• This topic has 38 replies, 30 voices, and was last updated 13 years ago by DrP.
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  • What should you do when someone knocks themselves out…?
  • lyons
    Free Member

    As above really, a friend of mine had a crash today, and was unconsious for a brief period. He then came round, with a few cuts and bruises etc, but couldnt remember where he was, or what had happened. He’s being treated in hospital now, and I believe we dealt with it ok, but was wondering what the professionals would do?

    Rusty-Shackleford
    Free Member

    Rifle through their wallet.

    alexxx
    Free Member

    personally I’d take his car keys out of his pocket and drive him to the hospital in your newly acquired car that he didnt remember giving you as a gift

    rOcKeTdOg
    Full Member

    make sure their underwear is on the right way round when they come round 😉

    CaptainFlashheart
    Free Member

    *Misreads title as “What should you do when someone knocks one out…?”*

    *Suggests passing them a tissue*

    *Realises mistake*

    *Shuffles off quietly*

    mandog
    Full Member

    as long as no neck or back damage put him in the recovery position?

    DrP
    Full Member

    Good question…
    The principles of ANY emergency are A,B,C:
    A- Airway – make sure they haven’t ‘folded’ their neck and occluded their airway. Gurgling sounds/no sounds are bad!
    B- Make sure they are breathing (once A is secure)
    C – make sure they have a pulse..

    Essentially, in a KO, the main issue will be with the airway, so making sure they have a clear airway will be paramount… i.e. recovery position, or lifting their chin up.

    DrP

    project
    Free Member

    Ring NHS DIRECT and say hes got a pain in his arm and chest pain. 😮

    Rob his bike,

    Leave him there get to the car plug the laptop in and sign onto Singletrack and ask us what to do, pick the best answer, and run with it then touch base.

    crikey
    Free Member

    i.e. recovery position, or lifting their chin up.

    I typed out a similar answer then thought about cervical injuries….

    I think the best and most productive thing you could do in this situation is get some recognised First Aid training.

    RealMan
    Free Member

    Switch their brake levers.

    crikey
    Free Member

    On a similar but related note, an acquaintance of mine turned up at my house and said:

    ‘I found a bloke who commited suicide today; he took all his clothes off and swam out into the lake’

    ‘ What did you do?’ says I.

    ‘Pinched his fags; I thought he’d given up…’

    ourkidsam
    Free Member

    cervical injuries

    Didn’t know that had another meaning!

    zangolin
    Free Member

    As DrP says A-B-C.
    If they aint breathing then thats the priority over any suspected broken parts.

    I would however add before ABC check you are both safe from other riders hurtling down the trail – no good ending up as casualty number 2. Send a lookout back up the trail or if solo put something to warn other riders of your location. If in a group worth getting someone to phone/call/fetch help as you are treating.

    It’s also worth spending a few quid + doing an outdoor emergency 1st aid course of some sort.

    DrP
    Full Member

    Thinks of Futurama:
    “is there a doctor in the house?”
    “I’m a doctor of philosphy..?”
    “You’re a doctor of squat!”

    DrP

    theotherjonv
    Full Member

    What the Doc and Xangolin said, but also Step 0 – don’t panic.

    Make sure you aren’t in danger yourself.

    Try speaking to him. Is he really knocked out or just lying there collecting thoughts.

    If no to both above, then ABC. But like I said, don’t panic. Don’t straightaway start wrestling him about; get your ear close to him and see if you can hear him breathing, or his warm breath on your cheek. Is he losing colour / lips going blue? You have plenty of time to assess this before starting to worry about maintaining an airway actively. But then, if he doesn’t have an airway then he will die so you have to deal with that before worrying about other problems.

    But then can you do that while maintaining a good neck / spine alignment in case.

    Worth doing a first aid course, basic first aid like this could come in useful in all walks of life.

    missingfrontallobe
    Free Member

    First aid training, ask to be taught the jaw thrust technique, which can be used to maintain an airway if concerned about neck injuries.
    Can only be used on a patient lying on their back though, which isn’t really likely to happen………

    I dealt with a similar situation once in Grizedale Forest, a rider came down on a wooden bridge (in those days before all wooden items seemed to be chicken wired!) KO’d himself, no recall at all of the days ride. He got himself up quite quickly, but the main problem I had was getting his responsible adult to take him to hospital, the amnesia & KO were not nice, and the RA was sort of just “I’ll take him home”, 90 miles away, and I was no, risk of head injury, get him seen, long story short he eventually went to Kendal hosp who transferred him to the neuro unit at Preston – stayed there for three days.

    lyons
    Free Member

    thanks, i would like to do a first aid course… What kind of course would be best?

    hora
    Free Member

    Recovery position

    Is that after the doggie and then the missionary position?

    djglover
    Free Member

    A danger ****

    TooTall
    Free Member

    Hazard – is what injured them still a hazard? Will I be injured?

