A silly OTB. A protruding dropper lever. A >1.0 cm deep, approx.10 cm long gash. Full cut through the skin layers into the fatty layer beneath but fortunately not into the muscle of the upper, inner thigh. Lots of blood but oozing only, not spurting, so easily controlled with non adherent dressing, gauze pad and elasticated bandage. Self-evacuated to safety then A&E at local hospital approx. 40 mins away.
Mrs Ambrose sliced her leg open yesterday when she crashed bikepacking from Machynlleth to Nant y Arian. Very close to the river crossing. Quite a bit of blood involved, plus bits of human tissue all over the dropper lever.
Treated as above plus 1x Paracetamol.
So far so good. She's had seven external stitches and feels just fine.
I need to unpack this though.
On the plus side I had a first aid kit, as she did also.
Both of us are lifelong first aiders.
Everything ended just fine.
Had the situation been worse there was limited mobile coverage.
There was a farmer with a 4x4 pickup about a couple of km back at Hyddgen.
We know the area very well indeed, 40 yes of experience.
But.
We only had silly little FAKs. Only a couple of non adherent dressings, only one (5 cm wide) elasticated bandage. Just two gauze dressings. My FAK is supposedly for arborists. Hmm.
Steristrips that didn't work.
Possibly a potential fatality? Femoral artery really rather close?
I've had to manage a number of nasty accidents previously including spinal fractures, big bleeds, burns, chemical injuries and general knocks and bashes resultant from falls, some from height. However this has really got me thinking. Up until now there has always been someone else close by. Yesterday if it had been worse and there was no mobile coverage it could have been a whole lot worse.
I'm after advice.
Firstly about what kind of FAK to carry.
Secondly, what First Aid course to do. I've been a first aider at work for a long time. Mountaineering first aid perhaps beckons?
Thirdly, what else?
It's been a bit sobering to be honest. The last time Mrs A smashed herself up and I asked for advice someone suggested that she should improve her skills. Please, no victim blaming/ shaming this time round.
I carry a crepe bandage and bigger wound dressing for this reason. But there's a limit to what I can do as a first aider should the shit really go down.
Indeed, I've been there and said bye to a mate who wasn't going to make it off the hill alive....if it hadn't been a miracle helicopter and MRT response he would not be here today. There's an STW article somewhere pre-hack about it all.
Thank you. Possibly awful outcomes that then turn into miracles are always welcome.
mountaineering first aid course could be a good idea.
its a very small subset of injuries where a first aid kit will make a significant difference and a lot of stuff can be improvised ie an innertube can be a sling or a tourniquet or tie limbs together or to a stick as a splint. t shirt makes a decent wound pad
..i carry steristrips, alginate dressing that helps clotting, hydrocolloid dressings that make a waterproof seal. tick hooks. some powerful painkillers cos im a wimp.
knowledge is the key thing.
First aid course is the best idea. Mountaineering one is a good shout. I did an 'outdoorsy' one years ago. Standard response to any question a FA instructor asks is 'first phone an ambulance'. Then this one says 'by some miracle you have a signal. MRT will be here in eight hours. What are you going to do next?' I think that was the biggest difference, rather than just keep them alive for twenty minutes whilst the ambulance comes it's suddenly a day and whole different ball game. I should probably do a refresher.
Also carry spare layers,. something very minor can become quite serious once you can't move (fast enough) and the cold sets in.
.
I broke my arm last year somewhere there was no mobile signal. Managed to make a sling from my spare base layer and walk two and a half hours out.
Wolverine at the Golfie, so hardly middle of nowhere (I was in quite a bit of pain and dragging a bike with my left hand so very slow, sped up when I bumped into two lovely Irish chaps who helped me) It was late on a Saturday in March. The forecast for Sunday was awful so entirely possible no-one would have ridden Wolverine for days. Had it been a leg I'd have been ****ed. Probably more so from exposure than from the injury (I live alone and wouldn't have been missed for a while) I now carry a PLB when solo riding just in case, works off satellite and radio transmissions so much more reliable than telephones.
- Most of the riding I do isn't technically difficult, but it's mostly alone and often remote. I leave Mrs Gordimhor a route card. I am a first aider and I carry a good well equipped first aid kit.To me there's no shame in thinking if in doubt chicken out It's questionable how much I could actually cope with in terms of first aid and self rescue, phone signal isn't great so maybe I should start taking a locator beacon on bike trips I already do for canoeing . Never used it yet fortunately
Another vote for a decent outdoors first aid course. I've been on a few from a variety of providers, but anything that is suitable for people with other outdoor qualifications is key (I need to keep mine up to date to use my ML, for example). Don't be put off if you think it's for the wrong activity - one of the best courses I've done was from BASP and I am most certainly not a ski instructor. My key takeaway from my first outdoor course was to understand the limitations of what I could do and prioritise accordingly.
As for what to carry in your kit, I'd wait until after the course to decide what will work best for you. My minimalist bikepacking kit has a few big dressings, a roll of electrical tape and a few pills. I still have my DofE leader FAK that has more stuff in it, but most of that is for minor things.
Is it wise to mention the Cedric Gracia crash at this point.... I think that was a groin / inner thigh incident too.
It sounds like the op needs to look at the type and position of dropper lever as both him and his partner have leg injuries from these. I would worry more about this than the first aid kit.
For outdoor fist aid there's a few options I've done over the years. Personally I've not worried about awarding body. 2-day outdoor first aid from reputable supplier.
If you're any where around children, get a paediatric first aid bolt on.
