First Aid, training and what the F to do when it happens

Riding on Sunday a friend went over the bars at 27 mph onto his head, destroying the helmet.
Must be the worst crash I have seen, it makes me fell sick still. Got him to the road and got picked up to get to hospital.

In hindsight I should have made him lie still and got an ambulance, but he was moving, conscious and talking.

So 3 days in hospital with vertebrae C6 fractured and a bone chipped. Doing well, but 6 weeks in a brace.

So what gear do you carry, when do you decide to get an ambulance, are there specific courses to do with outdoor activities?

Don’t get hung up on the “outdoor activity” tag.
Same body. Similar mechanisms of injury. Same effects. Same treatments.
Only difference is that you may have to deal with the environmental complications for a period of time until help arrives.

When do I decide to get an ambulance? If there is no way to evacuate the casualty safely with the equipment that I have at hand.

What gear do I carry? At work, that depends on what the governing body says I need to carry. For pleasure, normally some gauze, a dressing or two, and gaffa tape.

The British Assoc of Ski Patrollers Outdoor First Aid course is about the best I’ve done.

Moving, conscious and talking – i’d probably not have bothered calling an ambulance either.

Witness this in cannock chase..i believe rider has heart attack.. After dialling 999 and let the riders buddy speak on the phone. i just froze 😐

vertebrae C6 fractured

this is the kind of stuff that worries me, where do you draw the line between walking out and calling in the profesionals? Judgeing by the contents of A&E on saturday, I’d probably set the bar quite high, but that’s maybe not right, but equaly you could break your back doing something minor.

1. Check for Danger
2. Pause the Garmin
3. Check for response to stimuli
4. Check that the bike is OK
5. Check airway…
…etc…
10. Check for bike bling donor card. In absence of one, you’re entitled to take the best bits from their bike.

1. A decent home-filled first aid kit that weighs about a kilo, plus 2-man shelter & foil blanket as a bare minimum.
2. Any broken helmet should be treated as a potential spinal injury and that means immobilising your casualty and awaiting professional help. Hence the need for a shelter.
3. Lots of courses- Rescue Emergency Care network, British Association of Ski Patrollers, Glenmore Lodge, plenty of independant instructors (I know of two around Dundee alone). Any MBL tutor should be able to come up with a few names near you. Doesn’t need to be bike specific, a course that is aimed at any outdoor instructors should give you everything you need. Don’t go to the Red Cross/St Andrews/St John etc, they are unlikely to be able to come close to offering you the sort of training that you need. Quite a few local council Outdoor Education facilities will run courses too.
Finally, get some practice in then you’ll be confident and calm when a big one happens again. These are some of the most important skills of all.

Generally if you suspect ANY head/neck/spinal injury, the casualty MUST NOT be moved ESPECIALLY if they are unconscious but then it’s very difficult to tell if there is a head/neck/spinal injury if the casualty can’t talk to you unless there are any unnatural angles, lumps or swellings.

Concussion isn’t always immediately apparent either – it can set in a lot later. Even if the casualty is upright and talking, you should insist on a visit to A&E for a “check-up from the neck up”. Obviously you cannot force them to go if they don’t want to but if they collapse 24 hours later with a brain bleed, at least you can say “well I did tell you…”

The biggest thing to be aware of is the onset of shock – this is the biggest killer of the lot, especially in the outdoors, and it needs treating IMMEDIATELY. Symptoms include raised pulse, very dialted pupils, cold and clammy skin even on hot days, talking rapidly and not making much sense, shallow breathing, confusion, dry mouth, nausea, lapsing into unconsciousness and eventually death.

I could go on about this for pages and pages – get yourself booked on ANY first aid course (your local St John Ambulance and British Red Cross offer them regularly) and get a bisic first aid kit and some wound dressings in your pack and you’re good to go.

BTW if you do have need of rescue in a remote area (e.g. Mountain Rescue, helicopter extraction, etc.) you should alert the police first – they will arrange for the required services to attend. No good calling an ordianry ambulance if they can’t get to you!

http://www.firstaidtrainingbradford.co.uk/

I did the 16 hour outdoor first aid course. I’ve only used my training a couple of times (one heart attack and a dislocated finger – although pretty sure I didn’t need any training to spot the latter).

As well as learning the CPR stuff, DR ABC and suchlike, we also had a real cheerful conversation about the extremes – the stuff that you simply don’t have the skill, knowledge and experience to do much about.

