The approach to this will depend on the cause.

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causes include 

being "Winded"

Obstructed airway

Broken ribs 

Injured lung tissue

Pneumothorax (punctured lung)

Blood loss

Injured heart 

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Many people after a fall are simply winded which takes a couple of minutes to establish - but other serious causes include injuries to organs such as the ribs, lung and heart

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Are they alert ?

As you approach take note of how alert the rider is.

​If they are drowsy or if still laying flat 

are they making any unusal noises when breathing ?

​the causes of this include decreased  conscious level with an obstructed airway - if drowsiness is the main cause see previous chapter on managing airway in unconsciuous patient - using a jaw thrust etc 

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Are they choking ?

other causes of an obstructed airway include direct trauma to the throat or choking on an object such as a  dislodged tooth or vomit (see choking page)

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Remove their helmet 

You need to remove their helmet urgently if they have an obstructed airway (video of helmet removal to follow)

 

If they can talk .. ask why they cant breath ? they may tell you its because of pain etc​

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Have a look at their chest ​

Remove chest protector and upper garments , with scissors if necessary (link here ) 

is there a hole in the chest wall

is there any obvious deformity - is any side of the chest moving less / more than the other 

is anything stuck in it .. bike lever etc

or sticking out if it such as rib ends ?

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If the main symptom is chest pain (likely broken rib)

let them sit upright if it helps ​

or go on all fours 

these patients need analgesia fast ​

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​​if there is a hole in chest - do not cover it  - unless you have training and have a apecialist chest seal

we can train you to use these (link here)

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​reasons to call 999​

apart from the obvious holes in chest etc 

if breathing symptoms continue to worsen 

if coughing up blood 

if blood in vomit

if blue tinge around lips (low oxygen levels)

if drowsy

 

Rib fractures can be very painful , and limit effectiveness of breathing coughing and can lead to serious pneumonia 

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chest seal is part of bleed kit 

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