In case of accident…important information

Recumbent bikes are the ultimate long haul bike.  So comfortable, it barely matters how long you’re in the saddle.  For some of us, that means “yearnin’ for the open road.”  Even if it’s just for a weekend, for me, there’s simply nothing quite like living by bicycle for a while.

However, some trips are less than all roses.  Predictable challenges come in the way of steep hills, bad weather, rough roads, motor vehicles, and getting lost — all part of a good day’s riding.  However, there are also unpredictable challenges, the worst of which are illness and injury.  Drinking bad water or hitting the pavement can mark the end of a — up till then — great trip.
There are good habits a cyclist can adopt to avoid accidents.  New York Cycle Club recommends all riders read Bicycle Safe for advice on avoiding accidents with oil-powered vehicles.  There is no question; an ounce of prevention is worth a pound of cure.
God forbid you’re in an accident, but I can’t think of any cyclists who haven’t hit the pavement at least once.  On trips, I try to live by the rule “prepare for the worst” so the worst doesn’t happen.  I also believe that thoughtful preparation helps us avoid accidents because it heightens our awareness to common dangers.  If only preparation could be prevention.  Most cyclists are protected by little other than skin, thin fabric, a helmet, and, if you’ve planned ahead, a few pieces of cycling armor.  Soft body, hard road; a bike accident is going to hurt.  (On long trips, besides a helmet, I wear padded shorts and elbow guards since these are common contact points in a recumbent fall.  Mine are from Six Six One and there are a few other manufacturers of bicycling body armor.)
Before I go any further, I will say that a responsible cyclist should obtain Wilderness First Aid (WFA) training.  This two-day class is offered by a few different schools.  Stonehearth Open Learning Opportunities (SOLO) teaches the class in multiple locations several times a year.  A trip leader could benefit from Wilderness First Responder (WFR) training, also available from SOLO.  This course generally involves 70 – 80 hours of class work.
If you can’t wait for the next class from SOLO, look into the day-long class in basic first aid and CPR/AED offered by the American Red Cross.  You’ll learn principals like checking for scene safety, wearing gloves to protect yourself from the victim’s body substances, using direct pressure to stop bleeding, recognizing the onset of a heart attack, and other basic skills.  Although there’s a big difference between getting hurt in the office and getting hurt on the road, it would be a mistake to dismiss this training.  If all you learn is to wear gloves before touching an injured friend, it may not save your friend’s life, but it might save yours.
The information here is intended to help you prepare for a severe accident as a result of which, due to reduced consciousness, you are unable to provide vital information that would assist with your medical care.  These recommendations are based on information that Wilderness First Responders are trained to gather when they first make contact with a victim.
Some training, racing and touring organizations gather an emergency contact’s name and phone number and not much more.  I’d be concerned that it expects too much of a spouse, friend, mother, etc….that they will a) be available during the critical hours after an accident, b) be able to provide complete and correct information, and c) know what medications you take, your drug allergies and your medical history.
Before your next trip, record your vital medical information in a permanent, non-electronic form that you can carry with you.  Accidents are tough on things and are more likely to occur in wet weather than dry, so make sure the material is strong and waterproof.  I suggest using a Sharpie pen on Tyvek or strong tape.  Personally, since I’m fortunate to have a short medical history, I write my information on removable tape and attach it to the main tube of my bike.  There’s no guarantee a rescuer will see it there, I realize, but it’s better than doing nothing.  If you have serious and chronic conditions, like drug allergies or diabetes, this information should be on a wrist or ankle in the form of a bracelet or tattoo.  You might also consider writing medical information in your helmet, though there isn’t room to write very much.
If you want to keep your information private, write it on Tyvek, fold it, and tape it to your bike.  Clearly label it as medical information so it isn’t easily overlooked.
The following information will be highly useful to first responders.
Name, age, sex (Don’t assume it’s obvious.)
Allergies (especially drug allergies and those that can cause anaphylaxis like bee stings, peanuts, etc.)
Medications you take, including all over the counter, herbal remedies, health supplements, prescriptions and restricted substances.  Natural remedies and dope are considered medications for this purpose.  Include when you had your last dose and information about what happens if you do not take your meds.  On long trips, write down doses in a log book to make it easier to keep track.
Past medical history.  Be complete, be honest.  Include all serious injuries, surgeries and psychiatric conditions as well as chronic conditions.  It may be a good idea to include significant emotional conditions if you know they could interfere with care.  If you’re alert, medical providers will want to know your prior history as it relates to the specific injury or illness.  However, if we are making advance preparations in case of an accident, we need to cover all bases as we won’t know how or where we might get hurt.  This may require a bit of work the first time, but if done properly and in enduring form, it only needs to be done once.  After that, just update the list.
Last oral intake.  On a multi-day trip, I keep a simple log book with the date and time of significant meals, what I ate, and the itinerary and mileage for the day.  I don’t agonize over it to the point it ruins the trip.  The point here is that a little information is better than none.  From the perspective of providing medical care, it will be helpful to know if it’s been 24 hours since a patient ate, or only an hour, and whether it was an energy bar and water or a Big Mac and shake.  A side benefit of a food log is that it may help you see how nutritional intake affects performance.
Emergency contact name and phone.  There’s a reason I list this last.  For cynical reasons — identifying a dead body or inquiring if a victim has insurance — yes, this is important.  But for emergency care of a living patient, this decreases in importance if you provide the other information on this list.  It’s more urgent for ER doctors to know if you have drug allergies than the name and number of your spouse.
On long trips, I keep an itinerary or log (paper-based).  This should include point of departure, way points and planned finish.  This isn’t to prevent spur of the moment changes in plan, a.k.a., “fun”.  It provides a basic framework so rescuers know what you’re up to.  It will be helpful to know if you’re traveling ultra-light 500 miles from home, or just out for a day ride in the hills.  For multi-day trips, worthwhile information would include waypoints, mileage, anything notable that happens, nutritional intake, when you take meds, injuries, illnesses, and mechanical problems.  As a bonus, at the end of the trip, this will be a nice little trip diary.  “5am woke up.  Cold.  Lips chapped.  BK: oatmeal w/ protein powder, hot choc.  Tightened seat bolts.  Got water.  I’m out.  Plattsburgh tonight — apx. 75 miles.”
Please feel free to write if you have questions about any of this or believe I’ve missed something.
Robert Matson
copyright 2011 Robert Matson

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