I always carry (not an exhaustive list):

Triangular bandages.
Protective rubber (although they’re not really rubber) gloves
Some sterile/saline pouches.
Blister pads.
Tape.
The mouth protecting jobby for CPR
Ambulance dressings – the ones with the absorbant pad and bandage all in one.
Water.
Energy tablets.

You could carry clingfilm to deal with burns, splints etc but you would end up carrying loads – i’ve tailored my “kit” to target what I think the probable injuries on the trail are and those that I can actually do something about.

Thanks everyone for the replies so far.

I think the best advise from the above, broken helmet means possible spinal injury.

The hospital asked to keep the helmet as evidence for their training, it was snapped in half.

We are doing a whip round to get the best helmet we can for the guy when he gets back on the bike!

And obviously first aid asap, then move up the scale.

Another injury picked up by another rider at another time, was branch down ear and perforated ear drum….

Slightly different acronym here. DRSABCD

S is send for help. Doing compressions for 3 minutes, alone, is extremely tiring! D is for attach defib.

I think the most important part of a first aid kit is a phone with charge and credit – assuming you’re in a signal area.

Broken lid after a big stack sounds awful. I’m sure you did the best you could at the time. Good on ya.

I did an outdoor first aid and incident management course a few years ago. I’ve had cause to use bits of the training on different occasions. I’m usually quite an emotional person but, when I’ve had to deal with an ‘incident’ I’ve gone into a different mode and just got on with it. I didn’t notice this but my wife did. I always tell whoever I’m riding with I have a first aid kit, where it is (in case it’s me that needs first aid!)and that I’m qualified to use it. The difficulty is when the person you’re trying to treat won’t listen to your advice.
As a minimum I carry;
triangular bandage
gauze pads
steristrips
sterile wipes
variety of plasters
zinc oxide tape
field dressing
crepe bandage
latex gloves
mouth to mouth resuscitation shield

Don’t get hung up on the “outdoor activity” tag.
Same body. Similar mechanisms of injury. Same effects. Same treatments.
Only difference is that you may have to deal with the environmental complications for a period of time until help arrives.

Many years ago I trained people in both “normal” and “outdoor” first aid. I would disagree with your suggestion. The logic may all apply – but there is a big difference between office/factory first aid, and in the middle of nowhere first aid. Here are some of the issues:

(1) you won’t have much or any equipment. This is OK but it makes people panic / think more.
(2) you may have fewer hands to help. Whilst not all office first aid has lots of help and not all outdoor stuff is on your own, there is definitely a difference, especially since:
(3) you may have to go a long way just to call for help. it is unusual in the mobile phone world we live in that you would need to go more than 2-3 minutes from an urban casualty to call for help. In
(4) the types of injury vary widely depending on the mechanisms. Whilst a full first aid course will typically teach a wide range of injuries it inevitably puts a limited amount of time on each. Depending on the course participants I changed the mix/balance. I could spend more or less time on drink/drugs; on chemical burns, poisoning and asphyxiation; on child or childbirth specific issues; gunshot wounds and stabbings; hypothermia; drowning; on traumatic injuries; mostly there was little or no “transportation” involved and what we did do – was predominantly using specialist equipment.
(5) the message in the urban setting is mostly get help and stabilise, but often with the knowledge that 999 will get you expert help in minutes. In a rural setting it may take longer for you to be able to make the call than it would for the ambulance to turn up and take the casualty to hospital.

Don’t go to the Red Cross/St Andrews/St John etc, they are unlikely to be able to come close to offering you the sort of training that you need.

generally I would agree – but there are some specialists in outdoor stuff in those organisations. One of my main criticisms of most FA training organisations is that the trainers may never have dealt with real casualties in real situations (you can become a FA trainer in a couple of weeks of classroom work without ever putting a plaster on!). You can become an expert at teaching people to pass courses very easily – that is not the same as teaching people to deal with significant accidents in the wild.

Personally I would be looking to BASP or similar and asking how much of the course is actually in the outdoors. Not all trainers are created equal. Not all organisations / courses are created equal.

I ride with various nurses and doctors and we never took anything at all, other than some duct tape and a handkerchief.

The knowledge of what to do is much more important than any amount of kit, and if you can’t fix it with duct tape and a hanky then it’s time to either go home or get the pro’s in.

Certainly when I’ve been injured at races, there was little worse than an enthusiastic but clueless amateur..

