Smarter than the average bear

  Emergency department discharge disposition

Emergency department discharge disposition

The word “bear” is derived from the old English word bera, which belongs to a family of names for bears originating from an adjective meaning brown. In Germanic culture, the bear symbolized the warrior. Bears are found in ancient literature, folk songs, mythology, legends, children’s songs, cartoons, on the shelves of your local toy store, or in the hands of a postoperative cardiac surgery patient to encourage coughing and deep breathing. In Chicago, IL, the Bears are the “Monsters of the Midway” and have a black bear as their team mascot. Smokey the Bear (another black bear) warns us of the hazards of forest fires; Yogi Bear (a grizzly) thinks that he is smarter than the average bear; and the Coca-Cola bear (a polar bear) encourages consumers to drink a well-recognized carbonated beverage.

Eight species of bear exist throughout the world.* Bears have lived in the wilderness of all continents except Australia at one time or another, and they are one of the most widely distributed terrestrial mammals on the planet. North America is home to three species of bear, including the black bear, the brown bear, and the polar bear. Each species has unique characteristics and appearances, but all are subject to the misconception that they exhibit predatory behavior toward humans. In fact, people are more than a hundred times more likely to be killed by bees in the U.S. than by a black bear.†

Bears may look like large versions of teddy bears; however, they are wild animals. The overwhelming majority of unplanned encounters with bears should not provoke an attack unless you get between them and their food, a sow and her cubs, or startle them with a surprise encounter, especially in remote areas where they sense that you are encroaching on their territory.†

In order to examine the occurrence of bear-related injuries in the National Trauma Data Bank® research dataset for 2010, admissions records were searched using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Specifically searched were external cause of injury E codes E906.8, other specified injury caused by animal (butted by, fallen on, gored by, run over by, stepped on), or E906.5, bite by unspecified animal. A total of 1,935 NTDB records were found to contain the subset of bear injuries. In all, 1,705 records contained a hospital discharge status, including 1,513 discharged to home, 86 to acute care/rehab, and 87 sent to skilled nursing facilities; one died. These patients were 61 percent male, on average 39.8 years of age, had an average hospital length of stay of 4.1 days, an average intensive care unit length of stay of 3.6 days, were on the ventilator for an average of 5.2 days, and had an average injury severity score of 9.4. Emergency department disposition has more than 40 percent of patients either going to the operating room or the intensive care unit (see figure).

When hiking, it is advisable to stay as far away as possible from remote areas that may be natural bear habitats. There are commercially available bear sprays one can carry that are red pepper-based, shoot more than 20 feet, and have been known to repel a bear attack. However, if an individual encounters a bear, it is a good idea not to run, as bears are capable of chasing you at greater than 25 miles per hour. If the bear comes within 10 feet of an individual, experts suggest lying face down on your stomach with your hands over your neck and playing dead. It is important to remember that as humans we may think that we are smarter than the average bear, but the best rule of survival is to avoid an encounter in the first place.

Throughout the year, we will be highlighting data through brief reports in the Bulletin. The National Trauma Data Bank Annual Report 2011 is available on the ACS website as a PDF file and a PowerPoint presentation at In addition, information is available on our website about how to obtain NTDB data for more detailed study. If you are interested in submitting your trauma center’s data, contact Melanie L. Neal, Manager, NTDB, at

Statistical support for this article has been provided by Chrystal Price, data analyst, NTDB.

*National Geographic News. Most endangered bears ranked. Available at: Accessed February 27, 2012.

†Lovgren S. Recent bear attacks are “freak occurrences,” experts say. National Geographic News. Available at: Accessed February 27, 2012.

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