MEDICAL ARM BANDS FOR ALL

So the Houston show didn’t exactly go as planned… bear with me, this is long, tedious, and totally worth your time.


I took my laptop in hopes of doing an update over the weekend in my downtime, but alas, no free internet at the EQCenter. So on Friday, after my braiding signs were up, I found a comfortable seat in the show ring to watch “warm-up day” festivities. Little did I know where my weekend would take me.

In between cruising the internet on my phone and watching riders school through the rings, there was a commotion from Ring 2 and I looked up in time to watch a horse spooking. He spun and gave a buck that sent his rider to the ground. The horse didn’t go far, confused and shaken, but the rider didn’t move. Nearby trainers ran over as many cries went out not to let her move, although she hadn’t moved since she hit the ground. Riders in the ring dismounted, the horse was collected, but the rider lay still. I yelled down from the stadium seats if she needed an ambulance. A moment later, someone said yes and I pulled out my phone.

I was immediately connected with local dispatch and I headed down towards the arena (down a flight of stairs and around to the arena entrance) as I informed her that I was at the Equestrian Center and needed an ambulance. I gave her the road and the city name and informed her that there was a fallen rider, conscious, but with severe back pain. Dispatch gave me hell about needing a specific address or a cross street and I had to sprint outside to find the numbers on the building. I’m thinking just Google already - it comes up on Mapquest!

I guess it’s just not that easy.

Finally with dispatch confirmed that an ambulance was on the way, I was let off the phone. Two riders who had dismounted had stabilized the rider’s neck and legs. I finally was able to get the rider’s name; Sarah, and I introduced myself. We went through all the precursory questions and Sarah, in evident pain, started rattling off information; where her keys, truck, and purse were, her medical allergies, and where to find her phone. At this point, I realize that no one had “claimed” Sarah – turns out, she traveled to the show alone and did not have a trainer or family member present. She was talking to me; I was her person (for all the Grey’s Anatomy fans who may be reading). I sprinted across the show grounds alongside her closest friend Bobbie Paulk, whose horse had been shuffled into the care of her husband. Bobbie helped me get her cell phone and purse from the car and I called her husband and left voicemails on his cell and work numbers. The ambulance pulled into the arena and the paramedics took the information from her license and made note of everything. As she was being loaded, I asked Sarah if she’d like me to go with her and she said yes, as I still hadn’t reached her husband.

Armed with two purses and a cell phone in each hand (one hers), I asked the ER staff where I could find Sarah. Sarah who? They asked. Shit. I didn’t even know her last name – it had all been a blur of madness to make sure she was okay. Picking up the day timer in her purse, it was the ever-familiar USEF membership card that jumped out at me. Perfect. I told them the situation and handed them the card with her last name spelled on it. I had beaten the ambulance to the hospital, so I sat down to wait as they confirmed that Sarah was on her way.

I was finally brought to the room where she was. Still strapped to the backboard with a neck collar, Sarah looked terrified and worried. I cleaned the blood off her nose where she’d collided with her horse – her helmet visor saved her a broken nose. I listened to her explain the rest of her medical history to the attending nurses, some of which prompted more tests and scans. I finally got ahold of her husband, who would be battling Austin traffic for a few hours before he could get there. I also got word from the show ground that the horse was taken care of, injury free, and settled back in his stall. Over the next few hours, she was wheeled away intermittently for X-rays and CT Scans. I took up my post near a wall plug for my phone charger and prayed for good news for this stranger I’d just met through the worst of circumstances. I started to wonder how many people go to a show alone like this? I’d only done it once and I certainly never will again, but I remember believing that it was a way to “prove myself” at the time even though the truth was just that no one was available that weekend. Making the long haul solo, warming up, showing, getting through a test with only yourself to coach, relying on your horse for companionship, it was all a rare one-on-one bonding experience away from home. How satisfying, and yet, how dangerous.

