USERS GUIDE NATIONAL SKI AREA ACCIDENT REPORT (SAAR) FORM

Transcription

1 USERS GUIDE TO THE NATIONAL SKI AREA ACCIDENT REPORT (SAAR) FORM Revised and Updated October 2008 (previous version September 2006) By Tim Foster, Mount Baldy Carey Caswell, CWSAA Mary Lou Troman, Whitewater Winter Resort Kevin Nichol, Gougeon Insurance Brokers Jody Elliott, Gougeon Insurance Brokers Original Document Prepared by: Bob Bell, Ski Marmot Basin, Jasper AB Jim Hillman, Snow Valley, Edmonton AB

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3 USERS GUIDE TO THE NATIONAL SKI AREA ACCIDENT REPORT FORM Revised and Updated October 2008 The Ski Area Accident Report (SAAR) form is intended to be a general record of ski area incidents. In its present form it represents a balance between the requirements of insurers and ski areas, both large and small; it is the first step in effective follow up and investigation of all reported incidents. In the case of a serious incident, additional forms may be required for detailed first aid and patient information as well as detailed investigative follow up. We strongly suggest that you follow industry standard investigation protocols provided in the current incident investigation manuals, which are available through your Ski Association or your Insurance Broker. Each SAAR "set" contains the original along with 3 colored copies. Recipients for each copy are noted at the bottom of each page. The last copy is provided as reference information for the ambulance attendant if the patient is transported by an ambulance to a medical facility. Half of this copy is blacked out so that only the information relative to the patient s injury is visible. Release of the fourth copy to the ambulance attendant is strictly at the discretion of the Ski Patrol or authorized management. Please note that the Privacy Act forbids the release of personal information to outside sources without the express written permission of that person. A patient may have a copy of a SAAR form that he/she has signed but any personal names of other witnesses' etc. must be removed from the form unless written consent is obtained for the release of their personal information. A black marker over a photo copy then copied again usually covers the protected sensitive information. We recommend that you consult your insurance broker prior to the release of any SAAR form or other incident related information. The SAAR form is laid out so as to separate "First Aid / Patient Information" from "Incident Occurrence / Investigative" information. Much of the information collected on the lower half of the SAAR form is needed for analysis by the ski area, association and insurers. The information is largely statistical in nature and is collected in broad categories for analysis of regional and national trends. It is critical that all participants use the same definitions and parameters for recording the information. This guide is provided to assist users in better defining these parameters and to encourage a detailed and systematic approach to the collection of this most valuable information. We suggest that incident follow up including the correct completion of the SAAR forms be included as part of annual pre-season training for all Risk Managers and Ski Patrollers and that this guide be used as a reference. The importance of complete, detailed and legibly printed information cannot be overstated. Please note that only one form should be filled out per patient. If you need to void a form, please mark VOID clearly across the form and DO NOT destroy it. All of the forms are pre numbered and must be accounted for. A copy of a current SAAR form is attached to aid in relating this guide to the respective sections of the report form. Changes to the form this year have been brought forward to allow for better integration with the Accident Analyzer web based application that is currently under revision. Accident Analyzer allows a resort, their insurance company and their respective industry associations to work together to evaluate statistical information and work together to proactively control incident trends. The program is expected to be available to participating resorts across Canada this winter.

