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In riding, working and just being around horses, accidents can and do happen. Nobody plans to fall from a horse, get kicked, trampled or even bitten, but when this happens, we need to know how to assist those who have been injured, without causing more damage.
SA Horseman spoke to Maike Löwe, a qualified basic life support paramedic, about the do’s and don’ts in these situations. Above all, stay calm and follow the advice below.
Q. When a rider has fallen and is unconscious, how should one assist, if at all?
A. The first thing one should do when approaching a scene, is to make sure it is safe for you, the aid-giver. Your safety is very important because you are worth nothing to the victim if you are injured as well.
The second thing is to tap the rider on the shoulder and talk loud to him/her to make sure there isn’t any response. Thirdly, make sure the individual’s airway is protected – make sure the rider can breathe. Try not to move the person unnecessarily, as you don’t want to create more harm. Also manually stabilise the spine.
Q. If breathing is impaired, what must one do?
A. With any fall from one metre and above, it is assumed that the patient has sustained a spinal injury, and therefore precautions have to be taken not to aggravate this possible injury.
When breathing is impaired, one has to make sure the airway is open by performing a jaw thrust (opening the jaw) in the event of spinal injury or a head tilt in the event where spinal injury can be counted out. Always try to protect the spine.
Q. In what circumstances can one try to move the patient?
A. The only time one can attempt to move an injured patient, is when the patient’s life is in danger if left in the current position.
Q. What do you do when there is an obvious break in a limb?
A. Do not try to reposition the fractured limb. Stabilise the limb with splints or anything you can use as a splint. Make the patient comfortable, elevate the limb if possible and wait for an ambulance or take the patient to the emergency room for treatment.
Q. When a person is winded, what can one do to help?
A. When a person is winded, one should try and increase the thoracic cavity (chest cavity) to allow airflow into the lungs. This is done by simply letting the winded person straighten their arms above their head, and encouraging the person to take slow deep breaths.
Q. How does one treat an open wound with blood gushing out of it?
A. First one should put the patient at rest by making them comfortable, talking to them and explaining what you are doing; this slows down the heart rate. Then one should apply direct pressure to the wound with a gloved hand (if gloves are not available, a plastic bag can be used) and gauze or any other clean dressing material to stop the flow of blood. Thirdly, try to elevate the injured part above heart level.
The dressing material should be clean and non-fluffy. It is also important to remember that one should never remove a dressing once it is in place. If the dressing gets blood soaked, simply apply another dressing over the first one and so on.
Q. When there is obvious head trauma, what should one do?
A. Firstly, put the patient at rest by talking to them and explaining what you are doing. Immobilise the spine. Call for backup emergency medical services (EMS) as soon as possible. Keep the patient calm and try to prevent him from moving around.
Q. What if he is wearing a helmet?
A. If head trauma is suspected, then spinal trauma is also a big possibility. Never remove the helmet if you are not trained to do so. Removing the helmet can cause further injury to the spine and head if not done correctly. Keep the patient calm and wait for EMS to perform their procedures.
Q. How should one treat dislocations?
A. Stabilise the dislocated limb and make the patient as comfortable as possible. Do not try to pop the limb back in as you may cause a lot of structural damage to the limb.
Q. Should sugar water, alcohol or anything else be given for shock?
A. No, as a lot of people start to vomit as a result of shock and this can cause aspiration (inhalation of vomit). If the individual is really thirsty, you can dampen his lips with water or an ice cube.
Q. Should any medication be administered for pain before medical help arrives?
A. If possible not, as certain medications given will prohibit the paramedic to use the medication they have available. Giving the wrong medication can cause complications in further treatment.
Conclusion
While we all hope never to be placed in this situation, it remains necessary to adhere to some safety regulations at all times and to apply some common sense. As they say, prevention is better than cure. That said, please remember the following:
- Never do an outride on your own
- If you do go on an outride, even in a group, make sure you tell someone where you will be going and for approximately how long you will be out
- This is the age of technology – take your cellphone along when you ride out
- Do not take unnecessary risks
- Even if your discipline does not require it, use a safety helmet when riding (especially when riding out). It is always wise and will protect the head in a fall
- When working with nervous, young or unbroken horses, always keep your eye on them
- Never approach your horse in a field full of horses with handfuls of tidbits. The other horses may start fighting about the food and you could end up in the middle, getting kicked or trampled.
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