Would You Know What To Do? We learn about common trail injuries and how to treat them.

by
January 12, 2018

It’s a regular topic of discussion: which kit should you take on a ride? And the closely related: which kit do you take on a ride. Here in the office we pretty much fall into two camps: the ‘it’ll be fine, it’s only a short ride, I’m not far from home/the car’ group; and the ‘I might just need that layer, and those dry gloves, and that’s my food, and that’s my emergency food’ camp. Needless to say, one lot thinks the others are a bunch of worriers, and one lot thinks the others are a bit irresponsible (and worry that they’re going to come a cropper).

first aid
This handy sling technique disables both arms and Robot James.

As Chipps is an actual qualified guide, he’s required to keep a current first aid certificate in order to maintain his certification. Since Chipps was going to need to renew his first aid training, a few of us thought we might as well join in and sign up too. Perhaps we’d learn a few useful things, and maybe we’d come out of it with a more informed perspective on what we should be carrying in our bags when we head to the hills. Richard from RCS Training and Consultancy, who also volunteers for our local mountain rescue service, came along to give us a couple of days of schooling.

The Pupils

  • Amanda Wishart – Has a casual approach to crashing, currently nursing a broken finger.
  • Andy Pigg – Fell runner and occasional mountain biker. Sensibly cautious and responsible.
  • Beate Kubitz – Endurance pedaler with a tendency to use her face as a brake.
  • Chipps Chippendale – Qualified guide, so he ought to know what he’s doing.
  • Hannah Dobson – Cautious, with a good line in steri-strip self repairs.
  • James Love – Getting more responsible since he dislocated his shoulder (again).
  • Ross Demain – Serial crasher. Wears broken ribs like a badge of honour.

The Course

We had a two day course – day one spent in our (FREEZING) studio learning about different medical conditions we might encounter, some methods for treating them, and some means of dressing injuries. There were lots of acronyms that are meant to help you work through any situation you might encounter in a methodical name. If you can remember them. Which is the point of training – doing things over and over, you will eventually get to a point where you click through the steps, even when adrenaline tries to derail you from rational thought. Day two was spent at Havok Bike Park giving us a bit of a taste of the real world – complete with fake blood, smoke, and grotesque prosthetic injuries. It’s amazing how a bit of drama makes it easy to forget what you’re supposed to be doing. OH LOOK, THERE’S SOMEONE WITH A STICK IN THEIR LEG, QUICK, HELP! Oops, we forgot to block the trail and another rider has just ridden along and crashed right into us…now we have multiple casualties.

Havok snow
Thanks to Havok for giving us a chance to try techniques out on the trail.

Here’s a brief list of some of the things we covered:

  • Symptoms and treatment of:
    • Heart Attacks
    • Anaphylactic Shock/Allergies
    • Asthma
    • Angina
    • Hypothermia
    • Diabetes
  • Assessment and treatment of the cuts, breaks, and other injuries you might find out on the trail.
  • How to use a defibrillator.
First Aid injury
We got to experience first hand just how little difference a foil blanket makes – quite a surprise.

We’re not going to try and give you a step by step guide to how to deal with different scenarios – you need to go on training for that. But we will try and give you an idea of the things that surprised us, and the things that made us think ‘well, I’m glad I learnt that’ – and then maybe you’ll be persuaded to invest a little time in learning some first aid skills too. You never know when they might come in handy.

Lessons Learnt

Amanda

How good did you think your first aid knowledge was before the course?

I was naïve enough to believe that I could cope in a crisis despite the fact I have never had CPR training or been given any educated advice on dealing with open wounds, breaks, concussion… I’m one of those people that likes to hope for the best and assume that everyone else will know what to do, but this course was the wake up call I needed because that is such a dangerous attitude to take out on a ride.

How well prepared did you think you were with the kit bag you usually carry?

