The mountain biking fall that proved emergency first aid matters

Cycling UK member Will Legon recently found himself on the receiving end of a high-speed crash while out mountain biking with his son. It was a stark reminder that accidents often come unannounced. What started as a fun day tackling local trails in Sheffield ended with a trip to A&E, a CT scan and some painful injuries. In this personal account, Will reflects on how his first aid training and a well-stocked kit helped him stay calm, manage his injuries and guide his son through a potentially traumatic situation. His story underlines just how vital basic emergency first aid skills can be when things go wrong on the trail.

An unexpected crash and the value of being prepared

About 1am, as I waited for the results from a CT scan, and just a little more than 12 hours since I had first arrived at my local A&E, I contemplated that it’s often easier to get into hospital than out of it.

When I checked my emails and messages yesterday morning, I note that nobody had sent me the memo that I’d have an accident that day. Nonetheless, being the self-confessed first-aid nerd that I am, I had gone out to session some local trails with my 13yo equipped with a first aid kit, and thankfully a bit of knowledge on how to use it.

The ground’s surprisingly hard …

I had a rare opportunity to go mountain-biking with my lad. We’re off to Madeira this summer where there are some legendary trails. For my son to get the most of them, I thought it would be good if we tried out some of the more technical stuff local to us here in Sheffield, at Wharny (Wharncliffeside) and Greno Woods (Grenoside).

We’d sessioned some drops I knew at Wharny and so via some wonderful flowy berms courtesy of Ride Sheffield’s ‘Steel City’ we arrived at the final bomb-hole. Dropping into this is normally a straightforward affair, so long as you don’t bottle it and have a modicum of know-how. And so, I said to my lad to standby and watch this master-class…

Quite honestly, I’m not sure what happened. Instead of experiencing a glorious moment of air, and a roll out the other side, like so many times before, all I remember is brutally hitting the floor. I may have blacked out, (everything was black), and I emitted this awful involuntary guttural sound from the back of my throat.

Years of teaching outdoor first aid kicks in

Eventually I seemed to come round. Patrick was with me now and somehow despite being in a complete fug, my training kicked in. Well mostly it did - my adrenaline was flowing, I was in a lot of pain, but also there was a bit of me that wanted to show my son that I was alright.

My shoulder hurt and so did my ribs. I supported my right arm, taking the weight off my injured shoulder. Patrick unbuckled my belt kit and opened my first aid kit. I spied the paracetamol and asked him to pass it to me.

Local teenagers stood around the top of the bowl and shouted down asking if we needed any help. “Tell ‘em we’re ok P” - help’s good when it’s needed, but somehow, I thought I had this: and really didn’t want to manage a larger group in the outdoors, as well as my own recovery.

Next, I needed something to support my arm. I explained to Patrick how to apply the sling. The phrase we teach is to ‘bind it as you find it’. I knew what was going to offer me pain-relief and without really knowing where the damage was, he tied up my arm. My jacket was then strapped around me to keep it all still and simultaneously felt supportive for my ribs. This worked.

What’s the plan now?

We moved ourselves to somewhere safe, and I laid myself down on my side on my uninjured side. I wasn’t sure what to do next. I knew we’d need to be going home but wasn’t sure how. Could I drive maybe, would we need rescuing, or maybe another way? I didn’t know but instinctively told Patrick to reach for the casualty monitoring card in my first aid kit. Fill in everything you can I told him, and bit by bit, with a bit of help from me he did so.

Worst case scenario, whatever happened now he’d have the information to call the emergency services, and to give them some key information to get to us. I taught him how to find my pulse and was relieved to know he could find my radial pulse in my wrist. At least my blood pressure is normal, I thought. Internal bleeding is hard to see, but this is one indicator of how things are going inside.

Concussion’s confusing

When it came to looking at my level of consciousness, I knew that I really wasn’t in a good way. My head had taken a good battering, and I struggled to keep my eyes open, or know exactly where we were. I couldn’t even work out what month it was. I dwelled upon how funny it was that I could talk my boy through this sheet, but didn’t have a clue what had just happened or where I was. I told him to call my wife: there was no way I was driving home!

I didn’t feel ready to go anywhere right now, so I decided to start again at the top. I knew I had an airway and that I was breathing. Until now though I hadn’t actually got Patrick to do a full casualty survey of me. My shoulder and ribs really hurt, but these could be distracting me from something else. Starting at the top I then talked him through how to check me over.

My face was bruised and my temple was tender. I recalled the immense pain of hitting the deck with my head, and even with a full-face helmet, that had hurt. He checked my eyes and systematically worked his way down my body. Blood was coming from my elbow now, through the sling he’d applied, but that was not to be worried about now. My right thigh was tender too, but I knew it was ok.

Time flies

We went through more iterations of my vital signs. (I had forgotten that we’d already done this six or so minutes before). It all looked good: most importantly no signs of shock. The mechanism of injury could easily have meant things could be bad for me, but for now at least I was just a bit battered and bruised with some terrible concussion still going on.

Eventually we picked ourselves up, and pushed the bikes up hill. My wife had just arrived and was able to further assess me. (She’s a medic). Moments later we were headed to the local Emergency Department where I was swiftly triaged.

At A&E

Once more I needed my first aid training: sat in a seat outside the Radiology Department, I was beginning to feel faint and slightly nauseous. This isn’t surprising for someone who had suffered such a bang to the head. I knew I needed to get on the floor and placed myself in a recovery position. Very quickly I was found a trolley to lie on and wheeled off for my first set of X-rays.

Later a doctor came to assess me. She carefully palpated my stomach, and amazingly she’d elicited another source of pain. A tender tummy is potentially a sign of internal damage, and this being my right side, it was my liver at risk. And so, I was referred for a CT scan…

End to a long day

By 2am I was allowed to go home. I’m not sure if, at that rude and early hour when I called her for a lift home, that my missus was relieved or annoyed that I hadn’t broken any bones, nor done any damage to my head or liver. I was ok.

Just as importantly, my son was ok too. Seeing his dad come off his bike like that and emit those horrible guttural sounds, could have been quite traumatic, but being helped through the accident procedure kept him focused and centred. This morning, he just wanted to see my bloody elbow and to know how many ribs I’d broken. “None son, not a single fracture. Turns out I’m just a malingerer!”