First Aid

[ttcycle]

Bit off topic but a paramedic is more skilled than an ambulance driver and technician aren't they?

Yes

 

[fossyant]

Does this mean I need to carry one, since I'm a girl? Must get myself organised

Nope you are a cyclist, and real cyclists don't take first aid packs round with them. You get off the floor, check the bike is OK, notice missing body parts, and cycle back home. One should really be carrying a paint touch up, couple of baby wipes and a can of polish. None of this sticky plasters and the like.

Or like my work colleague, you fall off, get up, check bike, continue for 3 days in the Alps, get home, ride next weekend wondering why your wrist is still sore climbing the Wizard, then think - better go to Hospital. Find out it's broken ! Kudos points earned.

 

[mrandmrspoves]

Research by Prof Malcolm Woollard shows that lay people were not managing to ventilate a patient due to poor airway management, this time off the chest leads to a drop in perfusion pressures and is linked to poor outcomes. You are correct that people did not do CPR as they were not comfortable doing ventilations but the reason the various councils/societies are saying compression only is due to the research bit.
Salbutamol is a POM, under what/whose clinical governance system are you prescribing and administering it?

I carry Salbutamol because I am asthmatic ....but would happily administer if I felt it was required...based on my knowledge and clinical assessment. Asthma still kills too many people. BTW it is now available on the P list so does not need prescription.

 

[lulubel]

Nope you are a cyclist, and real cyclists don't take first aid packs round with them. You get off the floor, check the bike is OK, notice missing body parts, and cycle back home. One should really be carrying a paint touch up, couple of baby wipes and a can of polish. None of this sticky plasters and the like.

Or like my work colleague, you fall off, get up, check bike, continue for 3 days in the Alps, get home, ride next weekend wondering why your wrist is still sore climbing the Wizard, then think - better go to Hospital. Find out it's broken ! Kudos points earned.

The first part matches with reality in my case. Last time I fell off my MTB, I got up, got the bike up, examined it for scratches and made sure everything still worked, then wondered where the blood was coming from. A bit of spit on some kitchen roll did a perfectly good job of cleaning the graze on my elbow!

I know someone who went around with a broken finger for 3 days after a fall before deciding he should get it x-rayed. Not as extreme as a wrist, but he is a doctor, so should know better.

I carry Salbutamol because I am asthmatic ....but would happily administer if I felt it was required...based on my knowledge and clinical assessment. Asthma still kills too many people. BTW it is now available on the P list so does not need prescription.

It's available without prescription over here too, as is Becotide, which suits me fine because I take both. But I do find it a bit worrying how easily available it is to people who don't know how dangerous it can be. My great grandmother died from a heart attack brought on by a bad reaction to salbutamol. She was given it in hospital, where she was being treated for emphysema, and they still weren't able to save her. Unfortunately, you don't know if you're going to be allergic to it until you take it for the first time.

 

[mrandmrspoves]

It's available without prescription over here too, as is Becotide, which suits me fine because I take both. But I do find it a bit worrying how easily available it is to people who don't know how dangerous it can be. My great grandmother died from a heart attack brought on by a bad reaction to salbutamol. She was given it in hospital, where she was being treated for emphysema, and they still weren't able to save her. Unfortunately, you don't know if you're going to be allergic to it until you take it for the first time.

Severe adverse reactions to Salbutamol are rare - but like with any medicine it carries risk. Where asthma is concerned, under treatment or delayed treatment carries a greater risk.
In hospital settings where large doses of Salbutamol may be given it is more likely that a person will suffer side effects. Fast heart rate and tremors being almost expected as they are very common. If someone has existing heart disease, it is possible for Salbutamol to trigger an irregular heart beat which can be harmful.
Sorry to hear about your Gran - but I would imagine that she was suffering from quite advanced disease if Salbutamol was judged to have actually caused her death.

 

[Grizzly]

I carry Salbutamol because I am asthmatic ....but would happily administer if I felt it was required...based on my knowledge and clinical assessment. Asthma still kills too many people. BTW it is now available on the P list so does not need prescription.

