I'm working on a new story on how to best handle rider injury--what the protocol should be. Like...What should you do at the time and what is the proper follow-up? Do you complete an incident report form (and did you devise your own?)? Note what happened, who was there, take some pictures? You do not want to recreate something a year down the road in a courtroom. And what about communication--from the trainer/barn owner to the hurt client, and communication between the client and his/her friends? I think that's important when a problem occurs, don't you?
Can you recommend an expert who might speak to this? Or any tips that have worked well for you? Timely topic at any time...Thanks.
Yikes, I must say it would be disconcerting to have my trainer or BO snapping photos while I lay on the ground waiting for an ambulance.
Not to say kinda scary.
I agree, I wouldn't appreciate having photos taken of me! Eeek! For minor students in a riding school, an incident report such as daycares and schools use might be appropriate...that's mostly to get confirmation from the parents that they'd been informed of what happened. Not so sure that would be appropriate for adults, who are there to speak for themselves.
As far as contacting folks goes, all the barns I've ridden at have a place for "Emergency Contact" on their liability release forms. I put my husband there, so someone can call him if I am not able to call him myself. Communication to clients friends should be left up to the client or client's family.
When I had my barn accident, my insurance company was rather diligent in pursuing who might be at fault ... so I suppose from a barn owner's perspective, at least writing down what happened might be a good idea if the rider tries to lay blame on the barn for what happened.
Insurance companies are pretty good at figuring out whether they have to pay a medical bill or not.
As a trainer or instructor, I would never admit to fault in an accident, as that for sure is what is used in a lawsuit. People fall off, it happens, so don't put yourself in a tight spot as far as liability if you don't have to -- and hopefully the person signed a waiver and you have the equine liability act posted prominently.
Now, if it is negligence -- bad tack, poor judgement, not telling the person the horse is a rogue or whatever -- then there is some blame to be spread around. Of course, that is what the barn has liability insurance for.
Editing to say, the protocol should be:
1. Assess the injury. Call an ambulance if it's serious, and if it's a head injury (if the helmet is cracked, that is not good), don't let the person drive home. Know the signs of a concussion! If it's a back injury, don't let them move, wait for the ambulance team. Blood -- clean it up as best you can, bandage.
2. Call the emergency contact if it's more than a bump or a bruise.
3. Make sure the horse is caught and put away if the person isn't getting back on.
4. Sit the person down in a quiet area (or don't move them if it's really serious), observe their behavior. If they are demonstratably OK, and it's NOT A HEAD INJURY, they can go home. Otherwise, wait for the emergency contact person or the ambulance to come.
5. Make sure the gate is open for the emergency vehicle, if there is a gate.
We just had two injuries occur at an event I manage. And fortunately we had discussed protocols for handling injuries/accidents just the week before.
1st thing is quick assessment. If someone came off a horse, call an ambulance. We made sure to ask the ambulance to turn off lights/siren before entering the grounds, and we had someone at the gate to meet them and direct them to the location. We also asked all riders to dismount and clear the area. In this case, I was told at the same time someone else was calling an ambulance. Our policy (as told to all of our coordinators for the event) was to call an ambulance and then find me.
I made sure a member of our board of directors stayed with the injured person at all times. MOST of the time it was me, but I had to run and get someone down to the front gate to direct the ambulance so I was gone for five minutes and another BOD member waited.
There were two EMTs attending the event, and they made sure no one moved the injured rider. Someone had asked her if she could get up, and they jumped in and insisted she not move.
Her husband was there, and we waited with him while the EMTs examined her. They released her without going to the hospital, but we did get her husband to take her in to an emergency clinic for an exam.
We followed up afterwards, too, to make sure she was doing ok and see if she needed anything.
In addition to running the rescue, I am also an equine behaviorist and serve as an expert witness, often in cases where someone is injured. One thing that I've seen in some of the cases I've worked is that the injured people are REALLY angry when someone involved either doesn't say they're sorry or doesn't check up on them afterwards. We're all told that if we say we're sorry that means we're admitting fault. I'm NOT an attorney, so this isn't legal advice, but I think people get more upset when they feel you don't care. Maybe they still would sue anyway, but you build up a lot of hurt feelings and anger when you ignore someone's pain. I know when I got hurt as a teenager by a 4-H leader's horse, I was quite angry and insulted when the 4-H leader called my dad, blamed the injury on me, and didn't appear to care how I was doing at all. He wasn't the kind to sue, but she's lucky that didn't make him cross that line! It was insulting - a simple, 'How's she doing? I'm so sorry she got hurt.' would go a long ways..
I don't think anyone is suggesting taking polaroids while the injured person is lying there after getting bucked off. Keep in mind safety incidents are not limited to falling off horses where there's not much you could have done to prevent it. The incident could easily be something like a boarder using the manure spreader without permission or training, and getting her hand mangled. Or someone backing their trailer up and breaking a fence, causing a horse jailbreak. Stuff where it would be simple to prevent it in the future by changing policy on using implements, relocating trailer parking areas, installing parking curbs, etc.
