Medical Emergency in a Remote Environment – The Kelly McGarry story
Following the good news story in last week’s blog, where a student of the First Aid Training Co-operative was able to use a defibrillator on a casualty successfully. This week, the sad news of professional mountain biker, Kelly McGarry ’s untimely death in New Zealand, serves to remind us of the reality of a medical emergency in the outdoors.
Details on Kelly McGarry ’s accident remain unclear at this stage, so it would not be appropriate to comment on specifics, particularly as the cause of death has not been determined, only speculated upon.
Our thoughts are with his family and friends and particularly those that were with him at the time in what must have been a horrendous situation.
However, we can use his story as an impetus to refresh our memories on cardiac arrest protocols, so that we can act immediately should the worst happen.
In a situation where someone has been doing an activity such as mountain biking, a sudden medical emergency such as cardiac arrest could very well lead to a big crash.  This could certainly confuse the situation and make prioritizing treatment very difficult.
So lets remind ourselves of the priorities in an incident like this:
A – Assess for danger. Make sure you, and any one else with you, is safe and will not come to any harm whilst the incident develops. Consider cross contamination, and put on some sterile gloves if at all possible.
A – Alertness. Determine whether your casualty is alert: Ask them questions, give them a Vocal command, squeeze their shoulders to see if they give you a Pain response. If they are Unresponsive, ask or shout for Help as appropriate.
A – Airway. Establish a clear, open airway for your casualty by straightening their windpipe and pulling their lower jaw forward. This will involve removing their helmet if they are wearing one and are unresponsive.
B – Breathing. Look, Listen, and feel for breathing for up to 10 seconds.
If the casualty is Unresponsive and Not Breathing Effectively, then they need immediate medical attention. Call for emergency services yourself, or ask a bystander to do it for you.
Describe your casualty’s situation, and ask for a rescue team and Automated External Defibrillator (AED) to be brought as soon as possible.
Remember that in a more ‘urban’ situation, an AED may be close to hand.
Your job now is to carry out CPR until either an AED or help arrives. So do cycles of 30 chest compressions to 2 breaths for your casualty to try and keep oxygenated blood flowing to their brain.
This treatment is more important than any other injuries, that have occurred as a result of a crash.
So if appropriate and these injuries are deemed to be serious enough (i.e. significant blood loss), a helper may try to treat these while you continue with CPR.
As we continue to push boundaries in sports like mountain biking, and travel further and further afield into more remote terrain, the reality of getting help to a casualty quickly enough if they’ve suffered a cardiac arrest is that it extremely unlikely.
However, knowing where you are, how best to contact the emergency services for that location, and what to do until they arrive can make a difference.
Remember that you can download a pdf of the incident procedure we teach on our courses directly from our website.
