10 Most Common Bicycling Injuries

Hit by a Car/Bicycle

I have been hit by a car – actually, it was a van. It was the real deal: ambulance, ER, MRI, police, court, lawyer, etc. – so, I know what it is like to be hit. As a medic, I have seen single bicyclist accidents, bike on bike accidents, and car/bicyclist accidents. Since I am usually doing bicycle tours, I have seen a lot more single bicyclist (discussed under First Aid Procedures) and bike on bike accidents than bike/car. However, the procedures for bike on bike accidents and bike/car are very similar. Of course, you are going to call 911 – any accident involving two people is technically a crime scene so, calling 911 is in the plan. However, prior to even that – do your scene size up, which I have gone into detail concerning on web page. AFTER you have secured the scene and called 911 (EMS will want to know your exact location and estimated age, sex, and number of PTs, mechanism of injuries, responsive/unresponsive, etc.) then determine which PT to treat first. At that time I usually ALSO try to find out what resources I have available – such as – are there any other medical professionals in the area. Frequently there are and even if they are not familiar with pre-hospital medicine, they can assist with vitals/etc. Treat the immediate life threats and do the primary and secondary assessments. Again – these procedures are to elaborate to write about here – take a First Aid Course. You will not only learn the procedures but also practice them to the point that when emergencies happen, the skills will come back.

Every accident is different. I say that because it is important to remember that just because you know how to do a head to toe exam and how to roll a patient – due to the MOI and extent of injuries, you may elect to skip some procedures and just wait for the ambulance. I say this thinking of a bike on bike accident I saw where the two bicyclists hit – head-on – and both of them were going down a steep downhill in opposite directions. They hit on the bridge at the base of the hill. One PT was so critically injured that I was afraid to even roll the PT on to his/her back in order to do a head to toe. We (there were several of us working PT) determined that the PT was breathing and his/her respirations were secure (ABC’s intact) in the prone position and we left him/her in that position. It was a simple decision: 911 had been called and we could hear the sirens; the PT had an altered mental status; and the MOI indicated that probably the PT had significant number of broken ribs- his/her bike was in pieces on the ground indicating a significant amount of blunt force; any attempt to roll the PT could have caused the broken ribs to puncture a lung/lungs – thus creating the potential for a pneumothorax/hemopneumothorax/tension hemopneumothorax (collapsing one or both lungs). We were on a backroad and miles away from any medical facilities. If we rolled the PT and punctured his/her lung/lungs and he/she went into a tension hemopneumothorax – we were totally unprepared. We did not even have 02. So we did C-spine, comforted the PT (an important thing to do) as best we could. We secured that he/she had adequate air passage (I cleaned all the blood, leaves, and dirt, (no broken teeth) out of his/her mouth to secure an open airway) and waited for the higher level of medical care to show up.

I am providing this example – not to scare bicyclist but to let everyone know that as First Aid people, our job includes making sure that we do NOT hurt the PT during our attempt to treat them. Sometimes the best thing is to just keep the PT from moving and leave them in the position found.

However, the standard procedure is to: conduct scene size up; check ABCs; treat any life threatening injuries; primary and secondary assessments; and ongoing medical treatment. These procedures – with hypotheticals – could easily take up 10 – 20 pages of writing. If is absolutely necessary that these skills are learned at a CPR/AED/First Aid course. Then practiced at least two or three times per summer/bike season. Take a course. I have learned – the hard way – that you may be doing your usual training ride. Then turn a curve on a road or bike path and find yourself at the scene of a very serious bicycle accident and YOU are the only person with any pre-hospital medical skills. What you do and what you know – will matter a lot. Know what to do – take a course.