A defined safety procedure where you actively investigate all incidents and look at root cause/how to prevent it in future really improves safety. It is also makes it harder for someone in a courtroom to paint your stable as grossly negligent.
A safety incident procedure doesn't have to be fancy, just a clear protocol of What To Do When $hit Happened. Ideally it would be used for Near Miss kind of events, too, so that the safety program is focused on hazard awareness and prevention instead of just reaction to an accident. The investigation is not about putting blame on someone, it's just hey-- this thing happened and it could have been any of us that got hurt. What ideas can we generate to prevent it from happening again?
The form you use can be really simple. It should include
When did it happen
Description of what happened & to whom
Description of Injuries or property damage
Who else was present
Weather / site conditions
Other contributing factors
Immediate Actions taken
Recommended preventive actions
The first priority is to take care of the injured party in a responsible manner. I am shocked sometimes when I see trainers and other trying to push riders to get up and/or remount after potentially significant falls. Sometimes injuries aren't immediately apparent. I'm also shocked when someone has a major fall yet they insist they want to drive themselves or have someone else drive them to the hospital. No, it's very simple, just call 911 and an ambulance will come. People often lose their common sense in emergency situations.
As far as trying to assess injuries, etc.--aside from providing basic first aid or CPR (if you are trained)--don't. Leave that to medical personnel. Just call 911 and follow their instructions. If you have extra people on hand, send one to the driveway entrance to direct an emergency vehicle to the scene when it arrives. Keep emergency contact information in an accessible area of your barn so that you or an extra person at the scene can alert a family member/SO/etc. as soon as possible.
I must say, as a rider who has fallen off pretty seriously at a show, I greatly appreciated it when I recieved a call that evening from the show management checking in on me-whether it was to cover their butts or actually caring doesn't matter. I wouldn't have held my fall against anyone at the show, but the follow up really made me feel as if they cared for my well-being, not just my entry fees
I like mares. They remind me of myself: stubborn know-it-alls who only acknowledge you if you have food. Titania: 50% horse, 50% hippo
Unforgetable: torn between jumping and nap time, bad speller
I just wanted to stress as cowgirljenn and Electrikk have, that a phone call/follow up of some sort would be much appreciated.
I had an accident last spring while riding an unfamiliar horse which ended with me sustaining a concussion (I don't remember, but I'm told that horse unexpectedly reared and cracked me in the head hard with his own head/poll, knocking me unconscious and off of him). I was doing a favor and riding a horse for a friend of a friend to show him off for a prospective buyer.
It did not sit well with me that the horse's owner never called, texted, e-mailed or otherwise checked up on me. I don't at all blame them for the incident - I've been riding long enough to know that sometimes crap happens, but some acknowledgement that I had been injured (enough to prevent both working and riding for several weeks) would have made me feel much better in an upsetting situation.
In that situation, my friend and the barn owner who were present did a lot right to put me, the injured rider, at ease. My friend accompanied me to the hospital and was present to answer all of the questions about what had happened - particularly important for a head injury, but I think potentially useful for many riding accidents as it can be very hard to determine what happened in the moment. They also made sure all of the information re: the barn's insurance policy, my insurance policy (through pulling the card from my wallet), etc. was easily available and something I did not have to deal with.
Once I was cleared to go home for the evening, my friend and the barn owner asked what I wanted them to tell other clients/barn folks re: the incident as I was a frequent rider and my absence was noticed and inquired about by others. I really appreciated the opportunity to control in some way what was being said about the incident and also let my friends at the barn know how I was doing without having to handle it myself. Different people will have different comfort levels with the sharing of medical information, so I thought it was very nice that it was up to me to make that call.
Hum- honestly when you say protocol for rider injury, my first thought is the proper FIRST AID protocol. IE – knowing when to move someone, and when to not move them. How to check for breathing, clear airways, and CPR if needed. How to stabilize for neck and back injuries which are common with riding.
The protocols you speak of seem to surround legal liability and insurance claims. Which honestly, in the heat of a serious accident, where a rider is hurt, attending to their first aid needs, and communicating to emergency personnel as efficiently and effectively as possible would be my top concern.
I would be worried about First Aid classes before “incident reports”. But I am also not a BO – but I hope my BO would be more worried about my physical condition, then documenting for the court room!
(hum – This reminds me, I should take a brush up first aid class)
As a medical provider, I've got a lot of experience about assessing injuries- my own (including the head injuries i blew off that turned out badly), other riders, ortho & ED patients etc and my dad used to be a the steeplechase doc-on-premises, so I've learned from the best.
My best recommendation is two fold: 1) take a first aid course via the red cross & a CPR course. They go over laws about helping the injured, plus what to do. 2) call rescue (911). Riders are notorious for serious head injuries that don't declare themselves until either someone with excellent medical training sees them or later at home when no one is around....which is scary & not good.