I know I'm going to come across as being arsey (dont know if that is a real word) but I can't agree with your approach to this. Adsa do sell Salbutamol over the counter but it is under a PDG, you have to meet a strict criteria to get it, it is still classed as a POM. As an asthmatic myself I know and agree totally with your point about asthma being a killer, but the treatment for a life threatening asthma attack is nebulised salbutamol, ipratropium bromide and IM adrenalin. Perhaps our experience of asthma is different and that is why we have different approaches to this.

 

[mrandmrspoves]

I know I'm going to come across as being arsey (dont know if that is a real word) but I can't agree with your approach to this. Adsa do sell Salbutamol over the counter but it is under a PDG, you have to meet a strict criteria to get it, it is still classed as a POM. As an asthmatic myself I know and agree totally with your point about asthma being a killer, but the treatment for a life threatening asthma attack is nebulised salbutamol, ipratropium bromide and IM adrenalin. Perhaps our experience of asthma is different and that is why we have different approaches to this.

Yes you are coming across as a bit arsey - but that's your prerogative!
In life threatening asthma, there's no doubt about it that the person requires urgent hospitalisation, and nebulised bronchodilators would be essential as would high % oxygen......but this thread is about 1st aid. I cannot carry an Oxygen cylinder in my saddlebag, nor do I carry IV cannulas, giving sets, a nebuliser, ecg machine, defibrillator etc. etc.
1 puff of Salbutamol delivered via an improvised spacer (A cone made from a rolled up sheet of paper will do) delivered at minute intervals until relief is achieved or an ambulance or first responder arrives will potentially save a life. 25 puffs of Salbutamol inhaler = 2.5mg as administered via a nebuliser.
I am not suggesting that everyone reading this thread who is asthmatic starts sharing their inhaler with anyone who is a bit breathless.... but nor would I suggest that people sit back watching someone dying in front of them while waiting for an ambulance, when they have a potent medical device with them that could save a life.

 

[SatNavSaysStraightOn]

Both my husband and I did an advanced first aid course designed for those who are going 'far from help' and have to keep the patient alive for days if needed until more advanced medical help is available. We have been trained to administer IM injections, insert canuala, give IV injections and fluids & suture small cuts (though just not in the UK with the odd exception or very remote areas in life threatening situations) and can purchase prescription only medications and other supplies to carry with us into remote areas of the world as well as all the usual for a first aid course.

And the truth is, I carry nothing with me except my 3 inhalers and my medic alert bracelet (I'm a moderately severe asthmatic (think 6 or 7 medications to control it) who is allergic to NSAID's), a phone, debit card and my medic alert info card.

In most parts of the UK you are never that far from medical help and as others have said, you have items around you that can help (like inner tubes, clothing, water), so there is little point (IMO) when out commuting/day trips on carrying much other than what you already know - knowledge weighs nothing. You have clothing, most of us carry water in some form and it is easy enough to flag a vehicle down and get more help if needed. Despite appearances most people have no issues in helping you if you are clearly in need of it and if you need it that much, a few plasters and antiseptic wipes are not going to help - trust me, I have been there. I won't link to the photos... most of you know the story and are probably really bored with it by now.

In places where I am further from help (I used to live in the Lakes at the very end of a long single track road, and the only immediate help was mountain rescue by helicopter and even that took plenty of time, as well having lived close to Rannoch Moor, so I am more than used to medical help being a long way off) then I carry a full first aid kit, not just plasters whether I am hiking, mountaineering or touring and there is always a full first aid kit in my car, no matter where we are in the UK, but on a bike in rural Cheshire, I carry nothing other than knowledge and initiative.

 

[mrandmrspoves]

Sometimes (indeed most times) 1st Aid for cyclists is actually self aid - it's about having something with you that will maintain your (or a companions) comfort while you finish your cycle ride such as a dressing to cover gravel rash after an off. Not life threatening - but inconvenient and uncomfortable.
Sometimes it's 1st aid as a sling to support a fractured wrist or arm after a more serious off or when you find a motorcyclist in a ditch or similar.
Rarely - but possibly, it's essential aid and can save a life. I do totally agree with those above who advise that 1st aid knowledge is more useful than a 1st Aid kit and no knowledge.
You can perform CPR with no equipment - it is easier and more pleasant (if giving rescue breathing) if you have a mask etc. but not essential.
You can prevent paralysis following spinal injury by recognising the risk and not moving someone when they can be kept safe where they are. (BTW if you move someone to your car to keep warm following an accident, be prepared for your car to be converted into a topless model (no not like Sam Fox used to be!) if they complain of even slight neck or back pain when the ambulance arrives)
You can stop bleeding by elevating a limb and applying direct pressure..... and so on and so on.

