another one that drops down to protect your lumbar vertebrae? Between our vests and our helmets, we have significant protection for all vital body parts except our extremities.

Some folks think that women are more likely to be involved in horseback riding accidents than men, but this study did not show that to be true.

  • Men accounted for 50.5% of the patients
  • Age 50-59 accounted for roughly 27%
  • 60+ was approximately 22%
  • 40-49 came in third at around 20%
  • 18-29 was only slightly less than the previous age group
  • 30-39 was the smallest group at 13% (they are home with little kids!)

A staggering 88% of hospital visits resulted in a hospital stay! Half of those patients were sent to a floor room, whereas over 28% went to the ICU and nearly 10% went to surgery.

The first day that Alan and I were at 4-J Big Piney last week, a guy came off a horse. A lady was messing with a water hose and the water shot into the air about 25 feet away from the horse. The horse made several twists and turns and the man was thrown off. Clearly, he suffered injuries to his thoracic cavity as he was in a great deal of pain, yet he declined to get evaluated. Instead, he and his wife left later that afternoon and went home.

Last year, a medivac helicopter landed immediately adjacent to our trailer. A lady was thrown from her mule and sustained serious injuries. I wrote about it here. I have several safety-conscious friends who include helicopter insurance in their list of things they do to stay safe. Interestingly enough, some of our neighbors on our mountain in Colorado are so remote that they, too, pay for additional coverage for a helicopter ambulance. It is not very expensive

Alan and I have long been in the minority when it comes to sporting our safety equipment. We wear Tipperary helmets and it seems to be the one I see most often on other riders. It is extremely comfortable!

This was our third season for wearing our vests, and the first time one deployed. Alan and Sadie were following Kadeen and me down a narrow, muddy embankment at the Big Piney. The space was narrow and the edges of the embankment were saddle-height on both sides.

Halfway down, Sadie changed her mind and tried to go backward. Alan’s legs were in a precarious position as she shimmied around, so he hoisted himself out of the saddle and simply sat on the side of the embankment while she regrouped! However, he watched his vest cord get tighter and tighter… and it deployed.

Many folks have told me they would never use an air vest because the noise of deployment would further spook their horse. I am here to tell you it made no perceptible sound. What might have happened if somehow Alan had ended up under Sadie’s feet on that narrow, muddy embankment?

We did have a couple of folks ask us about our vests on this year’s trip. They are so lightweight we don’t even know we are wearing them. I suspect if the man I wrote about above had been wearing a vest, he wouldn’t have had to go home early with probable rib fractures…

I know that wearing safety equipment is a sticky topic among horse folks. I’m not sure if it is the “cool factor” or unwillingness to recognize that we engage in a risky activity? Is it a matter of “If I wear this gear will it look like I don’t know what I am doing? Will it make people think I don’t ride a good horse?” Or is it simply a willingness to roll the dice and play the odds?

Alan’s grandson just broke his femur playing tackle football in middle school. I admit, we were surprised that he was playing tackle football at that age! And this is why! How much force was he hit with in order to break the strongest long bone in his body?

Why not do what you can to give yourself the best odds of walking away from an accident? Have a solid relationship with your horse. Constantly strive to improve your riding skills. Wear protective equipment and carry medical information on your person. If you ride alone, let someone know when you leave and when you expect to return. Don’t just count on playing the odds… unless you are okay with being one of the statistics in the next trauma study.

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