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CYCLING FIRST AID BRANDY FERGUSON, MD DISASTER MED/EMS FELLOW GWU HOSPITAL OUTLINE • • • • • Scenarios Common injuries First aid care Techniques Supplies OBJECTIVES • What would you do (as a first responder) when encountering an accident • What tools and techniques can you use • How to feel comfortable with different injuries COMMON CYCLING INJURIES • • • • • Head Injuries Broken Bones/Sprains Collapse Lacerations/road rash Wounds, bleeding FIRST AID GOALS • Provide aid to others • Prevent worsening injury/damage • Treat/stabilize patient until help arrives FIRST AID TOOLS: “WATER BOTTLE KIT” • Easy to use • Compact • Can be used for different injuries • Can buy pre-assembled kit • Can make your own kit WATER BOTTLE KIT: DIY • General Equipment • Small scissors • Duct tape • Tweezers • Headlamp • Medications • Tylenol • Ibuprofen • Antihistamine pills WATER BOTTLE KIT: DIY • CPR/Bleeding • Nitrile gloves • Antimicrobial hand wipe • Wound Care • Antibiotic ointment • 3-inch square gauze pads • Gauze wrap • Band-aids • Wound-closure strips WATER BOTTLE KIT: DIY • Blister care • Blister pads • Moleskin • Broken Bones/Sprains • ACE Bandage • Ice packs CASE #1 CASE #1 • 60 year old male cyclist on Rock Creek Parkway • Suddenly falls to the ground • He is not moving What next? APPROACHING THE SCENE • Care • Be aware of any dangers (moving traffic, blind bends) • Reconnaissance • How many people are injured? Minor or serious injuries? • Inform • Call for assistance or call 911 • Treat • Assess affected persons, do not move patient ASSESSING THE PATIENT: ABCs: • Airway • Look for objects in mouth • Look for any injuries to mouth, neck, chest • Breathing • Look, listen, feel • Circulation • Check for pulses, look for bleeding No breathing or circulation: start CPR!! BACK TO THE CASE • CRIT done: • Scene safe, 1 injured person, called for help, treatment started • ABCs: • • • • No airway issues Patient not breathing No pulse CPR started BACK TO THE CASE • • • • 911 called Ambulance en route CPR continues Supplies to use from water-bottle kit? COLLAPSE COLLAPSE • Important things to remember: • • • • • Scene safety is key! Use CRIT and ABCs Call for help Look for injuries, bleeding Start CPR if needed CASE #2 CASE #2 • 42 year old female involve in collision with oncoming car • Helmet broken • Confused, vomiting What next? ASSESSING THE SCENE • CRIT assessment complete • Scene safety • No other injured persons • Called for help • Treatment in process • ABCs • Airway is clear • Breathing normally • Good pulses What are we most concerned about? HEAD INJURY Different types: • Lacerations (cuts) to scalp • Concussion • Shaking of the brain • Compression • Bleeding in the brain • Skull fracture HEAD INJURY Important things to assess: • Check ABCs • Level of consciousness • • • • Alert and responsive Verbal: responds to speech Pain: responds to pain Unresponsive: no response • Monitor pulse, breathing • Look for wounds, bleeding HEAD INJURY: TREATMENT • Control bleeding • Check your water bottle kit • Do not move patient! • Do not remove helmet! • Keep head still • Wait for assistance to arrive CASE #3 CASE #3 • 21 year old male fall into brush • Has large branch in left leg • He removes branch and has profuse bleeding What next? ASSESSING THE SCENE • CRIT assessment complete • • • • Scene safety No other injured persons Called for help Treatment in process • ABCs • Airway is clear • Breathing normally • Good pulses What are we most concerned about? BLEEDING Body reacts to bleeding in 3 ways: • Blood clots • Ends of blood vessels contract • Blood pressure falls BLEEDING Preventing blood loss: • Position patient • Expose/explore for other wounds • Elevate affected limb • Pressure BLEEDING: APPLYING PRESSURE BLEEDING: APPLYING PRESSURE • If bleeding after 10 mins of direct pressure: • Apply pressure to pressure point • If gauze soaked, add additional gauze to wound BLEEDING: APPLYING PRESSURE BACK TO THE CASE • CRIT done: • Scene safe, 1 injured person, called for help, treatment started • ABCs: • • • • No airway issues Patient breathing Good pulses Blood oozing from left leg BACK TO THE CASE • Supplies from water bottle kit BACK TO THE CASE • Bleeding controlled with 10 mins of direct pressure • Bandage applied with gauze and gauze roll • Patient transferred to medical facility for further care CASE #4 CASE #4 • 33 year old female starts biking portion of Nation’s Triathlon • Involved in bike collision • Falls onto right arm What next? BROKEN BONES Function of the skeleton • Gives shape and support • Protects internal organs • Major bones surrounded by major blood vessels and nerves BROKEN BONES Broken bone (fracture) types: • Closed • Bone is broken but there are no wounds or broken skin • Open • External wound located adjacent to or over fracture • Bone may be protruding from skin • Complicated • Broken bones causing damage to vital organs BROKEN BONES Common fractures from cycling accidents: • Hand/wrist • Forearm • Collar bone • Shin • Ankle BROKEN BONES: SIGNS & SYMPTOMS • Swelling • Loss of movement • Irregularity • Pain • Deformity • Unnatural movement • Area tender to touch BROKEN BONES: TREATMENT • Upper limbs • Support in comfortable position • ACE bandage or gauze wrap • Lower limbs • Do not move unless scene unsafe • Do not try to straighten limb • Continuous monitoring of pulse in upper/lower limbs BROKEN BONES • Sometimes difficult to tell if injury is a fracture or sprain • Treat as a broken bone until person receives further medical care BACK TO THE CASE • CRIT done: • Scene safe, 1 injured person, called for help, treatment started • ABCs: • • • • No airway issues Patient breathing Good pulses Deformity to right forearm, no wounds or bleeding CASE #4: TREATMENT • • • • Placed right arm in position of comfort Used ACE bandage or gauze wrap for sling Monitored pulses Patient taken for further medical evaluation CASE #5 CASE #5 • 24 year old male traveling at high speed falls from bicycle • Skids across asphalt to a halt • Complaining of severe pain/burning to right side What next? ROAD RASH • These injuries look and feel painful • Important to look for: • • • • Any broken bones Internal injuries Bleeding Head or neck injuries ROAD RASH: TREATMENT • • • • • Look for associated injuries Wash out dirt from wound Cover with antibiotic ointment/gauze Consider pain medication Need medical attention for detailed wound care • Area needs to be thoroughly scrubbed/cleansed BACK TO THE CASE • CRIT done: • Scene safe, 1 injured person, called for help, treatment started • ABCs: • • • • No airway issues Patient breathing Good pulses Road rash to right side of body, no active bleeding BACK TO THE CASE • Dirt washed out from wound • Antibiotic ointment and gauze applied • Patient transferred for further care SUMMARY • • • • • Be prepared! Always apply CRIT Assess ABCs Always call for help Feel comfortable providing first aid for different injuries QUESTIONS?
