Transcript Cycling first Aid

CYCLING FIRST AID
BRANDY FERGUSON, MD
DISASTER MED/EMS FELLOW
GWU HOSPITAL
OUTLINE
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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
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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:
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No airway issues
Patient not breathing
No pulse
CPR started
BACK TO THE CASE
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911 called
Ambulance en route
CPR continues
Supplies to use from
water-bottle kit?
COLLAPSE
COLLAPSE
• Important things to remember:
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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
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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
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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:
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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:
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No airway issues
Patient breathing
Good pulses
Deformity to right forearm, no wounds or bleeding
CASE #4: TREATMENT
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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:
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Any broken bones
Internal injuries
Bleeding
Head or neck injuries
ROAD RASH: TREATMENT
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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:
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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
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Be prepared!
Always apply CRIT
Assess ABCs
Always call for help
Feel comfortable providing first aid for different
injuries
QUESTIONS?