It was confirmed after X-rays that she fractured her L1 vertebrae and would go in for more tests to determine if and how bad the surrounding compression damage was. She finally got an IV and morphine. Tim, Sarah’s husband, arrived after I’d spent a few hours getting to know this fascinating woman. It seemed that the wheels never stopped turning as much as I tried to distract with conversation – there was one concern after another as to how she’d cope with this, rearrange that, or postpone plans. The prognosis and stress was debilitating, her spinal fracture aside.

Before she could express her concern with how she’d get her horse home, I offered to drive her truck and trailer back to Austin the following day – I had plenty of downtime during the day anyway as the horse I usually groom for had scratched. It was absolutely amazing how the events lined up so well. So on Saturday morning, I loaded up Shimmer, her Dutch Warmblood, and headed out for the two hour drive west. I couldn’t imagine the stress they must go through, and to be two hours out of town on top of it all. Everything went without incident on the trip home for Shimmer, and when I called to check on Sarah, Tim informed me she’d been transferred downtown in order to see a specialist.

Thankfully though, Sunday morning when I called to check on Sarah again, the verdict was that she would not need surgery. They molded a brace for her back and would be waiting a few days for it to be made – a “turtle shell” to prevent any further damage while she recuperates. A day or two of observation, and then she’ll be released home for her long road to recovery.

During the entire ordeal I kept playing the “what if?” game, running through different scenarios. I played back over the scene in my head, asking myself “how could this have gone smoother?” and “what more could be done to prevent such chaos?” “what if Sarah had been unconscious?” Competitors may often travel to shows unaccompanied – in today’s world where work and play schedules conflict, a horse-show husband may not be able to tag along. Add kids or school to the mix and I can imagine it’s a downright miracle to have everyone pack up and leave for a weekend.

While Sarah certainly wouldn’t have gone without urgent care, things would have been different had she not been able to tell us her medical history and allergies. It got me wondering how many riders may be riding with a medical history that would be vital for emergency personnel to be aware of in order to treat them effectively.

It’s no secret that working with horses is dangerous. How some people ignore a helmet when working with and riding several-thousand-pound, free-thinking animals is beyond me, especially after an accident like Courtney King-Dye’s. I know, I know, I used to be in that boat, but I woke up quick when an Olympian in my sport was debilitated. My Charles Owen and I are best of friends.

I am in no way saying that we should put a halt to the sport, but precautions to match the risks should be taken as such.

PROTECT YOURSELF.

When you travel with your horse, to a show, lesson, or a trail ride, bring someone with you if you can, and have them stay with you at all times when you’re mounted. Just having someone to hang around and check out the concession stand while you’re warming up isn’t enough – it would be just as bad for your person to be absent at the time of an accident than not there at all!

If you can’t bring someone with you, let people know when and where you’ll be. Designate times to call them and give them updates, and even line up the “if you don’t hear from me by this time, call this person” to find out. Keep your cell phone charged and ON you while riding – there are a million different belt clips and thingamajigs to keep yourself connected – no excuses here. And yet it seemed as though at the time of Sarah’s accident, I was the closest one with a phone – and I was in the stands!

Your trainer needs to be aware of your medical conditions, history, and care. This may include a copy of your driver’s license and insurance card(s), hospital preferences, allergies, emergency contacts, and how to take care of your horse should you be rendered incapable of doing so yourself.

Your equipment, tack, feed, and care should be CLEARLY LABELED. Meaning a complete stranger could follow the steps to tucking your horse in like nothing changed. This includes grain, spray bottles (Is it Liniment? Fly spray? Who knows!) hay, meds, supplements, and clearly spell out your veterinarian and farrier. This doesn’t just go for when you’re on the road, either. Your home barn needs just as much, if not more organization in case you can't be there to feed or care for them.

While it took an accident of Courtney King’s caliber to spur helmet regulations be put into motion, I do not believe it should take an act of negligence or failing/improper medical assistance to require that all riders aboard a horse on a USEF-sanctioned show wear a medical arm band. I’m already on top of seeing that this issue is addressed at the national level eventually. We cannot rely on minimal emergency contact information (not medical!) buried somewhere in a file folder in the show office to be the saving grace in the event of an accident.