Currently at work we use
http://www.theoutdoortrainingcompany.com/ (Scotland)
And
https://www.highpeakfirstaid.co.uk/ (Peak area)
And
https://freshair-training.co.uk/
Glad all waa OK in the end. Redid my FA at work last week and it made me very aware of the limitations of what I know regarding "wild" first aid, but my riding is nomever wild enough to not have a signal, and the small kit I carry on group rides should be enough.
The course did include how to use blood/trauma kits, so I will add a hemostatic (sp?) dressing to the kit for packing deeper wounds.
Mend soon Mrs Ambrose. It really hits home what can happen from an accident that all mtbers go through (otb) at some point in their riding.
This happened to me skiing in Whister. I hit some heavy snow, went over the top. Binding released, ski flew in the air, came down and sliced my knee. 7 stitches and v heavy bandaging for many days. I was so grateful to have phone signal and medical assistance was near.
I always ride locally if alone and with someone else if going out to more remote locations.
I carry a crepe bandage...
Sp. Sooner a crap one than none at all 🤣
Seriously though, having been at the scene of many a trauma there's a limit to what most of us can achieve even with a briefcase-sized kit. Just do the best job that you can with what you have; I don't think that there is a perfect bicycle-sized FAK
Training is the most important component of any FAK, some dressings are not within guidance for certain wounds, e.g. an occlusive seal might be better than an haemostatic dressing in some chest wounds. IANAE, get trained!
After that last of these threads i bought a whistle and a very light foil bag. i think for most uk off road cyclists in the uk one of the most significant hazards is hyperthermia after becoming immobilised. I once left some one with clothing after i came across them with a slash like the one described but across his knee.
I’ll review my first aid kit and training next
In theory my phone can do emergency contact via satellite. But I’ll think I’ll look again at trackers. In particular rental for longer bike packing
It sounds like the op needs to look at the type and position of dropper lever as both him and his partner have leg injuries from these. I would worry more about this than the first aid kit.
Dropper lever is below left brake lever, pretty much like almost everyone else's.
I don't recall that I have been damaged by a dropper lever; remind me?
knowledge is the key thing.
I think this is the key thing. I'm grateful to the Army for the many FA/Trauma courses it made me do. It enables appropriate reaction, control and more importantly improvisation where needed.
I don't really ride anywhere remote so don't carry anything routinely. If I'm going a little further afield, where basically it's a bit of a ride back to the van then I carry a lifesystems Nano FA kit (essentially small wound dressings/plaster/steristrips/pain relief), with a few bits removed and some added. And what is likely out of date issued emergency dressing/bandage and a roll of latex bandage.
It sounds like the op needs to look at the type and position of dropper lever as both him and his partner have leg injuries from these. I would worry more about this than the first aid kit.
Dropper lever is below left brake lever, pretty much like almost everyone else's.
I don't recall that I have been damaged by a dropper lever; remind me?
A silly OTB. A protruding dropper lever. A >1.0 cm deep, approx.10 cm long gash
This bit from your OP. Not sure I'd agree though - if it's not the dropper lever there'll be something else you can catch yourself on, be it the bar end, brake lever, a branch etc.
On some basic (but tricky) trails along a valley in Toronto I managed to go off the bike on the "steep" side (ie the one with the drop). Untangled myself to discover a large, sharp bit of branch had torn a hole in my front pocket, hitting my phone which was in there. It was only when I got home I realised if my phone hadn't been there the results could've been really unpleasant
Good thread.
Glad you're both OK.
Also see here (similar but different):-
https://singletrackworld.com/forum/bike-forum/solitude-and-accidents/
I think the thing in such cases is to be able to keep a rational head, and have the ability to problem solve/triage. You don't neccessarily need a "first aid kit". You need to (in your case) stop the bleeding. A buff and gaffer tape will do that (I carry tape wrapped round my pump). A glove would work - although obviously probably pretty manky, or a jersey - but that problem can be dealt with later by the grownups, you just need to get to them, alive.
Gaffa tape, cling film, tampons, cable ties if you have to. Do what you need to do. There's always "better", but what you actually need is "good enough" and if you go out equipped like a Mountain Rescue paramedic, you could well end up causing yourself a different set of problems.
I've done a variety of 1st aid courses over the years - mostly FAW/1st responder, but also some outdoors ones. They all focus increasingly on CPR; the best one I did was led by an ex-marine, who did come up with realistic scenarios. Looking back the thing that stands out is that all the courses are about you, the 1st aider helping a third party. Not you BEING the victim and needing to sort yourself out, which is what 95% of my 1st aid experience has been, as I ride on my own pretty much all the time.
Shoot can happen anywhere. Certainly make sure you've got layers - on the MTB I carry a foil blanket now having come across a lass impaled on her 'open end' MTB bars at Llandegla - gave them my waterproof as they were just in t-shirts in early Spring.
Basic first aid kit carried on bike packing - mainly to bandage a wound to get somewhere to get repaired.
It sounds like the op needs to look at the type and position of dropper lever as both him and his partner have leg injuries from these. I would worry more about this than the first aid kit.
I don't know why but I've injured myself, and broken dropper levers with my body, a number of times (and with a few different levers). Not sure why as they're smaller than the shifter on the other side of the bars and I've never done the same with them.
Shimano lever is my current preference and it does seem to be a bit smaller/neater/more rounded than a lot of them. And it's cheap. And it works well.
The main takeaways I remember from my mountain leader first aid days were 1) you can’t do much but what you can do can make a difference, 2) hypothermia is the biggest risk most of the time, 3) don’t muck around with wee plasters or dressings etc - super sticky gaffer tape and whatever bandage you have is the best bet if a wound needs dressing. I tend to carry a couple of triangular bandages as they’re quite versatile and a wee role of gorilla tape. Whether it’s a foil bag, bothy bag or whatever - something to keep you/the victim (or maybe the whole group) warm is very important.
