Life on aKnife EdgeCasualties from Crib Goch & Tryfan in Snowdonia

Dr  Nick  Brazel    Clinical  Fellow  in  EM/PHEM

Dr  Linda  Dykes  Consultant  in  EMYsbyty  GwyneddBangor,  Wales

Objectives & Background Crib Goch (a knife-edge ridge) and Tryfan (mountain) in Snowdonia National Park (SNP), are among the most popular Grade 1 scrambles in the UK. Tragedies on these routes attracts media attention: whilst it is popularly perceived that most of Snowdon’s trauma fatalities occur on Crib Goch (they don’t) there has been a recent spate of high-profile casualties from Tryfan’s North Ridge. We wished to ascertain whether Crib Goch really is more dangerous than Tryfan.

MethodsWe interrogated our database of mountain casualties brought to our hospital following contact with rescue services 2004-2014: most of SNP lies within our ED catchment area. Mountain usage estimates were obtained from SNP (Crib Goch 14,700 & Tryfan 60,000/yr). Comparative risks of death from different activities were obtained from the UK Health & Safety Executive website.

Results•Of 1187 entries to the database over the 11-year study period, 109 incidents (9%) occurred on Tryfan, 38 (3%) on Crib Goch.

•The average age of casualties was the same (40 years) though more males required assistance on Crib Goch (76% cf. 61% of Tryfan casualties).

• Mechanism of injury on the two peaks is approximately the same, with slips being the commonest followed by tumbling falls & direct falls from height.

• 3/109 (3%) of Tryfan casualties died (two had unsurvivable injuries following major falls, the third died of medical causes), cf. 4/38 (11%) on Crib Goch (three deaths from unsurvivable injuries, and the fourth from acute MI).

Conclusion About four times as many people climb Tryfan for every one traversing Crib Goch, but the ratio of Tryfan: Crib Goch casualties is nearer 3:1 and there are proportionately more fatalities on Crib Goch. Mechanism & patterns of injury are comparable, but Crib Goch’s reputation for danger has some merit.

Nevertheless, the vast majority of climbs are completed without serious incident: only around 1:6,000 Tryfan users (1:4,000 Crib Goch) end up in hospital (alive or dead!). The risk of death traversing Crib Goch is approximately five times more than climbing Tryfan (which is about is as likely to kill you as a single scuba dive), but still five times less likely to kill you than having a baby. Obviously, numbers are small and our risk extrapolations only illustrative. These tourist “honeypot” mountain destinations deserve to be treated with respect but serious incidents are very rare, and sensible precautions (adequate kit and checking the weather forecast) minimise the risk to what most people would regard as acceptable.

Head Upper Limb Lower Limb

Tryfan 33% 28% 63%

Crib Goch 28% 26% 58%

www.mountainmedicine.co.ukPhoto courtesy of Anthony Eccles