MOI -Lightly clad cyclist moving downhill - sudden stop and goes over the handlebars. Increase in forward motion due to slope and little clothing protection from the impact with the road surface.



Suspect spinal injury until proven otherwise by higher authority.

Collar bone pain is a distracting injury and could mask spinal problems.

Immobilise in situ, cover for shock and monitor until cavalry arrive.

Privamb is the pinacle of knowledge! I would be proud to take any advice given by him..........................poor guy is going to get a pile of questions off me in the new year - Sorry :)

GV, so long as you trust nobody, believe nothing and check everything you won't go wrong. But, advice always here if I can help you start out (and you check for yourself its correct before acting on it because you should believe nothing, trust nobody and check everything!) and there are a lot of good people on this site of many years standing who will offer the same for nothing in return. Sadly this area of work is full of quite sinister characters who pretend to be anything from student ambulance paramedics to qualified doctors as the sector benefited from little regulation which is now dwindling further. Only the other month a bogus doctor got caught out working for a CQC regulated ambulance service doing NHS front line work. You have the RGN ticket so there is your immediate credibility and its something you can make money out of if you do it well with a level head. NHS and care sector will concentrate more on the fact that you are an RGN than someone capable of delivering outsourced training when considering buying in your services, so its up to you to get yourself educated and current as its often the students themselves who smell a rat and report back. Best of luck with your new venture. If done correctly, it is a good financial reward in return for little financial outlay.

Could you explain to me what an ambulance crew would do with this walking talking patient with a painful shoulder and asymptomatic to neurological deficit? If people stopped using ambulances as a taxi to ferry minor injuries around or ceased calling them out because they can't think of anything constructive to do like put them in a car and drive them to hospital, the ambulance service statistics would not show that only 20 odd percent of all calls are genuine emergencies. If you can pick yourself up and dust yourself down, can stand on two feet without being dizzy and without difficulty in breathing then you do not, as with your friend, need the services of an emergency ambulance.

I like your way of thinking - but not for this scenario.  I agree with IHCDTech that the cavalry should attend.  Its suggestive of a C spine compromise and imobilisation should take place.

You seem to be sumising initially that the cyclist doesnt want one.  Re read the original scenario - there is no refusal, and no getting up.. therefore until he refuses, the ambulance should be called.



he can then refuse to the ambulance that arrives and they can advise...

"Here’s what happened next: the motorist offered to call and ambulance, but the cyclist said he didn't need one though he did accept the offer of a lift home. His wife then took him to hospital where he was diagnosed with a broken collar bone and given a figure of eight bandage to wear. Still not feeling too good a few days later he went back to the doctors who confirmed the broken collar bone, but added a cracked rib and vertebrae. Despite all this he was back to work within the week!"

No idea, but I'll try to fnd out.