Or you can panic completely and make a bad situation worse - so do consider getting some first aid training.

 

[hoopdriver]

I carry a few first aid things when I am touring (a few more still when I was touring in Africa) but for general riding around, no.

 

[subaqua]

Sometimes (indeed most times) 1st Aid for cyclists is actually self aid - it's about having something with you that will maintain your (or a companions) comfort while you finish your cycle ride such as a dressing to cover gravel rash after an off. Not life threatening - but inconvenient and uncomfortable.
Sometimes it's 1st aid as a sling to support a fractured wrist or arm after a more serious off or when you find a motorcyclist in a ditch or similar.
Rarely - but possibly, it's essential aid and can save a life. I do totally agree with those above who advise that 1st aid knowledge is more useful than a 1st Aid kit and no knowledge.
You can perform CPR with no equipment - it is easier and more pleasant (if giving rescue breathing) if you have a mask etc. but not essential.
You can prevent paralysis following spinal injury by recognising the risk and not moving someone when they can be kept safe where they are. (BTW if you move someone to your car to keep warm following an accident, be prepared for your car to be converted into a topless model (no not like Sam Fox used to be!) if they complain of even slight neck or back pain when the ambulance arrives)
You can stop bleeding by elevating a limb and applying direct pressure..... and so on and so on.

Or you can panic completely and make a bad situation worse - so do consider getting some first aid training.

and thats why i bought one mask that will work for all situations and keep it in my daysack . nobody knows when they might come across an incident. I was walking between 2 work sites when i did it for real. not on a bike , not on the shore or a boat. just ordinary everyday life

 

[Drago]

...and it is easy enough to flag a vehicle down and get more help if needed.

On my midnight commute home on country roads I'm unlike to see a car the whole journey, and there ain't no mobile phone signal for some of it on any network. I hurt myself, I'm on my own, and even if I could summon help I'm not likely to get it in a hurry out there.

 

[SatNavSaysStraightOn]

On my midnight commute home on country roads I'm unlike to see a car the whole journey, and there ain't no mobile phone signal for some of it on any network. I hurt myself, I'm on my own, and even if I could summon help I'm not likely to get it in a hurry out there.

50% of my old 15 mile commute, one I did for 7 years before going off on a RTW tour, was not even on roads (single track or otherwise), going across an MOD training area and 2 nature reserves. 99.5% of the time, I would not meet anyone at all even during daylight hours. It was unlit, overgrown and subject to being very wet, muddy and difficult anytime it rained with trees frequently fallen across my route. I lived rurally with no neighbours, when my husband was away, him checking I had arrived home at night ringing our landline was the only way anyone knew I was home safely. There was no mobile phone signal at home and none at work either. Needless to say anywhere inbetween was not covered either. I did not even bother carrying a phone, in fact did not have one. I was on my own. This was rural Surrey/Hampshire border area. (For reference: I have lived in some of the most remote places in England & mainland Scotland where medical help is often hours away after being able to summon it and usually arrives by mountain rescue, not ambulance. I am used to being self sufficient.)

My point is that plasters are not going to be enough if you are needing that much help - it is better to have the knowledge to improvise; a sling can easily be made from clothing and commuting, that is something you usually have available even if it is only the dirty stuff coming home. Wounds can easily be washed out with water carried in a water bottle, and letting a small wound bleed is often the best way of cleaning it out. Personally I never commuted without full waterproofs being available to me - something that comes from my mountaineering, so combined with my work clothes (assuming I was carrying them), I had warmer clothes available, I had waterproofs available, I would have water to wash any wounds clean, I would have clothes that could be used for a sling, an inner tube for a tourniquet, an inner tube that could be used to stabilise a broken leg with the aid of a branch off a tree wrapped in clothing to make it more comfortable or even help stabilise a fractured pelvis if you got really creative(!) If you cycle in shoes with laces, tying them together will help stabilise a lower leg fracture as well - otherwise use that innertube cut in half to tie around your shoes. I would have some food & water with me and could easily support myself for 12 hours or so if needed by which time someone would have noticed I was missing (dealt with by my husband ringing me each night at a certain time when he was away from home). It would not necessarily be an easy 12 hours, or comfortable, but unless there was a severe frost due, I could survive (having completed a couple of survival courses helps just a much in those circumstances).

