Interviewer: How to be sure you are safe when you're riding a horse or are around horses, that's next on The Scope.
Announcer: This is, "From the Frontlines," with emergency room physician Dr. Troy Madsen, on The Scope. On The Scope.
Interviewer: Dr. Troy Madsen is an emergency room physician at University of Utah Health Care. I thought it was interesting. Dr. Madsen told me that in August here in Utah that there tend to be more horse injuries that come into the ER than any other time of the month. Maybe it's because of the fair circuit, maybe it's because of the rodeos. But I thought it would be interesting to find out what are the common horse injuries you see so people could be wary of that and protect against those sorts of things. So what is it?
Dr. Madsen: Well, you w you're exactly right. It is something we do see and for whatever reason, maybe more in the month of August, like you said, because of fairs or different events, rodeos, things like that going on. It's interesting; several years ago we actually looked at the causes of more significant trauma in our ER, those people who stayed at least overnight in the hospital, and horses were on the top five in that list at University of Utah. So kind of interesting.
Interviewer: Wow, I never would have guessed that. I would think there are so many other things out there that would be so much more dangerous, but . . .
Dr. Madsen: Exactly.
Interviewer: . . . a horse can be pretty dangerous, apparently.
Dr. Madsen: Horses can. I mean, at least in terms of some of the injuries we see.
Interviewer: Yeah. Doing some serious damage. So kind of what's the most common horse injury that you would see that causes a lot of damage?
Dr. Madsen: The most common injury would be head injuries. You've got to think of it kind of like bikes or motorcycles. If you fall off a horse, the biggest risk is going to be your head and your spine. I think the biggest thing we see with horses is people who get bucked off a horse, who come down on their head, who then have a significant head injury. Maybe a skull fracture or lacerations, bleeding in the head being the most significant thing that we see.
Then they are either brought to the ER because they're unresponsive or maybe they lost consciousness, they regained consciousness. We do testing on them to make sure there's no bleeding or lacerations to repair or any of a number of things that can happen with the head injuries.
Interviewer: So it sounds like that could be just about as dangerous like a motorcycle or a four-wheeler and so forth or maybe even more so?
Dr. Madsen: You've got to figure the height you're up on a horse. You're probably up sitting at least 4 feet off the ground and when you fall from that height, that's certainly higher than you would fall off a motorcycle or a four-wheeler.
Interviewer: A lot of times, a motorcycle might go down sideways so you're even closer to the ground before the head hits. So when you fall off a horse, it's . . .
Dr. Madsen: Yeah, exactly. And you're 4 feet up and then, if a horse kind of rears up and throws you off their back, you're even higher. So you can come off a pretty good height, not necessarily at the speeds for four wheelers or motorcycles but still, there's definite danger there in terms of coming down and hurting your head. As I mentioned, the other thing too is spine injuries. When we think of head injuries, we also think of the head getting pushed forward or some sort of damage or something hitting the spine directly. And then that can cause some very serious issues as well. So that's the other big thing we see and we look for.
Interviewer: All right. So helmets for head injuries, even though it's not as cool as a cowboy hat
Dr. Madsen: That's right.
Interviewer: I mean, I guess if you want to be safe. Spine injuries, is there really anything one could do to protect themselves against that if you're getting on a horse?
Dr. Madsen: Not a whole lot.
Interviewer: Yeah. That just might be part of the deal.
Dr. Madsen: It is and there are actually some inflatable vests that people can wear. I'm not sure exactly how they work, if here's something that then attaches to the saddle where if a person is bucked off the horse this vest inflates and actually protects the person. I personally know someone, an older lady, who was wearing one of these vests when she was thrown from her horse and she had some pretty significant injuries, but nothing that was so serious. And she probably really benefited from this vest inflating and protecting her.
She swears by it and says it made a big difference for her. So it's something where I know that's something that's out there that people may be aware of that you can use as well that probably does provide some spine protection and protection to your chest and abdomen.
Interviewer: All right. So those sound like ones that are probably staying overnight. Are there other injuries that you tend to see horse related?
Dr. Madsen: We see kind of the full spectrum of orthopedic injuries. People who get scrapes and cuts on their arms and legs, broken forearms. You've got to figure if you come down from that height, you try and brace yourself with your forearm. There's a good chance you're going to fracture your forearm. Ankle injury is also very common, depending how you come down. You come down on your ankle, your lower leg can snap. So we do see those injuries as well.
Again, those are things, maybe they're an overnight stay, maybe it's something we can repair in the ER. But kind of the full spectrum. Everything we see with motorcycles, with ATVs, with bicycles, we see all those things with horses as well and maybe even compounded a little more just because the height the person is falling from.
Interviewer: Sure. It sounds like maybe the advice is to wear a helmet and then also just treat the horse, treat the animal with respect. I think it can be easy for a horse person to kind of forget.
Dr. Madsen: Exactly. You become comfortable with the animal. You think, "Well, this is safer than a motorcycle or an ATV." Again, it's on our top five list of things we do see injuries with. They do happen. It's something to be aware of.
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