1. First Things First
When you are called to help an injured equestrian rider, you must make your initial assessment in order to do the most good and avoid creating additional injuries. Your general impression of the situation will determine right away what type of additional help you will need. You will then determine the mental status, or alertness of the injured. These two steps should take but a few seconds and immediately afterwards, you must check for a viable airway, if the victim is breathing and has a pulse. You must also get an initial set of vital signs from the victim.
2. Time to Touch
After your initial assessment, you will want to perform a more in depth assessment of the victim. You will always start at the head and work your way to the feet. It is important to note that if there is obvious head trauma that a second person should be called to action and immediately hold the victim's head with both hands to prevent any kind of movement. When checking the head, you will start at the skullcap and gently massage the scalp. If you feel a grinding, this is crepitus: the skull has been fractured and you are rubbing the bone against bone. This is bad and the patient must be transported immediately. You will also visually inspect the area for signs of trauma and act appropriately upon your findings. You will follow this same process down the neck, chest, arms, abdomen and legs.
3. Bind Them Up
If you find that you have a basal skull fracture, or suspect a fracture of the neck or spine, you must fully immobilize the patient. This involves placing a cervical collar around the victim's neck, log rolling the victim onto a backboard and then completely strapping the victim to the board. Chances are, they will not like this at all. Two cushion blocks will be placed on either side of the head and straps will be used across the forehead and the chin to secure the blocks to the head and board and the victim's head to the board as well. Your victim will be fully immobilized and ready for transport. If the victim has only a broken arm or leg, you will use a sling for the arm, or possibly an air cast if one is available. A traction splint will also be used in the case of a completely broken femur and the bones need pulled back into proper place. For a bone that has broken and is protruding out through the skin, merely cover and secure a bandage over the bone. If there is severe bleeding anywhere, you must address this with plenty of bandages and direct pressure until the bleeding is slowed or under control.
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