Ready for Anything

What to do if you come across an injured person

The obvious first thing to do when you come up on an injured cyclist is to make sure the scene is safe. Ideally you are not moving an injured person unless you can do this without causing further harm. However, you might need to move someone out of harm’s way or protect them by signaling or warning oncoming traffic.

Then there is a standard basic life support sequence we use to check for threats to life. It’s an “ABC” approach familiar to people who have taken CPR or basic first aid courses. We check the “A” or airway and make sure air can move in and out of the lungs. There may be a need to clear the mouth of blood, vomit, broken teeth, or to position the patient on their side so they can breathe.

Next we check for “B”, breathing, and hopefully don’t need to perform mouth-to-mouth or mouth-to-mask breathing. The only first aid for broken ribs, which can cause pain and shortness of breath while the injured person tries to breath, is simple reassurance and support until help arrives.

The “C” or circulation step is to check for a pulse and to begin chest compressions if there is no pulse present. It’s also importantly a check for severe bleeding and stop it. Direct pressure on the site of the bleeding with a hand or better yet a piece of fabric or an actual wound dressing will stop more bleeding.

We can add a “D” and an “E” to this sequence as well. “D” is the assumption of a spine injury and protection of the spine by avoiding unneeded movement until help arrives. “E” reminds us to look at things that are bent, broken or out of place to find serious injuries and also reminds us to think about the environment. The cyclist who was warm in the saddle may quickly become cold on the pavement.

Ideally you now hear the wail of the siren signaling that help is on the way.

— Tod Schimelpfenig, curriculum director, NOLS Wilderness Medicine Institute

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