*** Disclaimer – this post is not intended to give medical advice nor seek it – merely to discuss! ***
I had my first fall in six months today. It was rather a relief and very minor; the last time I came off was in July, which is ages ago for me, and I knew it was coming. Arwen and I were jumping a course of fences (and she was jumping absolutely fabulously, I may add) when as we cantered around a bend suddenly there was no more Arwen under me. I did the tuck-and-roll move my body learned when I was falling off a lot of buckers as a yard rat; Arwen hit the deck next to me but simply bobbled back to her feet like a little rubber ball and cantered off with her tail in the air like a middle finger. It was nothing, but it did get me thinking again about the perils of the sport and, more importantly, what we can do about it.
None of us really ever want to think about it, but as a riding coach – or as any horseperson – one always has to have the possibility in the back of one’s mind that everything could go sideways in a split second. And with a half-ton flight animal and a child involved, it can go really, really sideways.
Of course most coaches have first aid training. But what about the average ammy just hacking with buddies? I never really gave it much thought, but now that I have had a little training, I would argue that everyone involved with horses should have level one, at least. Horse injuries are terrifying because usually they could be spinal injuries, which is where you can mess things up really fast if you’re well-intentioned but just don’t know what to do.
Just before I had my level one, I had a kid come off at fairly high speed right onto her head. She was, of course, wearing a helmet, but in hindsight I think she must have been mildly concussed. Despite having done extensive research on first aid I promptly proceeded to do almost everything wrong. I bumped her back onto her feet, plonked her back on the horse and finished the lesson because she wasn’t seeing double, she wasn’t disoriented at the time, and her mom encouraged her to. It all turned out OK, but I shudder in retrospect to think of what could have happened, had God not been looking out for her.
In sharp contrast, less than a month after getting level one I witnessed my first proper serious fall. I was leading a hack and the next moment a pony came by me at high speed with flapping stirrups. This fall was a LOT more serious than the first one – we had broken bones to deal with, but this time my training stood me in very good stead. I did all the primary survey steps, held C-spine, called for help, reassured the kid – the only thing I didn’t do was splint the suspected break, mostly cuz I didn’t have any out there in the fields. The kid was turned over to qualified hands and made a full recovery. If I hadn’t had level one – well, I would probably have shunted her back onto her feet just because people look so much less injured when they’re at least sitting up, possibly complicating the fracture in the process. I thank God that we never had any drama like this before the level one.
I find now the hardest thing to do is to decide whether or not your rider needs a medic or ambulance. As we know, most falls are decidedly minor, and it would be wasteful of valuable resources to call out a medic for just a little tumble. But where is the line?
Personally my rule is if they don’t sit or jump up before I get to them, I’ll ask them to hold still, hold C-spine and probably call the medics. Most of the time when one falls the adrenalin rush is such that you’re at least back on your knees before you can really think about it. In my experience most people sit up at once; if they don’t, they could well be hurt somewhere, and then I’d far rather be safe than sorry. That’s not to say somebody that stood up immediately might not be injured – sometimes the rush is such that they could still have hit their heads, so I would probably still at least check them out myself and have a parent take them to a doctor for checking out if I had any doubt at all.