Rescue has legal coverage for assessing a patient, is amazing at what they do and people can always decline going.....BUT that's where the legal stuff comes in. I would have a rider sign a waiver that they declined medical care --- like a patient signs an "AMA" form (against medical advice). But that's because of what I've seen in the ED, in the barn etc and people with head injuries, even minor, do not think linearly or logically, nor do they generally know what happens if you ignore XYZ-name -the- diagnoses- riders- get -from -falls.
PM me if u need more info from the medical aspect.
You could also cross post on eventing forum since eventers do seem to have more injuries than other disciplines.
And the wise, Jack Daniels drinking, slow-truck-driving, veteran TB handler who took "no shit from no hoss Miss L, y'hear," said: "She aint wrapped too tight."
At a recent schooling show run by our GMO, a rider fell off, did not get up, saying she had hurt her back. Long story short, staff called 911 immediately. ambulance arrived while rider said she would.not.go. to. hospital... EMT people said she would probably be ok, just sore, but we made her sign a release saying she refused to go be formally examined.
All barns I have been at have been very diligent about injuries on site, trying to keep rider from being stupid (which we can be!)putting horse away and following up as necessary.
Regarding incident reports, it may be a judgement call but here are my thoughts: When kids involved ( ie under 18) it would be very useful to document situation particularly if parents are not around. With adults, maybe less necessary.
We don't get less brave; we get a bigger sense of self-preservation........
I agree that if you are the BO it is a good idea to talk with the person about what they want you to tell others at the barn. Some people are private, and might not want to discuss any injuries. Sometimes people might not want to protect a horse's reputation as well, i.e. not publicize falls off of a sales horse.
I also agree that it is generally best to follow up and offer sympathy and show that you care, but I've seen this backfire/get awkward, too. Some people DO interpret sympathy and/or apologies as an admission of guilt/wrongdoing, or take the opportunity to take a "you owe me because of what happened" stance.
A rider had a fairly ordinary fall while working with a trainer on the trainer's school horse--no wrongdoing or negligence, no serious injuries. The trainer was very helpful and sympathetic afterwards. I don't know if the client liked the attention or liked having something to hold over her trainer, but for a long time afterwards she would discuss the fall (in front of other people, which is how I know this) and say things like, "Oh, trainer X, you're lucky I'm not the kind of person to sue." Later I found out she had gotten behind on her bills with the trainer (who was also the BO) and when pressed basically told the trainer that she owed her at least that much for "everything she had been through" with her "injuries."
I'm not saying don't be sympathetic, just be aware that sometimes people DO feel that they are owed something beyond sympathy and an apology after an accident, whether or not there was any wrongdoing. Also, in our litigious society people sometimes have very different ideas about who is at fault.
These are just amazing, intelligent responses. I was bucked off a loser sales horse, fractured L1...and left to deal with it. Nice. I'll be in touch with y'all privately.
Way to go on really thinking this through...
[QUOTE=cowgirljenn;In addition to running the rescue, I am also an equine behaviorist and serve as an expert witness, often in cases where someone is injured. One thing that I've seen in some of the cases I've worked is that the injured people are REALLY angry when someone involved either doesn't say they're sorry or doesn't check up on them afterwards. ..[/QUOTE]
I had a friend that fell off a horse, she was surrounded by trainer and other boarders - trainer and 1 boarder both had Red Cross training, both asked if they wanted to have them call family/friend, 911 etc. She denied any assistance; so after a bit she got in her car to drive home. Once home, she realized she couldn't get out of car, and ended up in hospital w/ broken pelvis. This happened at my barn (wasn't there) but she still complains that No one ever bothered to call her to see if she was okay. At some point I did get tired of having to defend the barn & trainer. Even though friend denied assistance, she was still upset that there was zero follow-up. Best advice would be to check w/ your business attorney about protocol etc.
I had a friend that fell off a horse, she was surrounded by trainer and other boarders - trainer and 1 boarder both had Red Cross training, both asked if they wanted to have them call family/friend, 911 etc. She denied any assistance; so after a bit she got in her car to drive home. Once home, she realized she couldn't get out of car, and ended up in hospital w/ broken pelvis. etc.
Exactly my point about riders not knowing when they r hurt. Gotta remember when u are in a fall, accident, crash etc, your adrenals start shooting out epinephrine (adrenaline) so u don't feel as much pain, so u can run, and get out of the situation. That's part of why riders get back on, saying everything is fine & and then fall off again in some cases. Not to bring up a sore & controversial subject but this is the exact reason I support the 1-fall rule.....from a medical standpoint.
When I practiced Sports Medicine, the attendings, residents and I could always guess what sport a person was doing based on their X-rays, ct, MRI, etc: the worst sports-related permanent injury accidents we saw were riders first, then football players...
And the wise, Jack Daniels drinking, slow-truck-driving, veteran TB handler who took "no shit from no hoss Miss L, y'hear," said: "She aint wrapped too tight."