    Response – shouting at them / pinching the skin getting a response?

    Airway

    Breathing

    Circulation

    I bet a few others know their H R A B C almost as well as AVPU!

    monkeyp
    Full Member

    HRABC?

    I was taught DR ABC – seems easier to remember, but horses for courses,

    Danger
    Response
    Airway
    Breathing
    Circulation

    As for which course – see if your employer will pay. Ours is excellent with full first aid, airway management, defib etc etc all taught by an ex paramedic who will cover just about anything we want him to including dealing with children. The red cross course is OK, but to be honest we have found a lot of it is out of date with current thinking especially with regards to resuscitation.

    TandemJeremy
    Free Member

    I think my most recent update I was taught H R A B C but I have also bee taught another set of initials for dealing with emegancies 😕

    I have been told that the Ski patrol guys do very good first aid course. More about patching folk up out in the wilds rather than grannies having heart attacks in shopping centres. So a bit more relevant to stuff we do.

    bassspine
    Free Member

    I keep up my first aid qualification for work…I did an outdoor/adventure first aid course 6 months ago. We were told that its gone from DR ABC to just DR AB – that caused some argument!

    (the st johns ambulance theory is that many people were failing to detect a pulse when there was one present)

    RealMan
    Free Member

    I can’t who was telling me this, but there was a guy who crashed on his road bike quite seriously, paramedics came out, and they were struggling to check his pulse (think he was really wrapped up). One of the the guys who was riding with him just pointed out that he had a heart rate monitor on.

    Worth remembering as a lot of cyclists do use them I think.

    bassspine
    Free Member

    One of the the guys who was riding with him just pointed out that he had a heart rate monitor on.

    good point 🙂

    igm
    Full Member

    The ABC variants and very little else – easy to make injuries worse.

    That said the best injury (for comedy value) I ever saw was a rugby compound leg fracture caused by two defenders tackling a guy at the same time.

    Where the comedy you ask?

    Well, as he went down his support was very close, and the guy actually tensed up with his hand round his support player’s genitals – and we couldn’t free him

    Every time the injured player was touched, for example to put a blanket over him, the other guy screamed.

    It wasn’t until the paramedics arrived with gas and air (and possibly something stronger) that the support player could be detached.

    By this point the remaining 28 players, having laughed themselves silly for 45 minutes, couldn’t be bothered playing on and retired to the bar.

    Technically no one got knocked out in this story – but it did happen, I was there.

    devs
    Free Member

    I bet a few others know their H R A B C almost as well as AVPU!

    Yip. Drilled in every year for 23 years. Did the BASP course this year. It’s excellent and I highly recommend it. They say danger rather than hazard but they also have a little mnemonic “no wires, no fires, no gas, no glass” which I quite like.

    poly
    Free Member

    In theory it shouldn’t matter which organisation teaches you as they all work to the same European Resuscitation Council Guidelines. However the guidelines do change from time to time and, especially with larger organisations, it takes time to roll out those changes to everyone who is training. In reality the changes from year to year are unlikely to have any definitive difference on the outcome for an individual casualty that it makes no difference which you learn.

    I’d support what TJ said about the Ski Patrol course being more appropriate than the average Red Cross / St John / St Andrews course. That said there are some people at the British Red Cross who run specialist outdoor first aid courses but you’ll need to hunt them out. There are also a number of outdoor centres who run first aid courses specific to the “outdoors” which are likely to be appropriate. The problem is – whilst everyone really should do some training, the “outdoor specific” courses (both commercial and “charity”) are usually 2 days which is a big ask for the average biker who never expects to use it and has no “specific responsibility”. You can probably learn most of what you want to know in half a day. Jaw thrusts etc are all very well but there actually not easy to do effectively and the first time should probably not be on a mountainside – unless you are going to practice things like this then its best to stick to the basics – DR.ABC as suggested, resus if required, recovery position, and the basics of controlling blood loss through pressure and elevation and stabilising/imobilising a fracture and spotting and dealing with hypothermia.

    In general I’d say there is a wrong emphasis on the use of Mnemonics within First Aid Training which is about getting people quickly through exams not about actually understanding. Its also not uncommon for “First Aid Instructors” to have actually done very little real life hands on “first aid”, which is another reason that the Ski Patrol course is likely to be good – ski patrollers do actually see injuries.

