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If in doubt, call an ambulance. Never feel that you are 'bothering' them - that's their job.

If it were me I would be happy to assess the rider and make that decision (or assess myself), but you need to consider associated spinal injuries/head injuries etc as well as the requirement for pain relief which will become higher when the adrenaline wears off en route.

People call the ambulance for the most ridiculous things, eg paper cuts - so if you think an ambulance is required then you are justified. That's why we pay for it. Medical professionals don't expect you to make this decision on your own.

A consideration may be the time taken for the ambulance to arrive however, and sometimes may be easier to extricate yourselves. We had to administer CPR to that fellow in Daisy for maybe half an hour - and thats pretty close to the Logan Hospital. If you are waiting for 1 hour+ with a dislocated shoulder then I'd be walking...

Sounds like you need to do a first aid course Neilius. Well worth the time.

I've had 2 experiences similar to yours

the first was at sparrow hill near Canberra - where a friend put the front brakes on and did an OTB

we limped her out, and because she was a Canberra local wouldn't let us take her to queanbeyan hospital - she went to her local hospital and waited 6 hours in causality until she got medical care - she had a broken wrist, we should have called the ambulance

I had an OTB, and hit my forearm hard on an exposed root, we kept riding, and after about 10 minutes my arm wasn't quite the right shape - it didn't hurt much, but we called an ambulance, it met us at the car park and i got into causality and got medical care straight away. I got the green whistle and didn't have to wait in the Logan base hospital waiting room for hours, which I think would have been more painful than my arm

if in doubt go the ambulance option its what you pay your levy for

If you want to reduce your wait time, having private health cover can help, though you will pay. both times I've broken my collarbone, I rode out, went to private emergency and was seen within the hour, also managed specialist appointments on the Monday/Tuesday after. every time I think about changing my private health cover, we end up having a personal medical issue in the household that reminds us why we have it.

as for your situation Neillus, I agree with Bangers, do a First Aid course, it can help you make better decisions, they may not be right decisions, but you'll feel more comfortable that you had a process to follow. don't kick yourself, hindsight is 20/20, I'm sure everyone would change what they in this situation with the benefit of hindsight.

Here is my experiences from having called a couple of ambulances and from having a few riding buddy's that are ambo's.

1. If MTBing and someone crashes and needs an ambulance call it. However if they are conscious, have not taken a head knock, havent possibly sustained an spinal injuries, they can walk and moving isnt going to cause them any further injuries walk them out to a trail head that the ambulance can easily get access to. Simply because getting an ambulance anywhere inside mose state forest is a ***. They will potentially end up having to wait for much much longer to get assistance while ambos potential hike in to attend to them. This happened to a ambo mate of mine at samford state forest a while ago when someone broke their collar bone. It took a hour to get a 4x4 ambulance there and get the right key when the person probably could have walked to the trail head.

2) For god sakes give good directions and tell the emergency dispatcher whats going on. Thats all they have to work with. Cases a graded in terms of how serious they are and that can affect how long it takes for an ambulance to get there. This happened to that rider that broke their hip at the bottom of Pipeline a while ago, by all accounts. From the sound of it whoever rang the ambulance failed to leg the operator know how serious it was which explained how long it took for the ambulance to arrive.

3) People act really strange when they've had a head knock. Even trained medical professionals will not do what they should. They will try and move, or get up or do any number of other things that their medical training tells them they definitely shouldn't do. You as their friends need to take control, don't let them self diagnosis if they arent in a position to be thinking straight.

4) Dont call the ambulance if its something so minor that your mother would have treated it by 'kissing it better'. Paper cuts, a broken finger nail or a tooth ache are not reasons to call an ambulance. That just uses up valuable resources that could be better used else where.

Quote: Nightrider

3) People act really strange when they've had a head knock. Even trained medical professionals will not do what they should. They will try and move, or get up or do any number of other things that their medical training tells them they definitely shouldn't do. You as their friends need to take control, don't let them self diagnosis if they arent in a position to be thinking straight.

LOL. Doctors are the worst patients....ever!

Great topic Neilius. Some excellent replies have already been posted above.

In my mind, an ambulance should definitely be called if the injured rider has

- a suspected head or spinal injury (neck or back)

- is immobile

- has a compound fracture (bone poking through the skin)

- the pain is severe (this is subjective, so some people will be wussy and others quite stoic)

- is requiring Basic Life Support (yes, obvious I know)

- if you're in any doubt if it's safe to move them

- crash at speed or fall from a height > 2m where the chance of internal or bony injury may be higher

Like Nightrider said, if you CAN move the rider closer to an accessible firetrail (SAFELY) and they don't have a head/spine injury then this would be sensible, make life easier for the ambos and ensure a much quicker retrieval time.

Quote: Bangers

I would add to this consideration of the mechanism. ie: fall from height, at high speed etc where the incidence of serious bony or organ injuries is likely to be higher.

Thanks Bangers. Excellent point - I have modified my post to include your suggestion.

that was my arm - it looked kinda strange so discretion being the better part of valour...

Had the ambulance to my house twice in the past year.

First time a spider bite that caused my wife breathing difficulties (not transported), the second a neighour's 9yo falling 4 metres out of his tree into my yard (transported to Mater).

If in doubt, do not hesitate to call the ambulance - let them come and assess. They won't mind if they don't have to transport the person to hospital.

I don't really agree with Bangers comment of "If it were me I would be happy to assess the rider and make that decision" - I did that a few years ago after a bike crash and rode around for 3 months with a broken back before eventually going to a doctor and getting x-rayed.

Agree with the recommendation about private cover, and a firm believer in getting to the biggest capital city hospital you can get to (The crooked Bundaberg Hospital killed my 23yo quadriplegic brother 16 years whilst he was up there on holidays - they actually discharged him with bright green fluid coming out of his nose, not able to sit up in his wheelchair, and not lucid. The nurses couldn't override the doctor's decision to discharge him due to the "system". They never even tried to look after him - didn't even do basic tests on him in the 3 days he was in there - treated him as a drug overdose when he was sufferring heat stroke. Because he was discharged, an ambulance wouldn't pick him up. We had to get a taxi to pick him up and take him to the airport. He got forklifted onto a Qantas plane, and the pilot demanded an ambulance meet the plane on the runway back in Brisbane - by the time he got to the PA it was too late. YES, I'M STILL LIVID.

Quote: supermanlegs

I don't really agree with Bangers comment of "If it were me I would be happy to assess the rider and make that decision" - I did that a few years ago after a bike crash and rode around for 3 months with a broken back before eventually going to a doctor and getting x-rayed.

That's because you aren't me, and that was a comment based on my medical training and experience in dealing with trauma. I would usually be happy to assess a rider and make the decision as to whether they need an ambulance or not. But I also know I'm not perfect, so if there were doubts or any of the parameters DrGeoff has suggested - then it would be an ambulance and I would consider beginning extrication based on what first aid and other equipment I had available. Last thing on my list is to try be a hero and bugger it up. I'm used to working in a team environment and that is what needs to happen asap in these situations.

Oh, and MTBKid - it wasn't just the nurses who didn't get paid. I was one week off defaulting on my mortgage and had to cancel my honeymoon (and Rotorua trip). Waiting sux, but we all work harder and faster than we can.

If you come in dying then you won't wait. The emergency staff are perpetually slammed and work as hard as they can 24 hours a day.