As of right now, the only USEF affiliate to require a medical arm band is the US Eventing Association, but this is only required when jumping:

2. MEDICAL CARDS. An approved and completed medical card is required any time while

jumping. It must be enclosed in a transparent, waterproof carrier. It must be securely

attached to the competitor’s upper arm on the outside of the competitor’s clothing. It must

include any relevant medical history, injury (particularly to the head), drug allergies and current

medication. Athletes are responsible to record all injuries on the card. Failure to wear

one’s own medical card shall be penalized by a fine of $100. (Payable to the Organizing

Committee) EC 2/16/10 Effective immediately.

A rider can sustain injury that rules them unconscious or unresponsive just by being in the wrong place at the wrong time, not just from taking solid fences or a 4’ oxer. EVERYONE on a horse needs this information on them – there is no guarantee your person will be a reliable back up in case you’re a diabetic transplant patient who happens to be allergic to penicillin, and OH YEAH you can't tell anyone because you're now a concussion-ridden lump on the ground. Slight exaggeration, but you get my point.

Personally, I stumbled upon RoadID when I was a triathlete a few years ago. My workouts often took me running or biking miles or hours from home, and the customized ID had everything on it that an EMT would need to know. Brilliant. They even make a version now with a web link where you can keep your information updated and include an infinite amount of medical history. They’re comfortable, sleek, you can pick your color, and it never fails that someone asks “what’s that?” The more that know the better! They’ve got hundreds of testimonials of people that were saved because EMTs and responding medical staff knew the information they needed.

Another issue at hand is the need for clarification in the Emergency Response Protocol as dictated by USEF, which currently states that “Exhibitors are asked to not make 911 calls using their cell phones.” EXCUSE ME, WHAT? This is so that instead, Show Management may call from a landline and direct the ambulance to hold sirens and find the best and fastest entrance. But there are several things wrong here. When show management DID finally get to the ring, they were on a cell phone connecting to 911 long after I'd been given confirmation that help was on the way and was allowed to hang up.

While I totally understand that spectators don’t need to call 911 if an EMT is on the grounds, and that during the show, a ring steward would have radioed a report of an accident in to the office and the EMT would have responded within minutes, as one is required during competition. However, an EMT wasn’t on the grounds yet, as competition had not started.  No one from show management oversees warm-up and show rings on the schooling day. Assuming (worst case scenario) I had been the only one to see the accident, a trek to the show office could greatly impede medical assistance. Minutes count. Definitely an amendment needed here.

Another thing that needs to change is that this response protocol be visible ALL over the show grounds. Emergencies create panic, and panic can make you forgetful. Someone who isn’t versed in dealing with an equestrian related injury (or emergency response in general!) needs to be able to follow instructions to get the fastest help. Even when I myself called 911, I had to sprint around the damn block to find the address – everyone I passed on the way outside didn’t know it either. The address needs to be posted on signs everywhere, probably as a permanent fixture if possible. But it certainly wouldn’t hurt to have Emergency Protocol with the facility address and directions put up in common places – bathrooms, bulletin boards, arena entrances – more than just the show office. The show office can be too crowded and busy to do “light reading” of small-print Emergency Response Protocol on the wall.



While this has been an EXTREMELY long post, I hope that anyone who has read it all will agree with me that action needs to be taken. Trust me, while I’m already working on it, but the more support the better. This is about coping with emergencies effectively and protecting our equestrian athletes from preventable mistakes in medical assistance. Protect yourself.



You’ll be hearing more on this from me as I venture into the realm of bylaws changes and affiliate backing for rule amendments. I’m not backing down from this one!



Helmets & Medical Arm Bands to all,
Lauren



P.S. Sarah is home now, on the road to recovery. She'll face 2-3 months of bed rest and downtime before she begins therapy. But considering the extent of her accident, she's doing as good as she can be!