Trailside Triage: First-Aid for Mountain Bikers
How to improvise a sling, splint or bandage when things go wrong
By Brian Fisk
Bringing a small first-aid kit is a good idea on mountain bike rides. Photo: Kurt Wilson
It’s all probability. When you ride on the edge, sometimes you’re going to crash. And sometimes when you crash, you’re going to get hurt. Do you know what to do if that happens?Nate Schotanus does. He’s a paramedic at the University of Kansas Hospital in the US as well as a mountain bike patroller with 13 years of experience and a member of IMBA’s National Mountain Bike Patrol advisory board. The first thing Schotanus says any first responder to an accident should do is make sure both you and the person you’re helping are out of danger (no traffic, no falling trees or rocks) and that the injury doesn’t involve the head or spine. (If there’s helmet damage, you watched them hit their head or they’re lacking sensation in their extremities, get help to come to you — don’t move the injured person.)The (sort of) fortunate truth? Most mountain bike injuries involve trauma to the wrist, arm, shoulder or collarbone. Here’s Schotanus’s advice on how to improvise first-aid devices to get your mate out safely and effectively — because that’s the point of first aid: to stabilise the injury so you can get to a hospital for expert help. The Splint“The idea with splinting is to prevent further damage and pain,” Schotanus says. The trick is to stabilise the bone above and below the injured joint or the joints nearest the injury; for example, with a forearm injury, you want the splint to be long enough to stabilise the wrist and the elbow. What to use: Two sticks! Staying with the forearm example, you’d choose sticks (about as big around as your thumb, with no jutting branches) long enough to go from the palm of the hand to the elbow. Put one stick from palm to elbow joint, and the other on the opposite side. Lash the splint in place using spare tubes or pieces of clothing. The Sling“When most people fall and hurt their arm or elbow, the initial reaction is to bring the arm in against the body and hold it there,” Schotanus explains. “That’s a comfortable position, and that’s what you want to think of when you’re improvising a sling.”What to use: Two tubes! Use them in a sling-and-swath technique: loop one over the injured person’s neck, and use the bottom of the loop (shortened with a knot if needed) to hold the arm in a comfortably bent position — this is the sling. The swath prevents lateral movement: take a second tube and tie it around the person to hold the arm in place. The BandageMost cycling clothing is designed not to absorb liquid, so it doesn’t make the best bandage. What to use: Pressure. “If you apply firm pressure, even without a bandage, it will take care of most bleeding,” Schotanus says. Looking for a less-direct option? Try your gloves — the terrycloth patches actually are absorbent and can help blood clot. If it’s a big slice, hold the gloves in place by tying a shirt or tube around them to keep pressure applied while you help the person get out of the woods. And what if they’re really bleeding — as in spurting blood from a deep cut? Direct pressure — a lot of it — above the cut can stem the flow. Schotanus even says that tourniquets, once thought of as a no-no, can still be a life-saving measure of last resort. The person might lose a limb, but the tourniquet could save their life.
If the injury is that bad, you’ll need to act fast. Tie a shirt around the wounded limb, about an inch above the wound. Take a stick (again, a little thicker than your thumb) and tie it into the cloth above the knot you just made. Now, twist the stick, and keep twisting until the bleeding stops. Tuck the stick in so it doesn’t unwind. With the bleeding stopped, call for help (if someone hasn’t already) to get the person out. You brought your phone, right?