Tour with a Tourniquet… Save a life.

The bike is prepared and ready to go; weeks have been spent agonising over which tools, spare parts, clothes and devices to take. If it’s a trip abroad, ferry or plane tickets were bought ages ago; immunisations, passport and visas obtained. Perhaps you’ve bought an ‘off the shelf’ first aid kit with the usual crepe bandage, eye-patch and sling plus a few plasters and safety pins to which you may have added some insect-bite cream, paracetamol and something for diarrhoea.

But wait… is that going to be enough? Obviously you have to be selective if you’re not going to be carrying an entire pannier of ‘just in case’ first aid supplies, but there are certain items which can be packed without taking up much room. These could save a life in the event of a serious accident as I learned at the Major Trauma Awareness Course I attended recently.

The day-course was arranged by Ants Bolingbroke-Kent and Marley Burns, co-directors of Edge Expeditions in conjunction with the Crux Medical team of Will (critical care doctor) and Christian (critical care paramedic) who go all over the world to disaster scenes, arriving by fast car or helicopter. More used to being in extreme outdoor conditions surrounded by screaming people, on this occasion they were in Bristol in a cosy suite of rooms with good tea and coffee and lush chocolate biscuits. Their approach to situations of extreme emergency is ultra-aggressive treatment, and we were here to learn what to do if a serious accident occurs during a motorcycle trip.

There was time before the course began to chat to a couple of the other attendees. Patrick who travels on his motorcycle all over the world had been seeking a first aid course but found them to be prohibitively expensive. Then he heard about the Edge Expeditions‘ course and was delighted when, not only was it at a reasonable cost, but tailored for motorcycle travellers as well. Another attendee, Peter, had already enrolled on an ‘Edge’ tour and wanted to ensure he was a valuable member of the team.

Dealing with major trauma is a complex area to cover in one day and there was much to get through. After a brief introduction, we sat in front of the screen and were warned that what we were about to see was gory and to prepare ourselves. Some of our group were gung ho about it but a few were apprehensive. I’d seen a fair amount of road accidents as a student nurse on casualty duty, so thought I’d be alright, however, the film we were shown was actual footage from an American army dug-out in Afghanistan and nothing could have prepared me for the event on film which would set the scene for the day’s tuition. Seeing actual footage from the head-cam of a team medic attending a soldier with his leg and arm blown off by an improvised explosive device (IED) was a shock. (Rapt with attention, I suspect a few of us would have preferred to have been peeping from behind the sofa.) The film clearly illustrated how swift treatment can save someone from bleeding to death.

All soldiers are medically trained, and care was administered through a system almost second nature to them. The soldier’s colleagues set about their procedure to save his life competently and reassuringly. Yes, there was shouting and running but even though they were being fired on by snipers at the same time and return fire did not cease, there was no panic.

The first task was to assess the situation. He was unconscious but had the vital signs of life… breathing and pulse. He was soon responding to verbal stimuli. Tourniquets were whacked on in seconds and no-nonsense pain-relief given when his condition was stabilised.

The aim of our course was to introduce us to a similar structure in hypercritical interventions. Will and Christian talked us through a mantra of initial letters to help us keep a clear head if in a similar situation. The first were:-

Shout for help.
Safety… your own as much as anyone else’s.
Scene and Situation. What happened? What is happening?

Then there was CABCDE for Catastrophic Haemorrhage, Airway, Breathing, Circulation, Disability (neurological) and finally Environment when you’ve done what you can and need to keep the traumatised person warm and safe. Everyone was given a pocket-sized booklet with reminders of these.

We were taught a calming controlled-breathing exercise as there is no point in rushing around and flapping about in an emergency situation. The event can then be dealt with according to the instructions. Pulling on protective gloves is essential; in a major accident there’s going to be blood. Keeping it in the victim’s body and not on you is vital. We each have only about 5 litres of blood and if a femoral (leg) or brachial (arm) artery is severed, it will be pouring out like a running tap and be drained in just two minutes. A well-placed tourniquet will stop the flow. If a proper tourniquet isn’t to hand, find something else like a belt or scarf to wrap around the limb well above the wound because a severed artery will act like an elastic band and retract. Then pull it tight. Really tight. Don’t worry about bruises; it’s better to have a bruise than bleed to death and remember, you have only two minutes. Do not leave a tourniquet on for more than two hours though, as tissue dies without a blood supply.

You can easily hunt for limb bleeding even if it means cutting away clothing with tough-cut scissors which are cheap to buy and useful for many other things; but you can only do so much. Limbs are one thing, internal body bleeds need surgery and as Will said, “That’s not for you.”

If an accident on the road does not involve severed major arteries, there’s a bandage for every other occasion. Rather out of touch with emergency supplies myself, I was amazed at the array of dressings now available. HemCon bandages contain an antibacterial substance which also aids clotting for even quite wide, deep wounds. Another miracle dressing, when tightly packed into a wound, is Celox gauze. Both types stop bleeding within minutes. Modern chest seals are available in case your travel companion has a punctured lung caused, for example, by a handlebar or foot peg. The seal demonstrated by Crux was the Russell chest seal which can be placed over a chest wound caused by a sharp object (hopefully not a knife or a bullet). The plastic dressing sticks to the skin and the attached one-way valve will allow air to escape but not be drawn in. All these products are compact and easy to pack.

Should you remove the crash helmet in cases of injury? Again it’s a question of assessing the situation before doing anything that might make matters worse. If the person with the injury is breathing and responding with professional help not far away, leave it to the experts. However, if resuscitation is necessary or the victim clearly has no neck or head injury, careful removal of the helmet can go ahead. This needs two people if possible, one to pull the sides of the helmet to widen it before gently wiggling it off whilst the other supports the neck. It can be done with one person and there are videos on You Tube demonstrating how to do it either way.

After the explanations it was our turn to be practical. Christian demonstrated applying a tourniquet and then gave us the opportunity to try. Shouting and yelling instructions to simulate a real-life situation, we had to act quickly. I hurried, causing a scratch and bruise on Will’s arm which resulted in a “Well done, you could save someone’s life” from him.

We were taught how to support a fractured femur with thigh and ankle-straps and a strong but lightweight device like a collapsible tent-pole. We practiced on each other which produced lots of laughs amongst people who either did or didn’t previously know each other!

I would be greatly reassured travelling with anyone who had invested a day on this course and anyone who opts to travel with Edge Expeditions is immediately advantaged. The emergency kit carried on their tours is as comprehensive as any carried by medics, and both Ants and Marley know where it is, and how to use the contents. You can buy all sorts of first aid kits which vary in price, size and adequacy. Nomad sell an Ultimate First Aid kit costing £50. They also provide a bespoke service that allows over-the-phone consultation with a pharmacist for advice about contents to enhance the kit for adventure motorcycle travel.

Have another look at yours. Is it up to the type of incident you might encounter or be part of? Don’t stick it in the bottom of your pannier and hope you never need it. Keep it handy and be familiar with how to use it.

The day-course was enlightening and good fun. It’s unlikely that we will encounter IEDs but any one of us, by the very nature of what we do, can be a victim of a road accident or ride into a pothole and fly over the handle bar. Incidents can happen on good roads or rough terrain anywhere in the world. I left that day with the knowledge that my usual small supply of plasters and paracetamol would not be enough to save a life. In future I will be packing tough-cut scissors, two tourniquets and at least one of those miracle bandages which stop bleeding.

Oh, and if you’re wondering what happened to the soldier in the video clip, he was air-lifted to a secure field hospital within 12 minutes. The speedy and efficient actions of his fellows saved his life.

Words: Jacqui Furneaux