Mate took a tumble on the South Downs yesterday – bad enough to merit a cautionary visit to A&E with suspected concussion. We were close to home when it happened, and he was fine, but I realised I’d have no clue whatsoever if we’d been somewhere remote and he only had me to help. Anyone done a course, got any advice?

ta

St John’s Ambulance and Red Cross offer courses for around £100.I did a first aid at work course and now nearly always carry a small first aid kit with me on bigger rides in remote areas. Don’t want to sound OTT but it could save someones life.

It usually consists of: antiseptic wipes, latex gloves, dressings x 2, plasters, Triangular bandage, rescusi-aid, asprin and a foil blanket.

Its not the kit but the knowledge that matters.

Head injuries are either fine or serious – either way there is nowt to do at the trailside

We did Rescue and Emergency Care First Aid, specifically tailored for mountain biking. The course was run at Llandegla, but there may be a chance of running the same again down south if there is enough interest.

A couple of essential points – take a phone (with well charged battery), and don’t underestimate the need to stay warm and comfortable.

BASP – British Association of Ski Patrolers do proper outdoor first aid courses. Done my quals with them twice now and would recommend to anyone.

http://www.basp.org.uk

REC have a lot of trainers and we do regularly run a Level1 course here at Llandegla, however I did my Level4 through a company called Wilderness Expertise in Crowthorne near Sandhurst.

Ed O has an article about trailside first aid in the current issue of Singletrack which covers the basics.

I have First Aid at work which IMO is has limited aplicability to the being outside, when a lot more can be about decision making rather than First Aid skills.

Hence why I also did an ITC First Aid course to focus on that side of stuff as i work mainly inscolated locations with no recpetion or access etc.

http://www.itcfirstaid.org.uk/

Its also amazing the conflicting advice you hear about the use of 112 and what is possible with no network coverage.

A 2 day outdoor first aid course will give you what you need to ride confidently in remote areas.

Cyclewise at Whinlatter have an excellent course run by Vital Signs and you can ride the trails at the end of the day.

http://www.vitalsigns.org.uk/mountainbike.html

All of REC’s courses do practical scenarios outside and they help to bring home how tough it is to administer first aid in wildeness situations with limited kit and backup. Remember that the current thinking is that more than 20mins from a landline is remote country as it pushes a casualty potentially out of the ‘Golden hour’

[b]”It usually consists of: antiseptic wipes, latex gloves, dressings x 2, plasters, Triangular bandage, rescusi-aid, asprin and a foil blanket.”

Without sounding aloof…..there is actually very little that you can carry that will cover everything…and a lot that you can carry that will be of little or no use. Most of the above can be adapted from kit that you carry.

Aspirin?? What’s the point of carrying that?

Knowledge and good common sense is the key!!

Had a similar discussion on a windsurfing website….
So

Think basic

Scenario 1 – you’ve just broken your ankle at sea and after 2 hours of bobbing around have finally made it back to the beach but cant walk….what do you really need?

1.A mouthful of tablets that will take 40 mins or so to start working and may hinder your definitive pain relief from the medics later.

2.A Complete splinting of your ankle form a first aid kit that someone has never used before but wants to “just try it out” anyway.

3.A nice warm blanket that stops you shivvering those pruning nuts of yours off.

Scenario 2 – Someone collapses in the car park whilst your rigging your kit….its a windy day and your buggered if you want to help…but your good will tells you to go and help.You find the al git lying on his back going blue…and in obvious need of CPR.

Do you –

1.Leave him to try and find those keys that are hidden between the carbon brake dust smothered wheels of your van…and then try to find that first aid kit thats been covered in sails and old….wetsuits for the past 6 months…..meanwhile the seagulls are circling Albert!

2.Locate that comprehensive first aid kit that you carry on the back of your board at all times…….clear a space in the car park and spread out its entire contents as if your about to perform a frontal labotomy….. not really sure of which way up that plastic mask goes…

3.Forget about kit….and get stuck in….using the knowledge youve just learnt from a good first aid course / book/ quick glance at the resus councils uk website – http://www.resus.org.uk/pages/bls.pdf

If your unhappy about kissing the al fella on his lips – grab an old carrier bag and just pop a hole in the middle…or a thin towel this is just as good as any pocket mouthpiece….just try to make that plastic small enough to prevent anyone from thinking your suffocating Albert!!

