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Safety Highlight – Climber Struck by Bicycle
Lessons from Mountaineer Incidents

Seattle Climbing and Seattle Safety committees are experimenting with raising awareness of safety issues that can arise on climbs, scrambles, backcountry skiing, and other Mountaineer activities. Previous Safety Highlights and other information are available on the Safety Committee’s web page.

Identifying information has been removed or disguised.

-- Dave Shema, Seattle Branch Safety Officer

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In-town field trips and practices expose climbers and scramblers to a different category of risks.

I have included the MOFA leader's assessment of the climbing student as an example of an excellent patient exam. 

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April 5, 2012 - Discovery Park, Seattle, West of North Parking Lot

Injury: Broken Elbow

Cause: Struck by Speeding Bicyclist

Our party of 9 Mountaineers (3 instructors and 6 students) had just descended the paved hill west of the northern parking lot of Discovery Park (heading east) when a bicyclist, traveling at high speed (also heading east) came down the hill from behind us and collided with one of the climbing students in our party.    

After the impact,  the climbing student [AJ] lay sprawled on his stomach and partially on his right side with his right arm under him and his head resting on the southern curb, and with the bicyclist (wearing a helmet) sprawled off his bike in the center of the road.    We were fortunate to have an Emergency Room Nurse as the First Aid Leader of our party. 

Another member of our party positioned himself west of the accident scene to ward off other bicyclists that might happen to descend the same hill.    The ER nurse did an examination of the bicyclist (while our climbing student  was kept immobile in his original position), followed by an examination of the student .

The bicyclist appeared to have only minor injuries and after giving us his contact information left the scene briefly followed by his return and finally leaving for good.  AJ complained of pain to his right arm (which was under his torso) but claimed to feel no other obvious injuries at that point.    Another party member offered to drive AJ to the hospital where he was diagnosed with a broken elbow.  Fortunately, there was no nerve damage.  The recovery period is estimated to be 12 weeks.

[MOFA Leader]
After collision with bicyclist, [the climbing student] AJ was found laying on his stomach with right arm underneath him. He was alert and oriented to person place and event. He denied hitting his head or loss of consciousness. He denied neck or back pain.

C-Spine precautions were maintained assessment of neck and back were performed revealing no pain to bony prominences upon palpation.

AJ denied pain in abdomen or pelvis. He denied nausea/dizziness. AJ was then helped to a sitting position.

AJ complained of pain to right elbow. AJ had + pulses, capillary refill and movement distal to injury. AJ was able to perform flexion and extension of right arm without increase in pain.

AJ was found to have a hole in the jacket near right elbow with traces of blood. Upon removal of jacket and outer layer shirt AJ's skin was macerated over the elbow, tendon was visualized. It was unclear if there was damage to bone but I thought there might be possibility of a open humeral head fracture. I applied gauze 4x4 dressing to minimize bleeding.

AJ also c/o pain to left lower leg. He was found to have an abrasion and minor bruising to shin; circulation distal to injury was intact. He appeared to have no further injuries.

AJ was tachycardic in the low 100's  at time of injury which improved with duration since injury occurred.

AJ wanted to get up an walk after incident to get himself clear of the roadway, upon standing he became dizzy and pale in appearance. We sat him down for a few moments, he regained color to his cheeks and his symptoms resolved. AJ refused suggestions for ambulance ride.

After his symptoms resolved AJ was able to ambulate with steady gait to picnic table adjacent to the north parking lot. He complained of being cold and was visibly shivering. His cold and shivering resolved after multiple layers of clothing were placed on him.

His pulse rate remained stable in the mid 80's at that time.

I told both AJ and a volunteer driver that should he start feeling worse or his condition deteriorated in anyway, they should go to the nearest hospital and not drive all the way to Overlake Hospital. Both verbalized understanding. 

[De facto Safety Person]
In the minute or two after the accident, we were all focused on AJ and the bicyclist, who were both on the ground, obviously hurt. After a short time (I can't say how long exactly, maybe a couple of minutes,) someone said to me that we should be watching out for more bicyclists. I then jogged up the road to the curve and kept watch.

It is understandable under the circumstances, but in hindsight, it would have been better if someone had realized this potential hazard immediately and stepped back to assess and take control of the larger environment while others focused on the victims. You can think of this principle as "hazard awareness in the aftermath of an accident," and it has applicability to accidents in remote areas as well. This is a principle that could be included in the training of all members of a party that is going into a wilderness area.

[Note:  This is Step 2 of MOFA's Seven Steps.  "Approach the victim safely", looking out for hazards.]