4 GENERAL INFORMATION PATIENT Resort/Ski Area NATIONAL SKI AREA ACCIDENT REPORT Accident Number: Season (year1/year 2) 20 /20 Report Number Incident Date / / mm / dd / yy Incident Time (24 hr) : hh : mm The accident number (No.) is unique to each set of forms. It consists of two numbers. First being the Season (year1/year2). This year the resort will be required to fill in this block with the current season. IE: This year it will be 2008/2009. We have moved to having the resort complete this instead of having it prefilled in an attempt to safe money by not having to have the forms reprinted on an annual basis. The second part is the report number which is a unique identifier for this particular incident. Many resorts use this number to identify all related accident investigation material as well. Resort / Ski Area - enter your ski area name here. The date is recorded in MM/DD/YY format for consistency with computer date formats. Please note that Incident Time refers to the time the incident occurred, not the time of form completion. The time is recorded in 24 hour format. Note there are 3 other locations where times are required. Please be sure that the times are in a logical sequence. This must usually be estimated by the patroller. Identification Name Visitor Local Accommodation Info Home Address City Prov Postal Code Phone ( ) - If patient is a student, is he/she participating in a school ski program? Yes No Occupation/School Group This section identifies the patient. In the event of extreme time pressure (life threatening emergency) enough data for identification must be collected, usually name and one other unique item (i.e. phone). In any other case, all information should be collected. Local address is acceptable for convenience with destination guests. General Date of Birth / / mm / dd / yy Age Gender Male Female Height ft/cms Weight lbs/kg Patient Type Guest Staff-Off Staff-Work Ticket Type Day Ticket Multi-Day Ticket Season Pass Other Pass Not Applicable The other data (age, sex, height and weight) should be given by the patient. Obtaining a date of birth from the patient is of utmost importance. It is often the only way to track them down at a later date...4..

5 Patient s Description of Incident Signed: Patient/Guardian to initial here if treatment is refused: Recurrence of previous injury? Yes No Patient Parent Guardian It is very important to record the patient's description of the incident. Use quotation marks to indicate exact transcriptions. Begin with any statements made at the scene in response to your question "What happened?" If any patroller has some doubt that the incident happened as described by the patient, a patroller's report should be completed and attached to the investigation material. Take your time with this and make sure that what you have written is clear and legible. When a minor is involved, the parent or guardian should be asked to sign, as well as the minor. Patients refusing treatment should be asked to sign this form. If you are unable to obtain a signature it should be noted in the Signed box, i.e. unable to sign, or refuse to sign. In the patients description of the incident we should be asking 3 important questions to assist the patient in providing us a good description of the incident: Where were you skiing/riding? How fast were you going? Were you skiing/riding in control? A bad description would be: A good description would be: "Fell while skiing. Broken leg." I was riding down spill way real fast. I lost control and could not stop. I caught an edge and slid down the hill with my hands in front of me. Signs and Symptoms as recorded by Patroller/Doctor Record signs (physical observations) and symptoms (patroller/doctor) in medical terminology. Take your time with this and make sure that what you have written is clear and legible. Allergies None Medications None Related Medical History None Time of last meal: Drugs/Alcohol: Note relevant allergies (include drug allergies) Note relevant medications currently being used Note relevant medical history Time of last meal lets medical people know if and when to give meds. Drugs/Alcohol is to note if either of these is admitted to by the patient...5..

6 Circle or mark L for Left, R for Right and B for Both, mark all that apply Complaint L R B Foot L R B Lower Ab L R B Upper Arm Upper Back L R B Ankle L R B Upper Ab L R B Elbow Lower Back L R B Lower Leg L R B Chest L R B Lower Arm Tailbone L R B Knee L R B Neck L R B Wrist Head L R B Thigh L R B Clavicle L R B Hand Face L R B Hip L R B Shoulder L R B Thumb Medical Other injury L R B Finger No injury If multiple, note primary injury: Note that these locations proceed from foot to head. There is a blank box to record other locations. Note that the lower and upper abdomen, right and left can be used to record abdominal quadrants. Treatment Protocol Fracture Dislocation Internal Sprain Cardiac Illness Strain Stroke Deceased Bruise Concussion Laceration Hypothermia Frostbite Other treatment: Please identify which type of protocol that First Aid was applied to. This is not a diagram of injury or a medical treatment. First Aid At Scene On scene : Transported: : hh : mm hh : mm Base/Clinic In : Out: : hh : mm hh : mm Additional F/A info attached Medication administered: : by: hh : mm Some useful abbreviations are: P Primary Survey P/S Secondary Survey (Note: you MUST record which type of survey you performed TUP Tenderness upon palpitation R Right L Left C/O Complains of HX History of...6..

