Mountain Biking First Aid: What to do When You or Someone Crashes

First Aid and Wilderness Safety: Biking

Hi all my name is Stan, I’ve been a mountain biker for 6 years now. I have training in First aid, CPR, Trauma Care, and Remote Wilderness aid - All titles are with specialization/focus on cycling related injuries.

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There have been a few posts of people crashing and many people were wondering what they should to do help if a riding buddy has been too rad and wiped out. I’ll go over the basics!

Before riding checklist:

1. Water, Food, Tools, Lock, Spares - You need all of these to make it through your ride safely. Spares include tubes, chain links, optical glasses/contacts.

2. First Aid Kit - Band aids, ibuprofen, benadryl, gauze, tape.

3. Location - Someone (who isn’t riding with you) should know where you are and when to expect you back.

4. Communication - Bring a phone fully charged. If you’re out for long periods of time check in with your person from 2. Use this phone if there is an emergency.

5. Know terrain - If it’s a new trail, be cautious, take a map, don’t speed through on your first lap. If it’s a trail you’re used to, don’t take it for granted, also it may have changed since last you rode it. Many injuries happen on your home turf.

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What to do for yourself: If you are alone or with incompetent friends, this is how to care for yourself in these types of crashes

1. Abrasion or cuts - Wipe out on a turn scrape your knee etc. Care - Remove dirt/leaves if possible. Apply bandage to cover wound. Clean thoroughly when you get home. If it’s a significant wound, cover it to prevent blood loss. Use anything available, tee shirt socks band aids gauze. You may need stitches later.

2. Tumble - Sometimes we don’t see a drop or hill or whatever, and you tumble off your bike. If you have abrasions see above. Check yourself over and make sure there are no bones sticking out of you. If you stand up, wipe of dust, and feel fine, sit for at least 90-120 seconds anyways. Catch your breath, drink water. After sitting make sure you don’t feel any significant pains. If while sitting you start feeling a pain that you initially did not, check over the area and rest more; this can happen if you enter shock as your body typically blocks out initial pains. If you have a headache or neck pain, do not ride for at least 20 minutes. You may have just rung your bell or worse you could be concussed. If after 20 minutes you still feel pain consult a doctor. If after 20 minutes you feel alright, ride out slowly and go home, have someone pick you up if possible.

3. Eat S!*t - Everybody does it. This is when you have a really tough crash.

a. Do a full “Systems Diagnosis” Ask yourself:

1. -What hurts?

2. -Where did I fall from?

3. -Did I impact anything specific?

b. Refer to 1 and 2 for basic injuries. Again sit down and rest, do not force yourself to “ride it off”, you aren’t racing.

c. Broken Bones

1. i. Sorry you really can’t fix this one yourself. Use your cell phone and call for help immediately. That person should come meet you in the woods and help you evacuate. Tell them to bring a bike lock if you don’t have yours, leave your bike in the woods and come back later, or have someone else pick it up for you.

2. ii. Immobilize the bone if possible. Arms and collar bones can be immobilized by using your tee shirt as a sling: http://imgur.com/iAJUuTH Don’t try and make a splint unless you’ve got a 20 mile hike out, you’ll do more damage.

3. iii. If you have a leg or ankle injury it is best to wait for assistance. If help is not on the way you can use your bicycle as a crutch by raising the seat height and tucking it under your armpit. (rolling while sitting on the seat is an option for leg injuries, but only on extremely mild terrain.)

D. Head impact

1. i. If you’re alone and clobbered your melon sit down and relax. Drink water. Call for help asap if you aren’t seeing straight, have a headache for more than 5 minutes, feel blood anywhere on your head.

2. ii. Look at your helmet this can be a good indicator as to how serious your injuries are. Is it cracked in half? Call for help.

3. ii. Don’t rush to get back on the bike. I know you’re having fun but just chill.

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What to do if you see someone else has crashed?

Here’s the biggest rule of all:

1. Do not move them. Do not MOVE them. DO not move them. Do not move THEM. Do NOT move them. DO NOT MOVE THEM.

I don’t care if they scraped their knee or wiped out.

1. -They must initiate movement under their own power.
2. -Encourage them to sit and rest first.
3. -Help them up only if they ask for it.
4. -If they really hit hard tell them to chill out for a few minutes first.

When can you actually move them?