I didn’t consider it risky that I would head out with no first aid kit, it just wasn’t something that ever crossed my mind. I’ve had a couple of serious crashes myself and I have had friends injure themselves badly during rides, yet I still didn’t think I needed to prepare for the worst. I realised during this course that I like to rely on everyone else to be prepared. Not just for first aid but for spare tubes, tool kits and any other basic items I should be carrying on longer rides. I’m not proud of this!

first aid
The orange blizzard jacket/chocolate orange wrapper was very effective at keeping you warm.

Three lessons that stood out for you? 

  • The CPR training was a huge eye opener for me. It’s nothing like the movies, it’s physically challenging, exhausting, takes your full concentration and there’s more to it than the chest compressions and rescue breaths. The thought of having to perform CPR whilst dealing with other injuries or being out in the elements is quite terrifying and although I hope the occasion ever arises for me, I’m grateful to be more prepared for it.
  • How quickly your body temperature drops was also a shock. We did this training in winter and were wearing more than we would have on a ride, yet a couple of minutes of inactivity left us unbearably cold. I will never be heading out for a ride without having an extra layer in my pack, and for the longer rides I will be purchasing one of the shelters we used during the course.
  • I was interested to learn the reaction you could get from a diabetic low on blood sugar. I personally have snapped at people, got very grumpy and become stubborn during rides when I haven’t prepared properly, but I thought it was just a bad trait and not related to my insulin resistance/pre-diabetes! Knowing how to read that reaction could be the difference between helping someone and leaving them to fend for themselves, thinking they just have a bad temper.
First Aid injury
Would you be prepared for this? Note the unsavoury paparazzi photographer!

Any extra kit you’ll be carrying in future or going out to purchase?

I have already started to take an extra layer out with me, and I plan to buy a shelter. The items I would now consider essential for longer rides are a dressing, bandage, foil blanket/shelter, and for myself some emergency sugar!

Andy

How would you have described your first aid skills?

My knowledge was admittedly pretty poor and my thought processes were “hopefully there will be someone around to take charge” anything bad goes down.

What was your approach to kit carrying?

I’ll certainly be reviewing the first aid kit I have. This is for use with my running group and will perhaps cover a sprain. The most obvioius things that happen around me are falls and cuts although a few weeks ago at the beginning of cold snap I did seem to encounter an epidemic of winter diseases. I’ve always thought most important kit is a tenner for a taxi!

first aid
Learning to do CPR. Perhaps he should have risk assessed that heater before he started?

Any particular lessons learnt?

  • Isn’t resuscitation hard work?! Like most things it technique, technique, technique but if there are more of you that’s better.
  • I’ll be much more confident having done the course and that’s something I’ll take with me. It’s a process, I’ll need to continually revise my DRSABC to try and ask the right questions and spot the tell-tale signs.
  • Also learnt how cold Singletrack towers sudio annexe is and what its like to be in a pre hypothermic state!

What will you be adding to your kit bag in future?

A big trianglar bandage and something better than the foil sheeting I currently have.

Beate

How good did you think your first aid knowledge was before the course?

Vague and not sure what the latest thinking was as I haven’t done a course for over 20 years and advice changes.

How well prepared for rides did you think you were?

OK for training rides in Calderdale where the risks are cuts and scratches, but nothing more serious.

First Aid injury
Beate with a nasty looking injury!

Three lessons that stood out?

  • Anything is better than nothing – warmth and reassurance can really help.
  • You do still put people in the recovery position.
  • Check for other medical conditions.

…Oh and a *lot* of acronyms

Any extra kit you’ll be carrying in future or going out to purchase?

More comprehensive first aid kit with some dressings, a triangular bandage and a better survival bag/shelter, for longer rides or rides with lots of people.

First Aid injury
Learning to treat people while inside a shelter was useful.

Chipps

Did you have much to learn?

​I’ve done the course before, three years ago. However, I was amazed how much needed reinforcing. ​

What do you usually carry? And is it up to scratch?