7 First Aid treatments at the scene must be recorded here, together with time. Note that there is no space to record vital signs. An additional F/A (First Aid) form should be used to record these when judged necessary by the Patroller, and the Additional F/A Info Attached box must be checked. Any medication given by either staff or EMS must be recorded here, and signed by the person giving the medication. If you are unable to get a signature, indicate who gave the medication. Some useful abbreviations are noted in the First Aid treatment section where we record how we treat the signs and symptoms A good description would be: "C/O pain midshaft R tibia. Redness and minor swelling anterior R tibia. Point tenderness on palpation. Unwilling to bear weight." A bad description would be: evidence of sore leg, looks broken, pt is crying This is not a sign or a symptom Remember that, as in all Accident Investigation, it is just as important to record what is not observed, for example, "no swelling or point tenderness observed, able to bear weight."..7..

8 ACCIDENT INVESTIGATION Witness Information Witnessed By Witness Name Phone Accompanied By Collided With ( ) - Other: Home Address City Prov Postal Code Witnessed By Accompanied By Collided With Witness Name Phone ( ) - The reports of eye witnesses are a valuable accident investigation tool. At this stage of the accident investigation, it is important to identify the witnesses so they can be contacted at a later date if required. A detailed statement should be taken in a suitable format as soon as possible. Your ski area may require that detailed statements be taken by designated investigators or insurance adjusters Run Map/Grid Coordinates Location of Incident Exact Location This section describes the exact location of the incident. Use the run box to indicate the name of the run the incident occurred. Eg. Spill way The Exact Location should be a description of the site of the incident. Identify any permanent landmarks if applicable. Eg bottom 1/3 of Spill Way aprox 3 m south of tower 3. Marked Run Freestyle Terrain Terrain/Rail Park Competition Terrain Half Pipe Out of Bounds Closed inbounds Off Trail Lift Incident Premises Park Feature/Hit Run is posted Run is posted as Freestyle terrain (orange oval) Within confines of a terrain park (freestyle terrain) Active competition ie: racing Within confines of established half pipe Not within confines of ski area boundary On run or area marked as closed Off an identified trail but still within the ski area boundary Injured at a lift facility (surface lift, chair lift, tube lift etc.) Indoors or on a deck, walkway or stairs or in a non skiing area ie: parking lot Location not known Name of feature/hit..8..

9 Run Classification Easiest More Difficult Most Difficult Extreme Run is posted as easiest (green circle) Run is posted as more difficult (blue square) Run is posted as most difficult (black diamond) Run is posted as extreme (double black diamond) Drugs / Alcohol Are drugs or alcohol suspected to have contributed to incident? Yes No This section is new and requires the patroller to make an assumption as to whether or not they think that the patient is under the influence of drugs or alcohol. It would be recommend that the patroller filling this out also fill out their own witness form and include why they are making this assumption. Alpine Snowboard Telemark Nordic Touring Tubing Non-skiing Other: Activity Downhill skiing Downhill snowboarding Freeheel skiing Cross Country skiing Back country skiing (off piste skiing) Tubing Other activities not involving skiiable terrain Aerial, mogul or ballet skiing Site Conditions The site conditions sections refer to the conditions which were present at the exact site and time of the incident. For example, if the sky was clear, with no snow falling, at the time, but it started to snow during the rescue, Weather would be (X) Clear. It may be helpful to note the time that snow started, if that affects investigation material and photographs. In all cases, these are as estimated by the patroller. Exact measurements are not required, although they may be advised for a detailed accident investigation. Clear Overcast Snowing Raining Fog Weather The sky was clear or had some clouds There was a general overcast It was snowing at the time of the incident It was raining at the time of the incident There was fog at the time and place of the incident Incident was not reported when it occurred but at a later date/time Not applicable ie: indoors..9..

