Backcountry Bicycling First Aid

First Aid is exactly that, the first aid given to an injured person. On a ride where help could be very far away. A little knowledge can go a long way helping a hurt cyclist. The most important thing to keep in mind if you or your riding partner is injured is to stay calm. Assess the situation carefully. Bleeding, Breathing, Heart Attack, Poison, and shock is the order of life-threatening situations. This is not meant to be a complete description of all first aid, only as a concise guide.

Put on disposable latex rubber gloves, if available. Cover the wound with a bandana or a shirt, and tie it. If possible elevate the wound above the heart, this will help slow the bleeding. Add more cloth or bandages over the wound and re-apply pressure. If the wound is minor clean it with water. If you are prepared and have an alcohol pad use it. Cover it with a sterile bandage. A small cut needs to be tended to immediately. Infection can set in quickly. Always monitor for shock.

The Red Cross offers classes for wilderness and backcountry first aid.  The following are just general guidelines to some common situations that may occur.

Breathing Issues

Breathing stopped or slowed is the next most important life-threatening situation. If the person is unconscious put your ear next to their mouth and watch the stomach for movement.

If you determine the person is not breathing open their mouth and sweep your finger through the mouth to see if there is a blockage. If there is not a neck injury or back injury do not move the head or neck! Pinch their nose and blow two quick breaths in their mouth. Watch the chest rise. Continue every 15 seconds until medical help arrives.

Heart Attack

Heart Attacks can happen when cycling. If a person is having a heart attack they will have one or 6+more of the following: clammy skin, pain in the chest, and numbness on the left side of the body. An aspirin taken during the first few minutes of a heart attack can greatly improve a victim's chance of surviving a heart attack. Send for help and monitor their heartbeat and their breathing. Start CPR if hr Treat for shock. Poison specifically from snakes can be life-threatening.


Shock is something that is often overlooked in an emergency situation where there is an injury. Shock can set in after a simple cut. Shock occurs when the circulation system stops sending blood to all parts of the body. Certain areas of the body are deprived of oxygen because blood flow is to low. This can cause damage to your heart, brain, lungs, or limbs. Signs of shock include trembling, weakness, confusion cool and moist skin, shallow breathing, nausea, fast rapid pulse or extreme thirst. Have the victim lay down on their back. Elevate their legs about 1 foot off the ground. You want to try to get their head lower than the rest of the body to increase blood flow to the vital organs. Do not move the body if you suspect a back, neck, head, hip, or leg injury. Loosen all tight clothing and cover the person with something to prevent heat loss. An emergency space blanket works best, but pine needles or leaves can also help. Try to place insulation between the person and the ground. Make the person as comfortable as possible. Monitor breathing and heartbeat.

Head Trauma

Head Traumas can be very serious. You should never ride with someone that does not wear a helmet. In case of a head injury check for bleeding. Do not move the head if the back or neck is also injured.

If the victim is bleeding from the scalp: bleeding can be controlled by putting pressure around the edges of the wound, not on the wound. Use a long strip of cloth and wrap it around all four fingers on one hand until you form a loop. Leave a long strip of the bandage material to weave in and around the loop so it doesn't ravel. Use this ring pad to apply pressure around the edges of the wound. Don't wash the wound or apply an antiseptic or any other fluid to it. If blood or pink-colored fluid is coming from the ear, nose or mouth, let it drain. Do not try to stop its flow. Take aspirin, acetaminophen, or ibuprofen for the pain. Treat for shock. With all head traumas, it is very likely a concussion could set it. Do not let the victim get right back on their bike. Their judgment will be impaired.

Heat Exhaustion/Heat Stroke

Heat Exhaustion can set in when the core body temperature reaches a high level and is unable to cool itself. The result can be heat exhaustion or heat stroke, both of which are life-threatening.

Fluids and salt are vital for health. Symptoms to heat exhaustion include cool, clammy, pale skin, sweating, dry mouth, fatigue, weakness, dizziness, headache, and nausea. Heatstroke strikes suddenly with very little warning. When the body's cooling system fails, the body's temperature rises fast. This creates an emergency condition. Symptoms of heatstroke include: very high body temperature (104 degrees F or higher), no sweating, deep breathing, fast pulse, and the skin will be dry, hot and red. Move the person to a cool place out of the sun like under a shady tree. Place the feet higher than the head and remove the clothing and sponge the person with towels or sheets that have been soaked in cold water. Fan the person. Put cold compresses to the neck, under the armpits, and to the groin area. Immerse a child in cold water if he or she is unconscious. Give the victim fluids.

Frost Bite

Frostbite has the appearance of a serious heat-burn. The body tissue is actually frozen and in severe cases death. Frostbite usually affects the extremities. Fingers, feet, toes, earlobes, chin, and the end of the nose. Frostbite can happen when temperatures drop below freezing. It can be set in quickly or very slowly depending on how long the skin is exposed to the cold and how cold and windy it is. To treat the affected area needs to be warmed up slowly. If warm water is available to soak the affected area in the water. Do not warm up too rapidly, thawing can be painful and blisters may develop. If warm water is not available, keep the victim warm and place the frostbitten extremity in a warm body area such as in an armpit or on the abdomen.

Broken Bones

A simple broken bone is not visible through the skin nor is there a skin wound near the fracture site. In a Compound or open fracture, the bone may separate partially or completely from the other half and a skin wound is also present. The bone can protrude through the skin. You should never try to reset the broken bone. Use a bandage to apply direct pressure to the wound to stop the flow of blood. Do not put pressure on the damaged bone. Immobilize the limb with two sticks using strips of cloth to hold them in place. If it is the arm that is broken arm you can make a sling out of a triangular piece of cloth. Place the forearm in it and tie the ends around the neck so the arm is resting at a 90-degree angle. The general rule is to splint a joint above and below the fracture. Treat for shock.