My guiding pack I reckon is pretty sorted (though there are a couple of extra things going to be going in soon…) but my mini-First Aid kit that I carry on ‘normal’ rides could probably do with a bit of a refresh. I also need to always make sure that things like my spare beanie, mid-layer, armwarmers and waterproof don’t go wandering if I’ve used them. ​

Things you’ll be adding to you kit bag?

Probably a trauma bandage for extra-big wounds and a Blizzard jacket​. After my last guiding course I also bought tick tweezers and a resuscitation mouthguard.

First Aid injury
Does this count as an extra big wound?

Hannah

Any past first aid experience?

Once upon a time I used to be a lifeguard, so I thought my knowledge was probably better than the average person in the street, but likely to be a bit dated. I’ve never had cause to do CPR, but I did find myself dealing with someone’s severed artery quite recently. They didn’t die, and their hand didn’t fall off, so that was quite a success.

Are you usually a kit carrier?

I came to mountain biking from fell funning, where there’s a good culture of mountain craft and being ready to look after yourself and others if they need it, so I always ride with an extra layer of some sort. I carry a first aid kit on most rides, but I wasn’t really sure what I’d do with it if faced with something beyond the remit of steri-strips.

First Aid injury
Argh! That stick should not be there!

Three things learnt…

  • How to use an epi-pen. Since I have children who have friends with epi-pens, this is probably the most likely to be a true life saving skill I might need some day.
  • My insistence on carrying an extra layer is justified. Who knew you can get hypothermia when it’s hot? Once you think about it – the body’s natural temperature is 37°C, even a drop to 35°C will have you shivering and on the way to problems – it’s fairly obvious that even on a hot British summer day of 28°C you could still get hypothermia if your body isn’t able to generate heat.
  • Chest puncture wounds are scary. I’m going to be a lot more careful riding in the woods in future. I’d rather deal with almost any other scenario than a chest puncture wound – getting the first aid right is hard, but doing it right really can make a massive difference to the prognosis. That’s a lot of pressure on a first aider.
First Aid injury
Most injured riders do not land on a thermal mat, and will get cold quickly.

Kit changes…

It turned out that my off the peg mini first aid kit I’ve been carrying around wasn’t that useful. I’m going to return to my original dry bag first aid kit, and to my kit of choice (merino base layer, steri-strips, pain killers, tape, sanitary towel, tick tweezers, emergency blanket) I’m going to add a triangular bandage and a gauze bandage. I’m also going to invest in a trauma bandage and a SAM splint. They’re going to slot into the back of my back pack, where hopefully I can forget that they’re there and never need them. But they’re not heavy or bulky, and if I need one, I’ll be very glad I had them. I’ll probably look out for a small two man shelter too – they’re so much more effective and versatile than my foil blanket.

First Aid injury Sam Splint
A Sam Splint – handy for stabilising breaks.

James

What did you think you knew?

I had some first aid knowledge having completed a course 3 years ago…however without regularly practicing 1st aid since that course and not being in any situations where it was required I was intrigued to see what had been retained and what would come back when needed.

How good do you think your usual kit bag is? 

I was woefully underprepared, carrying no dedicated 1st aid kit & nothing useful.

Three lessons that stood out for you?

  • Don’t panic…stay calm, remember your training/lessons learned and be methodical and observant
  • Be prepared – carry some first aid supplies
  • Having been on and completed a first aid course three years ago, I was pleasantly surprised that many skills were remembered

Any extra kit you’ll be carrying in future?

A basic/tweaked small first aid kit with addition of military dressing and fabric for sling, tailored for local rides and bigger days out as necessary.

first aid
It’s easy to forget what to do in the drama of a scenario.

Ross

(Ross was poorly so didn’t do the second day of the course, but he still learnt stuff in one day)

Did you think you have much to learn?

I thought I had reasonable knowledge prior to course. I had a done a basic first aid course about 18 months prior so knew some of the basic stuff. CPR, recovery position, heart attack. Couldn’t really remember slings and things.

first aid
Defibrillators are designed to be easy to use even if you’ve never used one before, but it’s good to have had some training.

