First Aid for Cyclists

Cycle First Aid

by Steve Evans SRPara MCPara Liverpool Century RC Member

Cycle First Aid

Cycle First Aid Aims of First Aid • • • •

Preserve Life Prevent Condition Worsening Promote Recovery Send for Help Early 999 or 112

Systematic Approach C - Care – Be aware of danger to yourself “A dead rescuer is no good to anybody” and to the casualty and others • Moving traffic • Blind Bends • Spilt fuel • Create a NO smoking area

Systematic Approach C - Care R - Reconnaissance – You need to know how many Casualties there are, for each unconscious / seriously injured casualty you need an Ambulance ( 3 on the floor = 3 Ambulances )

Systematic Approach C– R– Inform – Dial 999 or 112 for the Ambulance Service or other Emergency Services if there is spilt fuel, threat of fire, trapped casualties, dangers to others

Systematic Approach C – R – I – Treat the casualties according to their needs remember your Priorities Catastrophic bleed, Airway, Breathing • Do NOT Move the Casualty unless their life is threatened

Common Injuries  Head on - Head and Face, Potential Neck – check the damage to the cars windscreen, Chest or Abdominal, fractures to thigh bone, (handle bars) hand / thumb  Side impact - Traumatic amputation of lower leg or fractures / dislocated ankle  FOOSH - Fractured Clavicle/Shoulder, broken wrist/forearm  Over Half of Cyclist who end up in hospital have Head injuries,50% Arm, 40% Leg, 5% Chest/abdomen.  Road Rash

Common Injuries

Consider the Damage Look at the potential for injuries,internal and external

Priorities • Catastrophic (life Threatening ) Bleed • Airway – clear if blocked or open if not breathing, being aware of potential Neck Injury, Cover open chest wounds • Cervical Awareness – DO NOT Remove Helmet unless life is threatened • Breathing – if No then start resuscitation

The No 1 Cause of Death • The No 1 Cause of Death in Trauma is a blocked Airway • When Unconscious the tongue drops to the back of the Casualty’s throat blocking their airway • This is preventable by performing a Jaw Thrust or Chin Lift

Tongue Blocking Airway

Jaw Thrust

Criteria for Helmet Removal • A Blocked Airway that cannot be cleared in any other way • The Casualty's Chest or Abdomen is not rising and falling (Not Breathing) • The need for Resuscitation • Remember that it takes 2 Persons to remove a Helmet safely

Control Of Haemorrhage

Wound Types     

Contusion (bruise) Laceration – tearing of the tissue Incision – clean cut with sharp knife Puncture – penetrating wound Graze / abrasion – Road Rash

Road Rash

Road Rash      

These injuries look and feel painful Look beyond the gore Are there underlying injuries Fractures Internal Injuries/bleeding Head Injuries

Road Rash Treatment    

Check for Underlying Injuries Wash out Dirt and Grit Cover with Clean dressing Needs scrubbing within a medical centre to prevent scaring and promote healing  Moist dressings help the healing process  Check for Infection later on,i.e. redness, hot to touch, swelling in Armpit or Groin

Body’s Reaction to Bleeding The body reacts three ways to control bleeding Blood clots Ends of vessels contract Blood pressure falls

Blood Loss P-

Posture / Position

E-

Expose / Examine

Foreign Objects

Splinter from the Velodrome track

Blood Loss P-

Posture / Position

E-

Expose / Examine

E-

Elevate

P-

Pressure

Pressure Points  Brachial – Upper arm, underneath the bicep muscle pressing against the upper arm bone

Pressure Points

Pressure Points  Brachial – Upper arm, underneath the bicep muscle pressing against the upper arm bone  Femoral – upper 3 rd of the groin pressing the femoral artery against the rim of the pelvis this will take 2 thumbs

Pressure Points  Brachial – Upper arm, underneath the bicep muscle pressing against the upper arm bone  Femoral – upper 3 rd of the groin pressing the femoral artery against the rim of the pelvis this will take 2 thumbs  Apply for Max 10 mins then release for 1 minute to flush the build up of toxins then re-apply if required

Shock Signs & Symptoms      

Pale, cool, clammy skin Ashen, cyanosed skin Fast weak pulse Rapid shallow breathing Nausea Feeling faint – lower level of consciousness

Shock-The Falling Lift  Early – Disorientated / Confused  Compensates by – Fast Pulse - Rapid Breathing - Pale cool Clammy Skin  Feels Faint  Late Sign – Cyanosed  Late Sign - Unconsciousness

Shock - Treatment     

Treat the possible cause Loosen tight clothing Rest – comfortable position Reassurance – Nil by Mouth Consider raising the legs – Not in Cardiac cases

Head Injuries  Laceration to scalp  Concussion – shaking of the brain  Compression – Bleeding in skull  Skull fracture – cranium / base

Levels of Consciousness • • • •

Alert and responsive Verbal - Responding to speech Pain - Responding to pain Unresponsive -No response

These are most important when dealing with severe head injuries

Compression Head Injury

Compression Head Injury  Bleeding within the Skull compressing the brain  Loss of Consciousness  Unequal Pupils  Flushed face  Slow full bounding pulse  Vomiting  TREATMENT = 999 Ambulance  Be Neck Injury Aware

Concussion      

Shaking of the brain Loss of Consciousness – amnesia Vomiting Headache/dizziness = Hospital Broken helmet = more serious Treatment, Monitor the Patient for changes, take to hospital if concerned

Head Injury Treatment  Gain history  Monitor AVPU, Breathing, pulse  Dress any wounds  If Unconscious A.B.C.

