The Basics of Mountain Biking First Aid

The Basics of Mountain Biking First Aid

If you’ve never been there, you will eventually: you’re going to get hurt on a mountain bike. Whether it’s a casual ride along a straight, flat road, or a rocky descent down a treacherous trail, odds are good that you’re going to get hurt. Maybe it’ll be something simple--a bee sting or a blister--but maybe you’re going to hit a root and go end-over-end down a sharp incline. Whatever the case, an ounce of prevention is worth a pound of cure, and being prepared and geared up for an injury is going to pay off big time. It may not seem like it in the short term--that may all just seem like extra weight you’ve got to carry in your streamlined and minimalized backpack--but when you need it, you really need it. Let’s go through some of the basics that any rider should have in their first aid kit, and then talk about how to apply those supplies to stem a possibly-severe problem.

What You Need In Your First Aid Kit

We recognize that you’re trying to cut weight wherever possible, so we understand that you’re not going to want to carry a full first aid kit in your pack when you go mountain biking, but if you want to bike responsibly, here are some of the most essential items we recommend you pack--whether you’re out for a leisurely ride or an intense trail run.

First, you should always have proper hydration. This will not only help once you’ve been injured, but it will help you prevent injuries before they happen by keeping you adequately hydrated and avoiding the side effects of dehydration like cramps, lack of focus, and shakes.

Your kit should also contain:

• Bandaids / moleskin
• Tweezers
• Gauze pads
• Pain reliever / muscle relaxant (acetaminophen, aspirin, ibuprofen, naproxen)
• An emergency contact card
• Antibiotic cream or alcohol swabs or wipes
• Anti-allergy medication (such as an Epipen or Benadryl)
• Zip-ties (for use as tourniquets/splints)
• Emergency snacks/food
• Whistle
• Money (for emergency food, repairs, water, transportation)
• Insurance information
• Latex gloves
• Duct tape or medical tape (this can come in very handy for all sorts of bandages and fixes)
• Extra batteries for your cellphone

You can see that all of these things can come in very handy in certain circumstances and they really don’t add that much weight to your pack. A thing like tweezers might seem unnecessary until that one day you don’t have them and get swarmed by bees; an emergency contact card may seem redundant unless you’ve fallen and are unconscious or incoherent. It’s a little thing that adds less than an ounce to your weight but could mean the difference between life and death. And while we never want to think of the worst case scenario, if you’re out on a solo ride and crash spectacularly you’ll be grateful for those zip ties, that whistle, the emergency food to keep you safe until help arrives. (For that matter, it wouldn't hurt to bring an emergency mylar blanket (they fold into a tiny packet, and a poncho to keep you dry.)

Insect Bites and Stings

Riding may not sound like the kind of activity where you’re likely to get bit or stung--you’re going too fast for that, right? But to be zipping down the road and get a bee caught in the folds of your shirt, or taking a break on a log only to discover it’s swarming with red ants. Here are some tips on how you can prepare for the rare but inevitable case of a sting or bite:

• First, if you’re stung or bit, get out of that area, because where there’s one insect there’s bound to be more. You may have ridden into a territorial swarm of bees that are in the process of changing nests and are trying to keep outsiders away while they protect their queen. Get out quick before you begin administering first aid.
• Next, when you’re clear, look for stingers. If it was an ant bite, there may be nothing there, but if you were stung by a bee you may need to break out the tweezers and dig out the stinger before it inflames the whole area. When the stinger is out (or the bite is determined to not have a stinger lodged in it) apply antibiotic ointment and put on a bandaid. If it’s in an area that rubs a lot--the back of the knee, or in between fingers--some gauze padding might be a good idea.
• When you get home, check yourself for ticks. Ticks can carry Lyme disease which is a serious affliction if left untreated. It can cause headaches, rash, and fever--and much worse if left untreated. To remove a tick, don’t try to pull it out with tweezers--this will only split it in half and leave the still-biting head stuck in your body. The easiest way to get rid of a tick is through suffocating it out: cover the area with vaseline, and it will back its way out of its little burrow in an attempt to find air.

Cuts and Scrapes

Crashes are inevitable after prolonged mountain biking, whether they’re big or small. The most common places for cuts and scrapes are on the knees and hands and, if you’re unlucky, your chin. If you get a cut or scrape, you’re going to want to clean it as quickly as possible, and your best bet for this is to use water or alcohol wipes. This may sting, but it will be so much better than an infection.

