You've just come round the bend and seen your riding partner take a serious slide, tumble or even impact. However, before you are able to stop your bike your friend is back on their feet and you breath a sigh of relief.

There are a number of unobvious, but important things to remember in this situation.

The casualty's body will be pumped full of adrenaline. It is quite possible that without this adrenaline they would not even be able to move. However, at the time their condition will be deceptive, as they will appear remarkably alert, strong, and healthy.

Injuries are not always apparent. The casualty could be conscious and coherent, but still suffering from a number of dangerous and life threatening injuries such as spinal damage, internal bleeding or even concussion.

The casualty will be confused, and will not be able to make clear decisions.

Therefore, I would recommend the following for all but the most trivial of falls:

Immobilize the casualty as quickly as possible to prevent aggravation of any spinal injury. If possible place some sort of support collar around the riders neck, and if they are still wearing their helmet do not remove it and do not let the casualty remove it.

Send for an ambulance as quickly as possible, despite whatever pleas the casualty may make to the contrary. Do not call friends, relations etc to give them a ride. An ambulance will provide the safest ride to hospital, particularly if there is any undetected spinal damage.

Dealing with a conscious patient is far more difficult than an unconscious one. If possible it is probably best to have a person that the casualty trusts on hand to help strengthen your persuasiveness.

The casualty will most probably be worried about the state of their motorcycle. Remember that they are confused, and not thinking clearly. If manpower allows it, arrange for the bike to be stood up and taken care of as best as possible. When the casualty asks you about their motorcycle, give them an honest answer. The reason is simple, if they think you are lying they will want to see it themselves.

Assure the casualty that their motorcycle will be alright, and if possible ask them were they would like it taken. It is best to promise the casualty that you will get the bike to where they ask, even if you have no idea how this is going to be achieved. Your most important duty is to keep the casualty as still as possible until trained help arrives.

The reason I have written these things, is that at the time it may seem unnecessary to take these steps, but please remember that the casualty may be seriously injured, despite their ability to smile and joke about the fall. Furthermore, due to the adrenaline rush, they will probably feel quite well, and try to argue over the above recommended course of treatment.

All of these comments are based on a real life experience that I recently had, where the seemingly healthy casualty was in fact suffering from massive soft tissue damage, possible spinal damage and mild concussion as a result of a nearly fatal fall.

I was thinking clearly enough to force him to go to hospital to be checked out, but not clearly enough to realise that just because he was walking didn't actually mean he was more or less unhurt. As a result of this, I made him sit down, but didn't immobilize him as I should have, and arranged a ride in a private car as opposed to an ambulance.

I am happy to say that the possible spinal damage seems to have never occurred, and that my friend and riding companion seems to be recovering well from his very near brush with death.

Although my friend's bike was written off, I still call things like this free lessons, and thought that others out there might like to learn this one the easy way.

Clem Colman,
Canberra, Australia.

The part about not removing the helmet is critical unless you have had special training on how to do it properly (and it requires two people). But one thing to be prepared for is that riders that have crashed and gone under (unconscious) often are very claustrophobic when they wake up, and want their helmet removed NOW, especially if it is a full-face (they will fight you to get it off). Do not let them convince you to remove it unless there is a medical need to remove it. Keep in mind that anyone that has gone unconscious or has hit their head MUST be assumed to have cervical spine damage until proven otherwise at a hospital.

If a crashee is confused, this could be due to an altered mental status, possible due to the early signs of shock. I have actually seen an automobile crash where a driver was up and looking fine. We were able to convince him to go with us in the ambulance (we gave him the option of going with us or going with the deputy to jail). We were later told that he had massive internal bleeding and would have been dead within an hour had he not been taken to the hospital when he was.

The point is to look at what we call Mechanism of Injury. If a rider lowsides and does not flip, well and good. But if they highside, flip, or hit something, then they need to be seen by a doctor. Only an x-ray can really rule out spinal damage. The best way to get them to a doctor is by ambulance (not by you), because an ambulance has oxygen and other life saving equipment on board.

Nick Marks

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