Scenario 3 – you see a bloody kitesurfer getting dragged along the beach and heading straight towards one of the sea defence groins.Trying not to smirk with glee you suddenly realise that the outcome of this situation is not going to be good…..when you reach the bloke in question you quickly jetison his kite ( shouting to a mate in the car park to go find it and hide it) and then somewhat confused by why hes wearing a pair of trousers over his wetsuit discover that he has a large wound to his upper arm which is spurting a lot of blood.

Do you –

1.Nip back to the van – cursing that 3 times in one day is just taking the piss….and the brake dust is ruining your pristine white rashie vest.

2.Cover him in sand and hope that noone actually notices that a kiter has been injured.

3.Make do with whats to hand – in an attempt to stem the bleeding….dont forget – if its that bad an injury you might live to regret not using that prized rashie to save someones life….whereas poor kiter boy well….hes one less on the water I guess.

Keep it simple and you can make a big difference.

We all know that phrase…..”all the gear no…..

Don’t we!

Mine has SAM splint, dressings plasters and banadages of varying kinds, artificial airways, pocket resus mask, alcohol wipes, stethoscope, saline pods, paramedic shears and varying other bits of kit to assist with casevac and trauma management.

Oh and the same patient report form used by one of the top mountain rescue teams in the UK

Brack:

Aspirin is carried as it can save the life of someone on the verge of a heart attack. But surely you’d know that if you’ve done a course? I believe it’s the only drug that First Aiders are supposed/allowed to administer.

Improvising with clothing etc. is all well and good, but a whacking great sterile dressing is a whole lot better.

Second Muffin the Mule BTW, did my course through BASP.

FWIW, I wouldn’t carry the plasters, antiseptic wipes or foil blanket though. I’d double up on big dressings.

A foil blanket is not much use in typical UK weather. It reduces heat-loss via radiation, but is no use if you’re soaked and sitting out in the wind. An old-school survival bag is a lot better, but you’re not going to be able to get a seriously-injured casualty into it. Best recommendation is the “thermal wrap” – get a survival bag and cut it open to give a big, flat sheet then spread a foil blanket out on top of it and duct-tape it down. Much easier to wrap around a casualty. Obviously you want to do this in a Blue Peter stylee.

I realise that but ‘heart attacks’? The OP was referring to first aid relating to mtbing ?

Aspirin is great for heart attacks providing you are totally happy with their drug regime…but could be bloody dangerous if given to someone with a head injury. I think there is a danger of just carrying too much stuff to cover every eventuality.

What I am trying to promote is a real back to basics approach towards ‘trail aid’ for average Joe.

Yeah, big difference between what I’d carry riding as a leader and just riding with mates!

EDIT: In reality probably not, because I’d never be organised enough to take the extra stuff out of my bag…

Carry a detailed map and know where you are on it. On the two occasions I have had to call an ambulance i had to direct them to the closest road junction. Grid references are of no use to the person at the emergency call centre. Make sure your phone is charged.

Grid references are of no use to the person at the emergency call centre.

Why not?

1) I’ve fallen off my bike somewhere and broken my ankle. I want those yummy serious painkillers before anything else happens. Otherwise I will scream
Immobilising it – bandages make it easy but improvisation ain’t that hard either

2) I’ve fallen off my bike and got some proper gravel rash. Film dressings mean it will stop hurting and sticking to stuff and might be the difference between continuing the ride or not. a few steristrips will hold the bigger gashes together. More comfortable evac or continuation of the ride

3) I’ve totally blown a gasket on a climb and my entire cardivascular system is **** I’m dead. Somebody else collapses – CPR don’t need any kit

Going out into the wilds I carry serious painkillers in a variety of flavours, a mix of film and absorbent dressings, a sterile needle, small amount of saline ( for eyes) a single crepe bandage, steristrips and a space blanket. Locally I don’t bother.

I carry a a small kit with a couple of bandages, plasters, paracetamol, anti-sting pen.

Purpose?

Not to save someones life, need knowledge for that – I do have some experience.

So why do I carry it?

To make myself (or wife and kids) comfortable if we have a little mishap.

Cut my finger, would rather have a plaster on than have my gloves rub the bugger for the whole ride.

Bee sting – ease the discomfort a little.

Chunk out of shin on son – bandage to keep cleaner, provide reassurance that we can continue cos he’s been patched up.

Headache – paracetamol

So, no, it’s not really for emergenies – just to keep things going smoother if a minor mishap occurs.

Also carry some personal protection stuff, plastic for CPR, gloves, wipes – in case I have to do real first aid on someone.

Had to do CPR on someone last year and was liberally covered in various body fluids – she didn’t make it unfortunately.