• First, if you have enough water, wash your hands before cleaning the wound, and if you have latex gloves, put them on now.
• Second, clean the wound with water or alcohol. You want to make sure that you don’t have any mud, stones, or pebbles in there--they’re going to have to come out eventually, and it’s so much easier to clean them out when the cut is fresh than once it’s begun to heal over. Speaking from experience, I can say that the emergency room has a toothbrush-like scrubber that they’ll eagerly take to your scab to scrub the offending particles out--and it hurts! Once you’ve cleaned it, use that antibiotic cream you’ve packed with you.
• If there is a lot of blood, bandage tightly and elevate the wound if possible. Obviously, if you’re on a deserted stretch of trail with no one coming to your aid, then you’re going to want to peddle your way out of there, but even elevating your injury for ten or fifteen minutes can allow it time to coagulate and slow the bleeding.
• Finally, if you think it needs stitches, get them taken care of quickly. There’s a window of time in which stitches can be performed, and waiting too long can cause much more unsightly scarring--and longer recovery times. Plus, if the damage goes all the way to the muscle, you’re going to need that repaired.

Bruises and Bone Injuries

Landing hard will leave a bruise that may show up immediately or wait a few hours (or days) before it turns into a full discolored shiner. But be wary of bruises. There’s a part of you that wants to wear a bruise as a badge of honor to show the massive trauma that you experienced on the trail, but there’s a more responsible part of you that knows that a big bruise can be a sign of an underlying bone issue.

When you fall and take a serious hit, follow the steps below:

• First, get off the trail. If the trail is used by others, they might not have time to see you and your bike before they have time to stop, and you’ll be causing trouble for all of them too.
• Second, try not to move the affected area too much until you can do a full assessment. An assessment includes looking for swelling, redness, bruising, and pain. Examine the area with your fingers--prod the bone or muscle to see if the injury is broad or acute. Check for numbness and tingling. Check for flexibility and movement issues. Are you having trouble flexing muscles? Curling fingers? Bending your knee? These may all be signs of underlying bone or muscle damage. 
• Third, address any bleeding and apply pressure where needed. This is where you’ll be glad you have those zip ties--they can hold gauze in place, can be used to make a splint, or can be used as a tourniquet in dire circumstances. 
• If you can’t move, it’s time to start using that whistle. Flag down other riders. If you have a cellphone and you’re in real trouble, make the 911 call. There’s no shame in getting emergency medical attention--that’s what search and rescue is there for!
• If you can make it out on your own, get medical care as soon as possible.

Bleeding

If you fall and start bleeding a lot, then address that first and foremost. 

• Apply direct pressure to the wound--with your hand if it’s all you have, then with a cloth (shirt, clothes) or gauze. If the gauze soaks through, don’t remove it--add more and continue to apply pressure. 
• If the bleeding slows on its own, clean the area and apply a bandage.
• If the bleeding doesn’t slow on its own, get help right away with that whistle or cellphone.
• Elevate the wound.

A few things to keep in mind

Get Trained

It’s all well and good to have a fully stocked first aid kit, but if you don’t know how to use it--to apply a basic bandage or splint a sprained ankle--then your kit isn’t going to do you a whole lot of good. Take a basic class (these are often taught for free at your local outdoor retailer) on how to administer first aid. 

Things You Don’t Need

• Snake Bite Kit: These don’t usually do any good, and can sometimes cause more harm than good. You never want to cut a snake bite and try to suck out the poison, and snake bites should never be treated with tourniquets. The specific anti-venom needed to help with a snake bite depends entirely on the type of snake, and if you apply the wrong one you could be in a world of hurt.
• Sutures: Unless you’re a trained EMT, nurse, or doctor, forego the stitches and wait until a medical professional can fix you up. An improperly sutured wound can trap in bacteria and dirt that will make the wound worse than waiting to see a doctor.
• Needles, IVs, Intubation equipment: Again, unless you’re a trained medical professional, you could do more harm than good trying to administer any of these things. Leave that for the paramedics.

Finally, tailor your kit to your environment. Know what the weather is going to be like and plan accordingly. Know what kinds of insects you’ll encounter, what kind of wildlife. Biking in the deserts of Arizona will be different from the mountains of Alaska.

Take care of yourself, be prepared, and have fun!