10 Most Common Bicycling Injuries

Cardiac Incident

There is no substitute for taking a CPR/AED/First Aid Class. These classes are lifesavers – literally. They explain what to do and WHY to do it. Modern medicine is phenomenal and what they can do for PT having a cardiac incident – from stroke to sudden cardiac arrest – is simply amazing – science rules. However, the hard part is keeping the PT alive long enough to get them to modern medicine and this is where a CPR/AED/First Aid course is so important. There is NO substitution for a CPR/AED/First Aid Course – take one. On a personal level – I have been on a bike ride when a PT had sudden cardiac arrest. We did CPR and shocked with an AED and the PT survived. The stuff works. Take a course.

A little common sense about cardiac events – not to be confused with taking a CPR/AED/First Aid course – I carry a face shield in my wallet and in my bicycle pack. I also have 4 – 81 mg CHEWABLE aspirin taped to my face shield with the knowledge that if the aspirin do not work – then probably I will have to use the face shield. Next, if there is ONE thing that I hope bicyclist will get from my writing is that a PT having a cardiac incident ALMOST never realizes or admits to themselves (or others) that they are having a cardiac incident. So, asking the PT if they think they are having a heart attack will almost always be answered with a no. Call 911 anyway – as a First Aid person, if a PT is presenting with chest pains, shortness of breath, pain in the left arm/back/right arm/neck, profusely sweating, tightness /pressure in the chest area – or any combination of these symptoms – call 911 and do NOT hesitate. Again, almost every First Aid course offered – states that frequently when a PT is having a cardiac incident – PT’s denial of a cardiac incident is actually a symptom of having a cardiac incident. The smart move is to call 911 and when the ambulance shows up and AFTER the PT goes to the hospital, then both you and the PT will find out if they had a cardiac incident.

Out riding your bike and a PT starts presenting with symptoms. DO NOT LET THE PT CONTINUE RIDING and call 911 or getting someone else to call 911. Then, put the PT in a position of comfort, loosen clothing, and do whatever you can to assist the PT in breathing. FIND OUT if the PT has medication for the cardiac incident. Assisting a PT with their cardiac medicine can be tricky – the meds will probably be nitro and there are complications – especially if the PT is also taking erectile dysfunction meds (Viagra). Let the PT make all decisions on taking the meds.

If they do not have medication and you have chewable aspirin, find out if the PT is allergic to aspirin or if they are on some sort of blood thinner. PTs with asthma frequently are allergic to aspirin. If allergic or already on blood thinners, then do not give aspirin but if they are NOT allergic or on blood thinners, then give them the aspirin. Remember, if you ask them if they want the aspirin they will probably say no because they (PT) does not think they are having a cardiac incident. It is denial –who wants to admit to themselves that they are having a heart attack – if they are not allergic to aspirin or on blood thinners – I usually just hand then the aspirin and ask them to chew them up. It is tough to remember numbers of mg/etc during an emergency and that is why I have the aspirin taped to my face shield. I know to give two or three aspirin. One last thing on aspirin – if the PT is going in and out of consciousness – do NOT give aspirin simply because the PT will probably start choking on the aspirin. Thus, making a very dangerous situation – even more dangerous. Use personal judgment on this.

Strokes are an entirely different matter. The symptoms are different and giving the PT aspirin is NOT part of the recommended First Aid Treatment. Again, there is no substitute for a CPR/AED/First Aid Course in terms of treating a cardiac incident. There are so many VERY important little things to remember. Take a course – the life you save will probably not be some stranger on the bike path. More than likely it will be a friend, loved-one, or a family member. Like I said, modern medicine is amazing but we have to get the PT to the modern medicine. Knowing what to do in the first 8 minutes can mean the difference between the PT’s life or death. Take a course. Oh yeah, and be sure you ride with folks that know how to treat a cardiac incident. The life that is saved – may be yours.