Airway, breathing and circulation take precedence in that order over not moving someone. For example, if someone plows headfirst into a tree and in addition to possibly breaking their neck is not breathing and has no pulse, it is absolutely okay to move them to properly perform CPR. If someone plows headfirst into a tree and has a pelvic fracture with heavy bleeding it is OK to move them to stop the bleeding. If you remember from that video they had to try quite a few different positions to be able to stop the blood.

If they're in the middle of the trail going to get run over, it may be okay to move them. Try to alert other riders first before resorting to moving them.

If someone crashes head first into a tree and somehow manages to pack their mouth and nose full of mud and can't breath, it is okay to move them to clear that out so they can breath.

If someone crashes head first into a tree and their is imminent danger (like rock slide, coiled black mamba under the rock they hit about to strike), it can be okay to move them as long as you are not putting yourself at risk.

Yes, in all these cases be careful, don't drag them around by the chin guard of their helmet! But do not let someone die because you are afraid to move them! Use your common sense and act logically.

Steps to addressing a fallen rider:

1. Alert other riders.

2. Yell: “RIDER DOWN, EVERYONE STOP” repeatedly.

3. If they are stopped in the middle of the trail put a bicycle or backpack or something easily seen “upstream” from the fallen rider. Basically make sure they don’t get run over.

4. If they are not in the middle of the trail, make sure their bike and gear is not in the way either. Make sure YOUR bike and gear isn’t in the way.

Attempt to establish Verbal communication.

1. Are you okay? Does anything hurt? Did you hit your head? Are you alone? What’s your name? Are you from around here? How can I help?

2. These questions can give you important info to better assist them

   -If they respond listen to the situation and act accordingly.

-Don’t let them say they are just fine. Ask them lots of questions. Some people get embarrassed.

-If they are unresponsive/unconscious. Call for help immediately. An ambulance or ride to the ER is necessary. Check for breathing/pulse. Perform CPR if you know how to.

DO NOT MOVE THEM People with head/neck/spinal injuries are in danger of paralysis among many things. Moving their bodies if they have sustained one of these injuries will increase the risk of permanent damage tenfold. If they are unable to move under their own power, don’t touch them unless they ask you for assistance.

1. If it seems apparent they should be moved but you are unsure, call 911 for help and the dispatcher will give proper instructions. Find out your exact location it will help rescue services. If they need help getting up or ask for help to be moved, don’t just do it. Ask: Does your head/neck/back hurt? Did you hurt your head/neck/back. If they say yes, don’t move them unless there are other imminent factors of danger. Wait a few minutes and see if they feel better. Don’t take their word for it. Call 911 for help if unsure.

Address injuries if possible. Only if the person is awake and hasn't sustained head/back injury

1. Airway and breathing. If they're unconscious make sure you hear/feel them breathing. If they are not breathing look for objects obstructing airway and begin CPR.

2. Cuts scrapes see 1 - Abrasion

3. Impacts, bruising, etc see 2 - Tumble

4. Head impact - check for concussion if you know how If you don’t know how to check, assume the worst. Make them walk out and seek immediate help.

5. Broken bones - Immobilize what’s broken if possible. Lock and leave your bike/gear behind, help them walk it out.

6. Internal Bleeding - Ask them if they impacted anywhere on their core. (Ribs chest back). (organs)

   1. Look at the area and check for swelling or reddening/purple skin.

   2. If you see this, get help asap they could have ruptured organs.

   3. If you don’t see anything initially, check again every 5-10 minutes. Internal bleeding can sometimes take a while to show.

7. Don’t leave them even if they say they’re okay Sometimes people will say they’re fine just going to catch their breath and rest. Don’t leave them until they get up and start to leave on their own.

Basic Common Sense:

-Whether it’s you or someone else who fell, don’t rush anything. Always sit and relax.

-If you are ever unsure of someone’s condition, call for help. Better safe than sorry.

-Don’t touch any conscious person unless they ask for help.

-Don’t move any unconscious person ever ever EVER.

-Don’t ride alone and if you do make sure people know your plans.

-If you see some idiot trying to "help" someone but doing it wrong, speak up. You know more and you could save someone's life.

Remain calm. Don’t panic, don’t rush, don’t do anything without taking a big breath and thinking with a clear mind. If you're unsure, call 911. This isn’t always easy, but you will do more damage acting rashly.

If anyone has questions or concerns or items that they think should be added please PM me.