Slightly different acronym here. DRSABCD

S is send for help. Doing compressions for 3 minutes, alone, is extremely tiring! D is for attach defib.

I think the most important part of a first aid kit is a phone with charge and credit – assuming you’re in a signal area.

Broken lid after a big stack sounds awful. I’m sure you did the best you could at the time. Good on ya.

Not what I was taught. If you’re going to phone an ambulance, it’s better to know the state of their breathing/circulation first. That will help the ambulance dispatcher to figure out how to prioritise you.

Any first aid course worth its salt will cover a wide range of injuries and conditions at its core. The only difference between an indoor and outdoor course is emphasis on the most likely injury or condition you’re likely to encounter. For example in my younger years I was a life guard and the course I needed to complete for that had a strong emphasis on drowning and asphyxia related conditions, but also covered the same areas of cuts, burns, fractures and all the other conditions you could come across that I covered in more recent ‘general’ first aid courses, so I wouldn’t get too hung up on it. Just get yourself on a course, whether it be st. Johns Ambulance or a local community centre course. The important thing is to go on a course.

It’s also worth noting hat the main goal of first aid is not to fix someone, that the job for the professionals who have the proper training and drugs. The main goal is to make the casualty comfortable and to prevent their condition from worsening until the professionals can get to them.

Slightly different acronym here. DRSABCD

Acronym? 😯 In which language?

My partner’s best friend’s son was involved in an RTA. He was moved clear of the wreckage by well meaning friends. He was paralyzed from the neck down. He was 19.

First aid can get quite emotive from “you need a be a fully equipped paramedic”, to “some gaffer tape is all you need”.

My experience was that I had done more than 20 years of first aid with St Johns and Red Cross first aid at work courses. I thought I knew what I was doing.

Then a couple of years ago a group of us were riding and the guy behind me went over the bars on a jump. I heard a shout so ran back up the trail. I was met with a river of blood and my mate was not breathing, was fitting and blood was gushing from his fairly well destroyed face and mouth. I had no idea. Another guy in the group who had done a wilderness first aid course sorted him with a jaw thrust and improvised recovery position etc. This was Swinley but it took the ambulance an hour and a half to get to us. After hospital treatment my mate recovered well, and the rest of the group all went on the Wilderness first aid course.

This was real first aid. The trainer sets up scenarios with realistic make up, protruding bones, lots of blood and gore and situations where injuries are from chainsaws, mattocks etc.

It’s a whole new world. The St Johns course is “here is someone with a bit of red marker pen sitting in a chair”. The wilderness course is “here is a biker whose head and torso is wedged under a landrover” do you move them or not? If you do, you may paralyse them, if not they my die simply because of a blocked airway.

This is the guy you want Best First Aid Training ever[/url] He used to teach re-sus in A&E departments. Best money I have ever spent.

So what gear do you carry?

Most of my rides are in the south and we are rarely very far from help, so typically i don’t carry anything other than a bit of acquired knowledge. On the odd occasion that i travel further afield then I’ll chuck the first aid kit in my backpack, we have two first aid kits, one in the car and one in the house. I’ll normally take the one from the car as this is stocked with more gauze and dressings and is better suited to temporarily plugging a hole.

when do you decide to get an ambulance?

No short all encompassing answer to that. Depends entirely on the injury, how well we can patch it up at the scene and the state of the person that’s taken a tumble. Suspected spinal injuries = keep ’em still and get an ambulance, most everything else is a bit of a sliding scale.

are there specific courses to do with outdoor activities?

There are, I did an outdoor orientated two day first aid course a few years back which I really should refresh sometime. It sounds similar to the one boriselbrus described above.

Having said all this, in twenty five years of riding I’ve never needed an ambulance to attend any off-road riding accident, few cuts and scrapes but fortunately nothing more serious. I was knocked unconscious once but after coming round, a bit of a sit down and a trail side assessment we rode home albeit a bit slower than normal.

Don’t get hung up on the “outdoor activity” tag.
…
Only difference is that you may have to deal with the environmental complications for a period of time until help arrives.

Many years ago I trained people in both “normal” and “outdoor” first aid. I would disagree with your suggestion…

Poly, I don’t disagree with anything you’ve said. Perhaps I was being a little too simplistic in the way I summarised earlier.
The points you raised are what I was loosely referring to as the “environmental complications”.
We’re on the same page.