A standard first aid kit would not make much difference. What would you carry? A typical pocket first aid kit contains the following: 1 x Primary Care Leaflet, 1 x Tweezers, 1 x Scissors (5.5cm Blade), 6 x Safety Pins, 1 x White Open Woven Bandage 7.5cm x 5m, 1 x Crepe Bandage 5cm x 4.5m, 1 x Savlon Antiseptic Cream (15g Tube), 5 x 4-Ply Gauze Swabs 5 x 5cm, 1 x Micropore Tape 1.25cm x 5m, 3 x Hygienic Cleansing Wipes, 1 x Low Adherent Dressing 5 x 5cm, 1 x Pack of Assorted Plasters.
How much use is any of that if you can't hold your hands steady from shock? How much is of use if you have a head injury and are confused? How much is of use if you have come off your bike and have an open fracture of your lower leg? Nicities, nothing essential.

The truth is that what you are probably already carrying as part of your commute will be just as much use keeping you warm and if you have no mobile signal, keeping yourself alive until someone does notice you are missing and sumons help.

I cycle in all weathers; this year in -15C in some remote Turkish mountains when my husband and I both needed help, not a single thing was of any use, in any of our first aid kits other than to cover my wounds to prevent frost bite something we could easily have done with clothing or a towel if needed - warmer layers of clothes & waterproofs, hats & gloves, water, food and my sleeping bag were of significantly more use, plus the straps that held our tent to the bikes to make a tourniquet. (My husband's injuries were left to bleed and not even covered - correct proceedure for his bite.) It was almost 2 hours before the first medical help arrived & 4 hours before I was seen by someone qualified to deal with an injury such as mine. I had a severed major artery, a punctured major vein, a severed major nerve and 1/3-1/2 of the back of my calf hanging off my leg amongst other issues. Of what we were carrying, nothing was big enough to even start to cover a wound that big. Cleaning the wound out, allowing it to continue bleeding a touch, dealing with shock and fluid replacement and staying warm in -15C with my blood freezing on the road was much more important. Ironically, that injury could just as easily have happened on my old commute though not necessarily from a dog. I doubt I would have got medical help any faster.

My point is that you are no worse off than before mobile phones when people relied on others noticing that you had not arrived and if you are that worried about it, you would be better off carrying something like a Spot GPS messenger device (such as I have) that uses satelite to give your location and obtain help (subject to being coherent enough to find the devise and press the correct button). I can't link you to my review of it because CGOAB is down again at the moment, but that would be significantly more useful than a standard first aid kit if you are needing help to that degree. If you don't need help that much, then your wound can be cleaned with water and you get home of your own accord. Small standard first aid kits are not the answer, (IMO they are a comfort blanket, great til you actually need them, then you find their short comings), knowledge of first aid & survival is much more useful IMO.

When in the mountains, or far from medical help, we carry a life systems mountain leader pro first aid kit (RRP £90) which we have added to. It's basic weight is 1.2kg and originally contained some 87 items; it now contains many more items. We are both trained to use all of the items and the truth is, that when we re-set out for more remote areas, we will still need to add more items to it. That is the sort of thing that would be useful, though you could probably get away with the smaller mountain version which only weighs 700g basic weight.

 

[Drago]

Roger that. T'is why I carry a little more than just plasters.

 

[Licramite]

extreme conditions require extreme kit, and the best kit in the world is useless if you don't know how to use it.
most first aid kits are for minor injuries, if its anything more than bad cuts and bits of skin missing , a thermal blanket and a phone are the essential kit - first aid knowledge after that is most likely to help the most.

the best method if cycling (or walking) in bad country , up mountains , inaccessible areas - is in pairs , don't go alone, in those conditions its a fair chance of dying alone.