10 Sharp Flat Whiteout Lights Dark Light There was enough light for distinct shadows Diffused light shadows are not distinct Diffused dim light or obscured light difficult to judge depth due to lack of shadows Night lights No lighting Incident was not reported when it occurred but at a later date/time Not applicable ie: indoors Temp C Above10 At the time and site air temperature estimate above 10 0 to10 As above estimated to 0 to to 0 Below 0 and above to -11 Estimated between -11 and -20 Below 20 Estimated below -21 Incident was not reported when it occurred but at a later date/time Not applicable ie: indoors When using numerical categories always include the boundary in the low range, i.e.: 5 belongs in 1 to 5, and not 5 to 10. Temperature refers to the general air temperature at the time and location of the incident. It does not refer to snow temperature, which will always be below 0. No new 0 to 5 5 to to 15 Over 15 Snow (cm) There has been no new snow in the previous 24 hours Up to 5 cm of new snow Between 6 and 10 cm Between 11 and 15 cm More than 16 cm of new snow Incident was not reported when it occurred but at a later date/time Not applicable ie: indoors This category refers to snow that has accumulated over the past 24 hours. I.e.: on the day of, and before the incident. Groomed Moguls Powder Variable Granular Hard Surface The surface at the site had been groomed recently There were moguls at the site There was some new snow on the old surface The surface had a mixture of snow types ie: slush or cut up powder The surface snow was melt/freeze granules ie: corn snow The surface was hard enough to resist penetration of poles or ski edges due to freezing or compaction..10..

11 Incident was not reported when it occurred but at a later date/time Not applicable ie: indoors General site conditions should be used, particularly if the run has been groomed. Note that this may vary due to the elevation and weather

12 PATIENT INFORMATION/HISTORY Beginner Novice Intermediate Advanced Expert Ability Beginner skier/boarder ie: able to ski green runs is able to ski green runs and some simpler blue runs Intermediate ie: able to ski blue runs Skilled but not expert ie: able to ski black runs Describes self as expert Unable to obtain information Not applicable ie: indoors Ability (skill level) is in the opinion of the patient. It is generally best to explain the range of options and let the patient rate themselves. The purpose of the following two categories (lessons and days skied) is to help investigator establish a level of familiarity with the ski area and terrain, and determine recent skiing history. Never This year _ yrs ago Lessons Has never taken an organized ski / snowboard lesson Has had a lesson this season Has had lessons before this season, note how many years ago Days Skied This Year At How many days has patient skied/ridden this year? At this area: At all areas: The intent is to discover recent skiing/riding history, and determine if the skier/rider is familiar with this particular ski area and overall skiing/riding days this year at all areas visited. How many times has the patient skied/ridden this run/lift before? When? Has the skier/snowboarder skied this particular run, or ridden this lift before? If so, how many times, and how recently? In an investigation, this will help to determine if local knowledge and familiarity are a factor. Owned Area rental Other rental Area demos Other demos Equipment Property of the patient Equipment rented from this ski area Equipment rented from a source other than this ski area Equipment being used for evaluation or demonstration Equipment being used for evaluation or demonstration from a source other than ski area Unable to obtain information Not applicable ie: indoors..12..

13 Note that there is space to record the boot and ski or snowboard numbers for further investigation by the rental shop. There is no space to record the DIN settings of the bindings. To read these settings properly, the technician should be trained by the manufacturer of the equipment. An investigator may wish to record the DIN settings of equipment and should use a trained technician to do so. Their report may be attached to a detailed investigation. Rental equipment must be tagged and secured for post incident testing and examination. Make sure that you are aware of your resort s procedures for this. All rental equipment is to be retuned to the rental shop as soon as the patient is cared for and released. Where bindings are intended to release in a fall, their function will be part of the post incident investigation. Owned Rental None Helmets This space is to record whether the patient was wearing a helmet and who the owner of the helmet was (patient / rental). None Left only Right only Both Pre-released Binding Release Neither binding released Only left binding released Only right binding released Both bindings released One or both bindings released before the accident. If a pre-release does occur indicate which binding either the L or the R released Unable to verify if bindings released as they were intended to Binding was not intended to release ie: snowboard General Incident Information Involvement Recreation skiing/riding Normal recreational activity Recreation jumping Intentional air time (may also be comp. if so check both boxes) Competition Active competition ie: racing Training Training activities related to competitions In lesson (circle SB/Ski) Incident occurred during an organized ski/snowboard lesson Tube slide On the sliding portion or walking to a tube lift but not the lift itself Unable to ascertain involvement due to injuries Other: Involved other activities ie: indoors or involving staff..13..