How well prepared you thought you were with the kit bag you usually carry?

Not prepared at all! Always end up relying on the fact that someone else will be prepared and have a first aid kit with them.

Lessons that stood out for you:

  • Learnt how to help / bandage people that had been skewered with stuff.
  • Learnt about collapsed lungs and air in chest cavity that I didn’t know about

Any extra kit you’ll be carrying in future?

I will be investing in an actual first aid kit for big days out.

What Can You Do?

Think About Things A Bit

It’s all too easy to think ‘It’ll never happen to me’. But it’s easier than you think to get hypothermic – you don’t even have to crash for things to go downhill pretty quickly if the wrong combination of mechanicals, kit and weather strikes. And what if you came across someone who needed help? They’ve been lying there injured for an hour or so and you are their best hope of survival – knowing just a little of how to help them might make you feel an awful lot better. Would you have enough kit with you to allow you to safely stop and help them without you ending up as a second hypothermic casualty? Even if you usually ride trail centres and are rarely in the wilderness, being able to do 20 minutes of CPR while someone drives a defibrillator up the fire road could save a life. You don’t need to be a fully qualified paramedic – just a little knowledge of what to do (and what not to) could go a very long way. And being able to do something is always better than just standing around hoping that someone else will say ‘Trust me, I’m a doctor’. Going on even a basic first aid course might help you feel a lot better about dealing with an emergency situation.

Carry Kit

There’s little point in carrying a specialist chest wound dressing if you don’t know how to use it, but there’s still merit in carrying something clean to staunch blood should you need to. A cheap emergency dressing option is a sanitary towel (which come conveniently wrapped in their own packaging), but you’ll need tape of some kind to hold it in place. Plasters might be easy to carry, but the chances are anything that can be fixed with a plaster isn’t likely to be a ride-ending injury.

It’s not just first aid kit that could save you – something to keep you (or someone else) warm in the event of an injury or mechanical could do wonders to stop a minor issue becoming a major one. A hat, a windproof and waterproof layer or even an emergency shelter tucked in the bottom of your pack could all come in very handy.

Know How To Get Help

If you’re not prepared to go on a course to learn how to administer first aid, you should at least make sure you know how to get help to you should you need it. (In the UK) Calling 999 or 112 will work if you have a signal of any kind – you don’t need to be within range of your carrier to make an emergency call. Obviously, knowing where you are will hugely help the emergency services in finding you. There are phone apps that can give you an OS grid ref, and knowing how to pinpoint your location on a paper map is always going to help.

If you text ‘Register’ to 999 you will be able to set up your number to send a text message for help should you need it. Since your phone may well be able to send a text even where there’s an intermittent signal this is well worth doing. Send that message to register now, before you read any further. Go on, do it!

Know Where Your Local Defibrillators Are

There are an increasing number of defibrillators (known as AEDs – Automated External Defibrillators) around, in places like supermarkets, community centres, train stations and all sorts of publicly accessible places. They’re designed to be easy to use – they’ll generally issue step by step instructions to you. You don’t need to have had any training to use one (although knowing what to expect will probably help with the panic levels should you need to deploy one) and they can make a massive difference to someone’s chances of survival. CPR will help a bit, but if you want to see Baywatch style coming back to life, then a defibrillator is what you need. Many (but not all) are listed on Heartsafe and a 999 operator should be able to advise you of where the nearest one is. Remember to call 999 before you start attempting to resuscitate anyone.

Go On A Course

There are first aid courses all over the place – your workplace might even offer one for free. The training we did was specifically geared to the outdoors, where an understanding of access difficulties and cold risk are especially important. There’s a good chance your local mountain rescue service offers or works with a training provider. Why not get in touch and organise a different sort of MTB skills day with your mates? You’ve probably thought about learning how to jump, or tackle drops – why not learn a bit about what to do if they go wrong?

Our thanks to Richard from Remote Care Skills from Halifax for our course. We can pass on his details if anyone’s interested.

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