TJ – Likewise ! I carry some nice strong analgesia…and that is purely for selfish reasons….but that’s about it really…because I know from experience how bloody long and painful a ‘remote’ tumble can be.

What really bugs me about ‘first aid’ though is this fascination and reliance upon equipment…I guess that this is down to having people with limited experienced training members of the public – and scaring the sh1t out of them!!

I sat in on a similar course a few months ago and came away thinking….I was going to kill someone if my compressions weren’t to the required depth…too deep…etc

Some of the best managed incidents that I have attended have been where ‘the common sense’ brigade are on scene….I have to admit that I tend to switch off if I hear some panicky voice telling me what they think is wrong with the patient.

Fortunately mtbers in my experience are bloody brilliant – switched on, helpful, aware of the environment and have a lot of common sense when the shit hits the fan!!

I’ve actually fallen off my bike on a solo evening ride and broken my ankle, and I can assure you the most useful thing to have is a mobile phone, I had to hop a few hundred yards to get a signal (hopping was rather more painful than I’d of liked). I was in A&E in under half an hour and I didn’t have to wait either.
I’ve been a qualified St John’s first aider for 25+ years but to be honest the training wasn’t a lot of use at the time, apart from the fact I could tell that I was going into shock.

Head injuries are either fine or serious – either way there is nowt to do at the trailside

Very far from the truth….
Most people who die from head injuries die not from ‘instant brain damage’, but from the simple complications of loosing conciousness i.e. they obstruct their airway.

The premise of any sort of emergency treatment is the A,B,C,D… approach:
A- airway
B- breathing
C- circulation
D- dissability

The reality being that you will DIE from an A complication first, then a B, and so on.
So, a head injury ‘on the face of it’ would be a ‘D’ injury (neurological disability), but the patient would die from airway compromise or breathing problems long before the brain damage became the ’cause of death’.

Thankfully, the principle of correcting ‘A’ problems can be met with very little specialist equipment – just some knowledge and confidence in that knowledge – a simple “head tilt – chin lift” can be a life saving manoeuvre.

So again; to say Head injuries are either fine or serious – either way there is nowt to do at the trailside, or to imply that even in serious, horrendous looking accidents there is ‘nothing to do’ is just mis -informed. Whatever the basis of the injury, follow the ABC approach and you can’t go far wrong.
Granted, you will eventually come up against a ‘brick wall’ so to speak, in that you simply cannot progress further, but correcting the A+B problems, and coming a cropper at the C could buy you sufficient time for specialist help to arrive.

If you are thinking about courses, I imagine they will all be useful, from simple first aid courses, to ATLS, and others such as ALS etc etc.

And for you interest, my first aid kit consists of simple pain killers, some bandages, and sterile wipes, amongst a few plasters too…!

DrP

not a bad course to get you started

Actually, I might start taking my ‘big’ first aid kit on the trails with me….

However, I don’t think this will fit under my saddle though..?

Now that’s just showing off isn’t it 😉

DrP

Ultimate willy waving 😉

Curiously enough, had a bit of a nasty incident to deal with on the trail today. Was out riding with some locals and one guy had a pretty minor spill but managed (it eventually turned out) to put a double-fracture on his kneecap.

I was carrying a SAM splint, which was really useful to put under his elbow to make his position on the rock he was lying against more comfortable. Other than keeping him warm and dry there was absolutely b*gger all that could be done for him until we got a doctor and some morphine on the scene – he was pretty comfortable as he was, but the slightest movement of the knee had him screaming. So we left well alone!

Get well soon Chris!

Following on from that, I know TJ works in the medical profession, guessing brack does too. Do you guys get your “strong analgesics” through work or is there stuff available to the public which is stronger than a 400mg Ibuprofen?

No intention of getting myself tooled-up and starting handing out drugs on the trail, just curious. Doubt anything in pill form would have done much for our mate today, the doc pretty much knocked him out with morphine before they straightened the leg (and even then I can still hear him).

I realised a couple of years ago that the chances of making a difference to somebody’s safe outcome through the use of a little first aid kit and even littler knowledge were minimal.

However, A number of rides have been cut short when mates have had cuts to, say, the eyebrow, cheek or arm which only need a bit of patching up. So therefore my kit contains mostly stera-strips and gaffer tape. That stops most bleeding and flappy bits of skin.

They can go to A&E after the ride for a proper mend.

Regarding pain killers – paracetamol and brufen (can take up to 800mg y’know…) are good first line meds, and you can also get codeine up to 15mg without prescription too…

DrP