14 Did the patient collide with a person or object? Yes No Collision If yes, describe This section is used to describe if the patient collided with another person or object. Please describe who and / or what the patient collided with. If lift related, check all that apply i.e. Struck by chair, Fell while loading etc If not a collision, what was the primary cause of the incident? Non-collision: Fall - skier lost control Fall - caught an edge Fall & struck by own equipment Fall - jumping Fall - change of conditions Fall - change of terrain Near collision with Prior medical condition Skied off trail Equipment failure (not binding) Binding pre-released Hit by other s equipment Lift Related Clothing caught on lift Fall while loading Fall after unload Fall from lift Jump chair lift Injured by restraining bar Struck by chair Non-skiing related Slip & fall (non skiing) Cold/weather related Not otherwise classified Other: If the incident was not caused by a collision please indicate what the primary cause of the incident was. To or From First Aid Station From First Aid indicates mode of transport for those areas with on mountain or mid mountain first aid facilities where the patient must be transported a second time by the ski area to their destination. To First Aid Walk/Ski Toboggan Snowmobile Helicopter Download On-hill Other Patient walks, skis or snowboards to (from) first aid station. Circle walk if they walked or ski if they skied or snowboarded. Transported to first aid by toboggan Transported to first aid by snowmobile Transported by helicopter Downloaded on chair or gondola Patient was treated at the site Patient refused treatment Private Car Taxi Company Ambulance Bus Helicopter Walk/Ski Other From Base Departing in a private vehicle or taxi Transported in a vehicle owned by the ski area Transported by ambulance Attending ambulance number and code Leaving by bus either charted or scheduled Transported from base (or on hill) by helicopter Patient walks out or returns to skiing..14..

15 Home Doctor Hospital Clinic Hotel Return To Ski Rest Other Destination Patient left to go to a private residence Patient was going to see a particular doctor (family physician) Going to hospital or emergency room Name of facility enroute to Going to a private or public treatment facility Commercial accommodations Patient returning to skiing / boarding Patient intends to rest Patient did not advise their intentions Personnel Involved The number space appears for convenience of those areas using Patrol numbers, it may also be used for Time on Scene, or any other information you find useful. Please PRINT and make sure the names are recorded legibly. Patrollers # 1 st # 2 nd # 3 rd # Form completed by (print) # Signed: / / mm / dd / yy It is important that the Patroller completing the form print legibly and sign his or her name and date the form. The form MUST be complete and legible. This form may be entered as a Legal Document in the event of a legal dispute regarding the incident. The completing Patroller may be called upon to give evidence as to the information contained in the form and his or her involvement with the incident. It is important the Ski Area's Legal Counsel be able to establish who recorded the information on the form. If patrol numbers are used to identify patrollers, a record showing a correlation between the names of the member and their ID numbers shall be provided to the area

