As adventurers, we must all accept that there is a risk of injury when we are exploring the outdoors. Nobody wants to get injured and by the same token, no one wants to see others get injured while out and about. But chances are you’ll be first on the scene during an incident at some point in which case it makes sense to be prepared.
So, what should you do if you come across someone that’s been injured? We have put together the following information and guidance. Please note that the following may not be applicable to to every situation. All advice should be considered as general advice only.
Whether it’s descending at 90km/h on your bike, or walking along a mountain trail path there is always that unfortunate risk of injury. With learned experience, we all constantly assess the risks and scan for hazards as we go. Sometimes however, incidents can and do happen.
So what should you do if you come across an injured person? It may sound very simplistic but a good approach can be using "DR ABC". As simple as it sounds, there’s a good reason why DR ABC has proved to be reliable when it comes to providing first aid.
Of course, if there is someone else present at the scene of an incident who has first aid or medical training, you should let them lead and assist where and when possible. But assuming you’re the only one there, here’s how to proceed.
Let's go through the steps:
D (is for Danger)
If the immediate environment is dangerous to either the injured person(s) or yourself, you need to make it safe before doing anything else. We will use a rider who has crashed as an example. If the injured person (e.g. rider) is on a road with traffic, your priority should be to ensure traffic isn’t an issue. This may involve:
Slowing or controlling traffic
Positioning your bike (upside-down) or car in a position ahead of the injured person to draw attention and/or to protect the scene and/or to avoid a secondary incident
Use a car’s hazard lights and or other people to warn traffic of the incident to assist with the above
If the above is not possible, you may need to move the injured person and yourself to a safe position
This final point should also answer the common question of whether or not you should move an injured person. Quite simply, you should move an injured person if there is danger to them or yourself. Importantly, if you’re going to move an injured person, try to immobilise the spine from head to bottom as much as possible.
Next you should decide whether or not to call 999 (or 112 which is the pan-European equivalent to 999 and can be used in the UK). Ask yourself:
Does the injured person(s) need higher-level, urgent medical care?
Do they need ambulance or helicopter transport to an emergency department?
Do the police need to be involved?
At this point you might locate or ask someone else to locate the nearest Automated External Defibrillator (AED) (read more about this below).
R (is for Response)
Check to see if the injured person is conscious. An unconscious person implies a more serious incident and someone that is at risk of further injuries. An unconscious person should not be moved unless the ‘Danger’ imperative overrides the risk of further injury. Again, the spine from head to bottom should be immobilised as much as possible when moving such an injured person.
A conscious person can be more safely moved away from danger as they can help splint any injured parts themselves. Clearly it is better to move away from a road when possible.
A (is for Airway)
Check that there is nothing obstructing the person’s airway (e.g. chewing gum, energy bars or broken teeth). Remove anything that is causing or may cause an obstruction but be careful not to push any obstructions down their throat. Consider placing the patient into the ‘Recovery position’: facing downwards and slightly to the side, supported by their bent limbs. This will help keen an unconscious person's airway open.
B (is for Breathing) and C (is for Circulation)
Check that the person is breathing and that they have a pulse. If they do not, then you should start Cardio-Pulmonary Resuscitation (CPR). This may involve chest compressions and ‘mouth to mouth’ resuscitation.
If available, you can use an Automated External Defibrillator (AED) at this point. An AED is used to administer an electric shock to a person who is having a cardiac arrest. AED's are designed to allow non-medical personnel to save lives.
AED's can also be referred to as Public Access Defibrillators (PAD) if they are made accessible in a location for public use.
AEDs are designed to be used by members of the public who have not received any training. They provide audible instructions and sometimes visual prompts on a screen. The AED will analyse the heart’s electrical rhythm and if it detects a rhythm likely to respond to a shock, it will charge itself ready to deliver a shock. Some devices then deliver the shock automatically without needing any further action by the operator; others instruct the operator to press a button to deliver the shock (these are often referred to as 'semi-automatic' AEDs).
After this the AED will tell the rescuer to give the victim CPR. After a fixed period, the AED will tell the rescuers not to touch the victim while it checks the heart rhythm and a further shock is given (if it is needed).
An AED will not allow a shock to be given unless it is needed, meaning it is extremely unlikely that it will do any harm to the person who has collapsed.
Bear in mind that if you’re faced with a situation where you’ve got multiple injured persons, the person(s) making the most noise may not need the most urgent attention. It is the silent, unconscious injured person(s) that should be attended to first.
As well as knowing how to react when someone’s been injured, there are also a handful of preventative measures you can take.
First aid training is offered by many different providers in the UK (and around the world) with the most commonly known organisation being St John Ambulance . A Certified First Aid course cost starts at about £150 for a one-day course and can go up from there depending on the focus. A Basic First Aid Awareness course will cost less than £50 and only takes a few hours. Book your course today with St John Ambulance.
ICE (In Case of Emergency)
Imagine that you are the unconscious person that is found. How would the rescuer know who you are, who your emergency contact is, and what medical conditions you may have? You should have all of this information easily available. Some commonly-used ICE solutions include bracelets or cards in a wallet/jersey pocket. iPhone users (or if you find a person with an iPhone) should check out the Medical ID function that is accessible on devices with iOS 8 even when the phone is locked.
First aid kits
Do you carry a first aid kit with you? Should you? You should plan to have access to a first aid kit when you head outdoors. Whilst a serious injury may necessitate calling for the emergency services, you should be able to deal with cuts and grazes yourself.
You should consider where you are adventuring, whether it is in a suburban area (where pharmacies and doctors are accessible) or up in the mountains (far away from medical assistance). Always take a small first-aid kit with you. This could be as simple as a small sandwich bag with adhesive dressings of various sizes and a small bandage.
If in a group in the mountains, it may be worth taking more supplies (e.g. triangular bandages, space blankets, different sized crepe bandages, more adhesive dressings, and even some antiseptic, spread amongst the group.
If you have a regular swim, climb or ride, an option for you might be to leave your own first-aid kit somewhere that you and group know and can access should the need arise.
It might sound obvious, but you should always let someone know where you are going, and when you should be back. And if you are heading for a remote area, do some research to find out if mobile phone coverage is available.