BRANDY FERGUSON, MD DISASTER MED/EMS FELLOW GWU HOSPITAL CYCLING FIRST AID

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

60 year old male cyclist on Rock Creek Parkway Suddenly falls to the ground He is not moving What next?

APPROACHING THE SCENE C are Be aware of any dangers (moving traffic, blind bends) R econnaissance How many people are injured? Minor or serious injuries? I nform Call for assistance or call 911 T reat Assess affected persons, do not move patient

ASSESSING THE PATIENT: ABCs: A irway Look for objects in mouth Look for any injuries to mouth, neck, chest B reathing Look, listen, feel C irculation 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

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

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

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: P osition patient E xpose/explore for other wounds E levate affected limb P ressure

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

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

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?