16 Resort/Ski Area NATIONAL SKI AREA ACCIDENT REPORT Accident Number: Season (year1/year 2) 20 /20 Report Number Incident Date / / mm / dd / yy Incident Time (24 hr) : hh : mm Name Visitor Local Accommodation Info Home Address City Prov Postal Code Patient Witness Complaint nditions Location 1 st Aid Phone ( ) - Date of Birth / / mm / dd / yy Age Gender Male Female Height ft/cms Weight lbs/kg If patient is a student, is he/she participating in a school ski program? Patient Type Guest Staff-Off Staff-Work Yes No Ticket Type Day Ticket Multi-Day Ticket Season Pass Other Pass Not Applicable Occupation/School Group Patient s Description of Incident Signs and Symptoms as recorded by Patroller/Doctor Signed: Patient Parent Guardian Patient/Guardian to initial here if treatment is refused: Recurrence of previous injury? Yes No Allergies None Medications None Related Medical History None Time of last meal: Drugs/Alcohol: Circle or mark L for Left, R for Right and B for Both, mark all that apply Treatment Protocol L R B Foot L R B Lower Ab L R B Upper Arm Upper Back L R B Ankle L R B Upper Ab L R B Elbow Lower Back Fracture Dislocation Internal L R B Lower Leg L R B Chest L R B Lower Arm Tailbone Sprain Cardiac Illness L R B Knee L R B Neck L R B Wrist Head Strain Stroke Deceased L R B Thigh L R B Clavicle L R B Hand Face Bruise Concussion L R B Hip L R B Shoulder L R B Thumb Medical Laceration Hypothermia L R B Finger No injury Frostbite Other injury If multiple, note primary injury: Other treatment: At Scene On scene : Transported: : hh : mm hh : mm Medication administered: Base/Clinic In : Out: : hh : mm hh : mm : by: hh : mm Witnessed By Witness Name Phone Accompanied By Collided With ( ) - Other: Home Address City Prov Postal Code Witnessed By Witness Name Phone Accompanied By Collided With ( ) - Other: Home Address City Prov Postal Code Run Map/Grid Coordinates Exact Location How many days has patient skied/ridden this year? Weather Clear Light Sharp Incident Location Marked Run Freestyle Terrain Terrain/Rail Park Competition Terrain Half Pipe Out of Bounds Park Feature/Hit: Closed inbounds Off Trail Lift Incident Premises Run Classification Easiest More Difficult Most Difficult Extreme Are drugs or alcohol suspected to have contributed to incident? Yes No At this area: At all areas: How many times has the patient skied/ridden this run/lift before? Temp (C) Above10 Snow (cms) No new Surface Groomed Equipment Owned Binding Release Activity Alpine Snowboard Telemark Nordic Touring Tubing Non-skiing Other: When? Rental Boot # Additional F/A info attached Involvement Recreation skiing/riding Recreation jumping Competition Training In lesson (circle SB/Ski) Tube slide Other: Ability Beginner

17 Overcast Snowing Raining Fog Flat Whiteout Lights Dark Did the patient collide with a person or object? Yes No To First Aid Walk/Ski Toboggan Snowmobile Helicopter Download On-hill Other From Base Private Car Taxi Company Ambulance # Bus Helicopter Walk/Ski Other 0 to10-10 to 0-20 to -11 Below 20 0 to 5 5 to to 15 Over 15 If yes, describe Destination Home Doctor Hospital Clinic Hotel Return To Ski Rest Other Moguls Powder Variable Granular Hard Patrollers/Cert# Area rental Other rental Area demos Other demos 1 st # 2 nd # 3 rd # None Left only Right only Both Pre-released Rental Ski # Helmet Lesson Owned Rental None Never This year _ yrs ago If not a collision, what was the primary cause of the incident? Non-collision: Fall - skier lost control Fall - caught an edge Fall & struck by own equipment Fall - jumping Fall - change of conditions Fall - change of terrain Near collision with Prior medical condition Skied off trail Equipment failure (not binding) Binding pre-released Hit by other s equipment Novice Intermediate Advanced Expert Lift Related Clothing caught on lift Fall while loading Fall after unload Fall from lift Jump chair lift Injured by restraining bar Struck by chair Non-skiing related Slip & fall (non skiing) Cold/weather related Not otherwise classified Other: Form completed by (print) # Signed: / / mm / dd / yy..17..