Bicycling Magazine has a surprisingly strong article aimed especially at mountain biker riding solo:
You always need to take an impact to the head seriously.” … call 911 if you or another rider has:
• ... a cracked helmet. That means you’ve hit your head hard.• ... a headache. Not just sore from the initial impact, but you have a headache that isn’t abating or is worsening.• ... lost consciousness. If you pass out, you need to get checked out.• ... confusion. If you don’t know who the president is or why you’re sitting on the side of the road, you need to get checked out.• ... vision changes. If the world doesn’t appear clear and normal, you need medical assistance.
Take a Deep Breath: Difficulty breathing is always an emergency situation. “Too often people crash and think they’ve cracked a rib, but figure ‘Why go to the hospital? They can’t do anything about it,’” says Martin. “But you need to go because those cracked ribs can have sharp edges and if it’s an unstable fracture and it shifts, you can puncture a lung.” If it hurts to take a deep breath, get to the ER.
Give Yourself a Gut Check: There’s a lot of vulnerable soft tissue and plenty of vital organs in your belly that can be damaged by impact with a handlebar. Take your hands and palpate your abdominal area. If you have an area that is more tender than others, you could have internal damage. If your belly becomes distended or firm, that’s a sign that you could have internal bleeding and need medical assistance stat.
Stop the Bleeding: Unless you’re a trained professional, forget what you’ve seen in the movies about fashioning a tourniquet around a limb to stop the bleeding. You risk doing more damage than good. The best way to deal with bleeding is basic first aid—direct pressure (preferably with something clean) on the wound. Keep it there till help arrives.
Be Smart About Your Spine: Neck and back injuries are scary. You can generally tell if you’re okay by checking your fingers and toes. Obviously, you want to be able to feel your fingers and toes, but if you have any numbness and/or tingling, that’s not good. You could have spinal injury. Also try slowly turning your head 45 degrees to the left and right. If you feel discomfort, stop. That’s also a sign of spinal injury. Get to the ER.
Make Your Personal Info Accessible: Whether you use Road ID, dog tags, or place ICE ('in case of emergency') information in your cell phone, having your personal information available for emergency workers can definitely save your life, says Martin. “We need to know your medications and your allergies," he says. "There are a lot of medications we can’t give you if you’re allergic to them… and we won’t give them if we don’t know.” New iPhones come with a Health app that provides a place for you to fill in all your medical information. Emergency personnel can access this information without unlocking your phone. “We know to look for it if you’re out there by yourself, unconscious, after a crash,” says Martin.
Leave a Note, or a Text: Riding alone? Take two seconds to leave a note or shoot a text to a loved one or buddy. “We’re all guilty of this,” says Martin. “We go out for a quick ride and nobody knows where we’re going. Even if you’re just 10 miles away, you might as well be 100 miles away if no one knows where you are.” The more remote of a place you ride, the more important this is.
It’s always safest to have a ride partner, but next best is to ride on well marked and trafficked trails. Riding on lesser traveled wilderness trails kicks the risk up several notches, just as with wilderness hiking or scrambling. Note the unstated implication of these recommendations is that you have a working cell phone and can call for help or advice after injury.
The iPhone Medical ID locked device access feature is obscure. You have to know to swipe to unlock then to tap the Emergency button then to look below the call keyboard and tap “Medical ID”. I hope EMTs are trained to do this. Apple forgot to enable Siri access, “whose phone is this” works on a locked phone, but “show me Medical ID” does not. I enabled Medical ID, but my phone’s lock screen has my contact info, more importantly, my wife’s cell number as Emergency contact. That was easy to do — I filled it out in iMessage, then took a screen shot, then made the screenshot my lock screen background. I need to check that I’ve set it up for my kids.
Sharing location on an iPhone using iMessage is easy, but also a bit obscure. You need to start with an existing message thread then tap the wee “i” icon top right. Just text that at start of a ride somewhere, update if you wish. I have Find Friend enabled, so if that works my family can track me (but they tend not to think of it).
Self-assessment with a head injury is tricky. I’ve had a concussion (inline skating actually), and it doesn’t help one’s judgment. If you whack your head out in the trail you should probably call in to a friend and have them check your thought processes. You may need to ride out before you can do anything more formal (assuming you can ride!).