Functions of the Skeleton  Gives shape and support  Protects internal organs  Along side major bones are major blood vessels / nerves for protection

Classifications of Fractures  Closed – the bone is fractured but there is no external wound  Open – there is an external wound leading to the site of the fracture. The bone may be protruding  Complicated – the ends of the bones have damaged underlying organs

Hand Injuries

FOOSH-Arm Injuries

Broken Collar Bone

Broken Collar Bone

Complications of Collar Bone injury • Damage to Underlying OrgansPunctured Lung causing difficulty in breathing • Damage to blood vessels- Arteries and veins leading to blood loss • Damage to nerves- loss of movement or sensation

Signs and Symptoms of Collar Bone Injury • • • • • •

Pain over the area of the break A bump may be felt or a step seen A reddish-purple bruise starts to appear The shoulder appears to sag or drop Inability to raise the arm due to pain People report a popping or snapping sound

Treatment of Collar Bone Injury • Look for Underlying problems, breathing or massive swelling • Apply a sling or at least support the injured side • Treat for shock • Give pain relief if available • Send to hospital for an X-Ray • Do not allow to ride any further

Leg Injuries

Signs & Symptoms of a fracture  Swelling  Loss of movement  Irregularity  Pain  Deformity

 Unnatural movement  Crepitus  Tenderness  Shock

Fractures - Treatment  Upper limbs – support in a comfortable position  Lower limbs – do NOT move unless life is threatened  Lower limbs – do NOT attempt to straighten limbs  Treat for Shock

Strains & Sprains  Strain – history of over stretching - sudden sharp pain - swelling possible cramps  Sprain – history of twisting a joint - pain at joint - swelling possible discolouration

Strains & Sprains Treatment      

Treatment for both R.I.C.E. Rest Ice – bag of frozen peas in a cloth Compress – not to tight Elevate – to the height of a stool

Spinal Injuries

The Spine

Spinal Injuries

Spinal Injuries - Causes       

Sports accidents Road Traffic Collisions Falls Vertical Deceleration Injury Diving Accidents Head injuries Direct force injuries

Spinal Injuries – Signs & Symptoms       

History is Vital May be no obvious signs of injury Lack of sensation Pins & Needles Inability to move limbs Back or Neck pain No symptoms present – damage yet to be done

Spinal Injuries - Treatment If you suspect a spinal injury  The Casualty must Not be moved unless their life is threatened  Keep the head still – Trauma Head hold  Do not allow others to interfere  Remember – there is no second chance

Trauma Head Hold

Spinal Injuries  If there is Vomit or blood in the Casualty’s airway and it cannot be cleared. Then there is need for a Log Roll to be performed  Log Rolls can only be performed safely with 4 persons, one to hold the head and control the rest of the group, there is a need to work as a team and roll the Casualty on to their side as one unit (Log)

Cardio Pulmonary Resuscitation

Priorities for CPR D - Danger R - Response S - Stop Life Threatening Bleeding A - Airway - be Neck Injury Aware B - Breathing NO dial 999 C - Compressions / Rescue Breaths (1 person to hold the head)

Trauma Head Hold

Hand Position - Adult

Adult Basic Life Support Notes The determinant for starting CPR is now a patient who is “Not breathing normally”. This indicates agonal or cheyne-stokes breathing where the heart has already Stopped. Agonal breathing is characterised by respiratory effort in short gasps, with absences in breathing up to 15-30 seconds in-between gasps.

There is no longer an initial 2 ventilations. Once a decision to commence has been made, the rescuer starts with 30 compressions.

There are no longer any pulse or circulation checks once CPR has started. The determinant for stopping resuscitation is a patient who is “Breathing normally”.

The rescuer has the option to perform compressiononly CPR, at a rate of 100 compressions per minute.

This is where the need for mouth-to-mouth would previously have prevented people from doing anything.

Effectiveness of Rescuer CPR Number of Compressions

Approved Compressions

1 min

81.5

92.9%

2 min

80.2

67.2%

3 min

80.6

39.2%

4 min

84.3

31.3%

5 min

77.4

18.0%

Hightower D: Annals of Emergency. Medic. (1995) Sept 26:3

ICE in your Mobile • It is recommended that you place In Case of Emergency (ICE) in your contacts within your Mobile phone • It is good practice as Emergency workers like Doctors , Nurses and Paramedic will be able to contact your family if you are Unconscious or Badly injured • Place Name, Number and relationship

Really Bad Cycling Injury Helmet Hair

Cycle First Aid

by Steve Evans SRPara MCPara Liverpool Century RC Member