The more involved we get with the equestrian world, the more we come to expect the inevitable tumble and fall of horse, rider, or both. Usually, these consist of only the rider’s pride being hurt and who, after a quick look to see if anyone witnessed their embarrassing mishap, do a quick dusting down to remove the evidence and on they go.

Regrettably, however, some accident will happen giving more serious injuries and sadly, fatalities. Unfortunately in the case of the latter, there will be times when nothing we or anyone else could have done would have made any difference, but in most other cases, your action or inaction will make a difference.

The following basic information and scenarios may help you to make that difference.

First Aid: The Basics

“First Aid” is what it says on the tin. It is the “first” aid given to an injured party at the scene of an accident.

The remit of a “First Aider” is simply to maintain life (without increasing the damage) until trained, professional help arrives. This may be as simple as ‘doing nothing but reassure’ or having to undertake full CPR on the patient.

However, if any doubt is involved in assessing the patient, get trained help ASAP. Remember, you are not a doctor!! 

So, what if?

The following tips are given as very basic guidelines and do not cover all the reasons that may have caused a rider to fall from a horse. We are assuming in these cases that the horse may have stopped or fallen at a jump, spooked or tripped, unseating the rider.

Scenario 1: The local show. What do you do when…

Question: You are at a local show and someone falls off in front of you, jumps up, gets back on, and rides off.

Answer: Nothing then, but advise them to call at the First Aid Unit and/or First Aider to be checked over.

Question: You are at a local show and someone falls off, landing heavily, gets up, but appears uninjured.

Answer: Nothing, except ask them to call at the First Aid point for a quick check over or ask a trained First Aider to go to them (some people may need help, but don’t realise it).

Question: You are at a local show and someone falls off, landing heavily, but does not get up.

Answer:

DANGER: First protect them from further danger by keeping their own horse or others well away from them.

RESPONSE: If they are conscious, encourage them not to move until they have been checked over properly. Steady their head and neck to avoid movement. Do not take their hat off. If their chin strap or back protector is restricting breathing, then they can be undone or slackened.

Get help, and reassure the patient.

If they are unconscious, get help immediately.  Dial 999 for an ambulance. Describe the nearest accessible point on the road, and arrange to meet them there. Have your mobile phone number ready. Describe the casualty’s lack of response and any obvious injuries. Steady their head and neck to avoid movement, then check:

AIRWAY - check that the airway is not blocked

BREATHING – check for breathing by looking, listening and feeling for respirations

CIRCULATION – check for signs of circulation.  If they have these, then do nothing else until help arrives. If their chinstrap or back protector is restricting breathing, then they can be undone or slackened, but do not take their hat off. Talk to the patient to monitor for any response. *

Scenario 2: On a trail ride

Question: You are on a local pleasure or trail ride and someone falls off in front of you, landing heavily, gets up but appears uninjured.

Answer: Ask them to take a moment before they try to remount in case they become dizzy. A second fall may cause more damage than the first. Ask them to call at the First Aid point (if there is one) for a quick check over. Some people may need help, but don’t realise it. Keep an eye on them for a while.

Question: You are on a local pleasure or trail ride and someone falls off in front of you, landing heavily but does not get up.

Answer:

DANGER: First, protect them from further danger by keeping their own horse or others’ well away from them.

RESPONSE: If they are conscious, encourage them not to move until they have been checked over properly. Steady their head and neck to avoid movement. Do not take their hat off. If their chinstrap or back protector is restricting breathing, they can be undone or slackened. If possible, phone for help.

If you don’t have a phone, wait for the next rider and use theirs, or ask them to go for help.

If they are unconscious, phone 999 for an ambulance immediately. Steady their head and neck to avoid movement, then check:

AIRWAY: that the airway is not blocked

BREATHING: check for breathing by looking, listening and feeling for breathing

CIRCULATION: check for signs of circulation.

If they have these, then do nothing else. If their chinstrap or back protector is restricting breathing, then they can be undone or slackened, but do not take their hat off. Talk to the patient and if you don’t have a phone, wait for the next rider and use their phone or ask them to go for help.

If they are not breathing, give two rescue breaths. If they have no circulation, start CPR, using 15 compressions followed by two breaths. Check to see if their chinstrap or back protector is restricting breathing. These can be undone or slackened, but do not take their hat off. Carry on doing CPR while waiting for the next rider and ask them to phone or go for help. Do not stop CPR unless the patient revives. Caution should be exercised if you have to turn the rider over to undertake CPR. If possible, get one or two other people to help keep the rider’s neck and back in line as you turn them.

If circulation and breathing restarts, but you have been unable to obtain help from anywhere, you may be better off stabilising the patient the best you can and going for help yourself. Put the patient in recovery position (on their side, with their back in alignment, and head resting on their lower arm).

At this point, the decisions you make can become critical and are too complicated to explain or discuss in this brief outline, but please remember, your job is simply to maintain life and prevent further injury until trained help arrives.

A few do’s and don’ts

Do protect the rider from further injury.
Do get trained help if in any doubt.
Do get an ambulance and trained help if the rider was unconscious at any time.
Do talk to the casualty calmly and try to keep them relaxed.

Do not move the casualty if you suspect a back or neck injury.
Do not give the casualty anything to eat or drink.
Do not give the casualty any medication unless it is their own, essential, and they ask for it (treatment for asthma, allergic reaction, diabetes, etc.). If they are unconscious, give nothing.
Do not allow the casualty to remount if they were unconscious or concussed.
Remember, your job is just to maintain life and prevent further injury until trained help arrives.

Tips

• If you have no first aid experience and a place becomes available on a course, take it. You could save a life.

• Carry a mobile phone when our hacking or on a pleasure ride.

• Ask for the number of the ride organisers or base before you set out.

• Carry identification on you and your horse so that both can be identified.

• Be calm, and don’t panic.

• Beware the ‘irate parent’. Some of these people are only interested in getting their child back onto the pony or horse so that they can finish the competition with total disregard for the rider (I know, I have met them!).

Remember, your job is just to maintain life and prevent further injury until trained help arrives.

And finally,

Let’s hope it never happens.

For course information, call or write to:

St. John Ambulance Northern Ireland Headquarters Erne Knockbracken Healthcare Park Saintfield Road Belfast BT8 8RA Tel: 02890 799393 districthq@ni.sja.org.uk

A Special Thanks to Dr Margaret Austin and Linda Pilcher from the St. John's Ambulance for help in producing this safety page.