PATRICIA SMITH: Those Hard-Headed Horsemen
I realized after seeing a rider fall off at the Hunter Pace last Sunday that we all could use a review of proper procedures for injured riders.
Luckily, the person wasn't seriously hurt. But it prompted me to ask my friend Cricket Gentry, who has been a paramedic for 30 years, to give us some guidelines to follow when a rider takes a tumble.
Here is what Cricket had to say:
Horse people are a tough bunch, hard-headed and stubborn and very good at denial. Don't let the person get up and walk until a trained professional has had the chance to evaluate the patient. I realize it is a waste of time to mention that we are horse people. When we take a fall it seems that if we jump up fast enough maybe no one will notice that we fell. Just know that sometimes a person is hurt a lot worse than he or she knows. The rider may have non-displaced fractures of the neck or back. An injured rider can have concussions which makes you do and say dumb things like, "I'm fine, I'll just walk it off" or "Where am I and what just happened?" If folks seem confused or dazed GET HELP. Very often if you have a head injury severe enough to cause a concussion you can have a neck injury too. You can always ask them if they know where they are or what day it is -- but don't ask who the President of the United States is -- you may get in a fight.
After a traumatic injury, such as a fall from a horse, it is best not to move the person any more than is needed until a trained person evaluates the patient.
Always make sure the person has an open airway, is breathing and has a pulse. If a person is talking to you, these things are obviously present. If the person is unconscious you may need to make sure there is nothing blocking the airway. Heaven forbid that the person doesn't have a pulse. You should be prepared to do CPR if needed. Take a CPR class -- it's a great skill to know. Also, the emergency dispatchers are prepared to talk you through the process.
Always try to stabilize the neck and spine at least until the trained personnel arrive.
Control bleeding with direct pressure and a dressing. After all, that was one of the original reasons to wear a stock tie -- it made a great bandage or tourniquet.
Boots can be removed or cut off. (Always cut down the seams so they can be repaired.) But, boots can often act as a splint until the arrival of trained personnel with splinting equipment. You'd be surprised how quickly a leg or ankle can swell when you take off the boot.
Always carry a cell phone with you and be prepared to give the dispatcher the closest hard-surface road to where you are located.
I would strongly suggest that everyone take a CPR class and some form of first aid training. It is helpful around the barn and with everyday life outside of the horse world.
The reason I have been in emergency medicine for over 30 years is because of the horses. Several folks from the Moore County Hounds took an EMT class in the 70s so we would know what to do when someone crashed in the hunt field. From that class I found a rewarding and fascinating career as a Paramedic.
Patricia Smith can be reached by email at firstname.lastname@example.org.
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