    The quality of the course is dependent on the specific instructor as much as the organisation – sometimes an instructor with a great reputation delivers a fun course but not great learning, watch out also for the “Paraheadache” instructor – this is the First Aider who thinks he is a Paramedic and wants to go beyond the basics on a basic course (or can’t help go on about how great they are).

    If you ride with children a lot you might want to make sure kids stuff is covered (it won’t be in a standard HSE First Aid at Work course). If you are learning about “bandaging” etc then you want to think about how it can be done with no or very little equipment – as sod’s law says you’ll only need it when you don’t have a first aid kit close at hand. Most of it is common sense – but improvisation for the first time is easier in the comfort of the classroom than at dusk in the pouring rain with an hour to get help.

    I’m slightly surprised there isn’t a MTB specific course approved by IMBLA or someone as the RYA (Royal Yachting Assoc) and BCU (British Canoe Union) both have specific courses adapted to their typical needs.

    aracer
    Free Member

    If you ride with children a lot you might want to make sure kids stuff is covered (it won’t be in a standard HSE First Aid at Work course).

    It was in mine – the SJA instructors have always taken the realistic attitude that if we were going to be “qualified first aiders” (I have used my FAAW to cover me for that in the outside world) then we ought to know about that even if it wasn’t strictly necessary for the course. I’m sure they’re not alone.

    bruneep
    Full Member

    A- Airway
    B-Breathing
    C-Circulation
    &
    D- Dysfunction check for broken bones twisted limbs etc..

    tree-magnet
    Free Member

    DCABCDE here, but the first C is catastrophic bleading and you don’t tend to see a lot of IED or gunshot wounds out on the trails…

    The last one is Exposure, which is pretty important once you’ve checked the others, paticularly if he’s unconcious and lying on the ground as he’ll be losing a lot of body heat. I carry a space blanket for this and it’s a light, small thing to have that can make a real difference.

    Oh, and draw on him.

    theotherjonv
    Full Member

    Oh, and draw on him.

    +1.

    It’s generally accepted that keeping a casualty’s spirits up in the aftermath of an incident promotes recovery. What better way than keeping the spirits of the rescue party up, which will then transfer to the causalty themselves.

    I reckon a huge cockandballs drawn on someone’s lower belly, which the nurses will find when he gets to hospital, would be ideal for making me chuckle right through the evacuation.

    chris_mbuk
    Free Member

    count to ten?

    jamesb
    Free Member

    Try First Aid academy; they do a 2 day outdoors course geared towards eg MTB., climbing, canoeing Fisr Aid scenarios. Did one a month ago and it was excellent, cost about £120 I think.

    Real key issue has been said above is Airway mgt, withouth an open airway patient will die; its a very difficult choice to have to move an unconcious person with airway issues (once youve got airway opened) to a recovery position if you suspect neck injuries, but if you don`t then they will die if airway becomes closed again through saying being left on their back.

    hora
    Free Member

    Take a polaroid picture of your cock on their face and leave it in their top pocket to be discovered later?

    khani
    Free Member

    Recovery position
    Is that after the doggie and then the missionary position?

    Take a polaroid picture of your cock on their face and leave it in their top pocket to be discovered later?
    POSTED 3 MINUTES AGO # REPORT-POST

    😆 your a sick man hora

    poly
    Free Member

    aracer – Member

    If you ride with children a lot you might want to make sure kids stuff is covered (it won’t be in a standard HSE First Aid at Work course).

    It was in mine – the SJA instructors have always taken the realistic attitude that if we were going to be “qualified first aiders” (I have used my FAAW to cover me for that in the outside world) then we ought to know about that even if it wasn’t strictly necessary for the course. I’m sure they’re not alone.

    OK I obviously didn’t write that very well: it is not in the standard/mandatory syllabus but should be included if the participants are likely to work with children – just as other specialisms become more important depending on the type / area of work. In some places instructors take the decision to include it – but in others they will not. To cover all the variations properly is probably an hour of extra instruction so, especially on the shorter “appointed person” course that becomes more difficult to squeeze in if there is no real reason for the employer who is funding the course. I also wouldn’t assume that because StJA included in your area that it would be on all StJA FAaW courses.

    white101
    Full Member

    the new European Resus councils guidelines on CPR will be announced on 18th Oct, this will result in changes no doubt to the current 30:2 compression/breath ratio for CPR. But don’t change your approach until your trainer tells you to at your next session of training.
    I tend to recommend ambulance services above SJA/BRC training to most of my customers, the training is generally from people who got the t shirt.
    Did my last course recently with the lead resus trainer at Manchester NHS and he was doing the DRABC thing, nice bloke.

    DrP
    Full Member

    One of the the guys who was riding with him just pointed out that he had a heart rate monitor on.

    True, but be aware of PEA…..

    DrP

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