BMJ Open

364

Abstracts of Current Literature

EMERGENCY MEDICINE JOURNAL

BMJ OPEN

Tibetan Plateau Earthquake: Altitude Challenges to Medical Rescue Work

Helmet Use in BIXI Cyclists in Toronto, Canada: an Observational Study

This prospective cohort study evaluated the effect of rapid altitude gain on rescue workers after the Yushu earthquake in April 2010. Seventy-eight unacclimatized rescue team members traveled from Beijing to Yushu county (altitude, 150 feet and 14,400 feet, respectively). The majority arrived via 34-hour land trip (n⫽74) and the remainder arrived via 2.5-hour plane trip (n⫽4). Objective measurements taken before departure, after arrival, during rest, and after 30 minutes of work include the following: heart rate, pulse oxygen saturation (SpO2), and acute mountain sickness (AMS) symptoms assessed by the Lake Louise Questionnaire. The investigators found that 37.2% of the rescue workers met criteria for AMS, and 20.5% were evacuated early to lower altitudes. The most common AMS symptoms were chest tightness, headache, dizziness, and shortness of breath. Additionally, the rescue workers demonstrated hypoxia after ascent, with SpO2 decreasing from 98.5% in Beijing to 90.3% and 79.3% at 14,400 feet (respectively during rest and activity). Limitations of the study include a small sample size, homogeneous study population, and recall bias using the Lake Louise AMS Questionnaire. The authors conclude that altitude sickness is a major concern for unacclimatized rescue workers and a high-altitude–specific disaster plan is needed that uses local acclimatized staff.

BIXI is a bike-sharing initiative in Toronto targeting populations that require short-distance commuting in an effort to support sustainable transportation. Participants can rent bicycles from one of the many docking stations in the city; however, there is no requirement to wear helmets while on the bicycle. Additionally, helmets are not provided at the rental stations and cyclists older than 18 years are not required by law to wear a helmet in Ontario. This cross-sectional observational study compared helmet use for the bicycle-share program vs personal bike riders in Toronto, Canada. A total of 306 BIXI riders and 6426 personal bike riders were observed during commuting hours during a 2-month period. Cyclists using the bike-share program had a significantly lower rate of helmet use compared with personal bike users (20.9% vs 51.7%, respectively). Among both study populations, a greater proportion of bicyclists were male; however, women were more likely to wear helmets while cycling. As previously piloted in Melbourne, the authors propose a future helmet dispensing station adjacent to bike rentals to increase helmet use in Toronto. In conclusion, this study identified a potentially dangerous aspect of a bike-share program and an opportunity for future promotion of helmet use for injury prevention.

(Emerg Med J. 2012 Mar 3 [Epub Ahead of print]). Xu T, Wang Z, Li T, et al. Prepared by Matthew Stewart, MD, University of Utah Emergency Medicine Resident, Salt Lake City, UT, USA

(Bmj Open. 2012 Jun 18;2(3). Pii: E001049). Bonyun M, Camden A, Macarthur C, Howard A. Prepared by Matthew Stewart, MD, University of Utah Emergency Medicine Resident, Salt Lake City, UT, USA