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Some critical decisions often need to be made and they can be
stressful for everyone involved, especially if you are a riding
dermatologist.
What if your 52 year old riding buddy starts having chest pain? What do
YOU do if you are trail riding in a remote area and someone falls off
her
horse and is knocked unconscious? How should you evacuate the person?
When
should you leave to call for help? When can you leave an injured person
alone to go for help? What do you do with the horses?
The first step in answering any of these questions is to be prepared.
Keep in mind and mentally rehearse what you would do in any of these
scenarios.
Tell someone where you are going and when to expect your return. Know
the
country in which you are riding as best you can and if unfamiliar to
you
should get a map well in advance. If you are a physician you will save
yourself a lot of trouble by carrying a cell phone on your belt in case
of an emergency. If it in on the horse, the phone may leave with your
horse.
Most hunt staff have radios and giving one to the physician of the day
greatly facilitates communication. We frequently have at least one or
two
physicians in our hunt field and usually one of us volunteers to stay
with
an ill or injured rider. A rotation keeps the burden lighter on
everyone.
Know what hospitals are in your area, their capabilities and which one
is the closest. Fortunately we have a familiar relationship with our
nearest
community hospital, the EM nurses recognize an injured rider is coming
when muddy people with boots on and lots of scratches on their faces
appear
at the door.
Take common sense safety precautions. Urge everyone in your field to
wear an ASTM-SEI helmet with chinstrap fastened. Encourage riders that
have potentially serious medical problems like diabetes, seizures or
heart
conditions to wear a med alert bracelet. You may not feel you are
responsible
for the medical care decisions of everyone with whom you trail ride or
foxhunt but you will be when they have a fall from a horse and you are
the only medical person available. Anyone who rides
or
is around horses should have an up to date tetanus immunization. Hunt
staff
should have preexposure rabies inoculation.
Know what medical skills are available, who is trained in first aid
or CPR. Does the local EMS service have a 4 wheel drive ambulance (most
don't)? What areas do you go into that might require a person being
hand
carried out on a backboard? Which is the closest hospital with
capabilities
to handle major trauma or head injuries? Do they have a CT scan or a
neurosurgeon
on call?
Carry or have available some basic medical supplies. For a days
foxhunting
or a local trail ride I carry in my sandwich case an ampoule of 1/100
epinephrine,
a TB syringe, a vial of injectable Benadryl, a 5cc syringe, a 14 g
angiocath,
a cotton triangular sling (never a lack of clavicle fractures in
riders),
Advil, Tylenol and hydrocodone tablets. If you are going on an
extended
ride of more than a day then you will need a more comprehensive pack as
well as to obtain a medical screening sheet on each rider before you
go.
Put a backboard, hard cervical collar, sheet rolls, and duct tape in
the
horse trailer and leave it there. (Your local EMS service will usually
give this stuff to you when it becomes worn or outdated). One day you
may
be very thankful.
Review emergency procedures with the other medical personnel on your
ride, as well as with the MFH and hunt staff. Follow basic precautions
in courtesy and etiquette. One of the cardinal rules of foxhunting or
trail
riding is do not leave the field of riders without notifying the
fieldmaster
or trail boss. This is basic common sense and helps avoid situations in
which you may be left alone and injured. When someone is injured in OUR
hunt we usually ask that the fie1d of riders go on leaving one person
to
hold the injured rider's horse, another to attend to the victim
(calling
for any riding medical personnel if not present) and a third or fourth
person to stay to hold the other horses and help the physician or
person
who is assuming care of the patient.
When an injury does occur you must assess the urgency and make a
decision.
Can the person walk out to the nearest vehicle? Can they ride out
or do the need experienced EMS evacuation? In general helicopter
evacuation
from the scene is not a good idea when you have multiple people in the
area on horseback. Before you know it YOU are going to have a lot more
problems on hand. Evacuating a patient by ground is often faster and
less
risky.
Initiate a call for immediate evacuation if the patient has the
following:
persistent altered mental status after a fall with loss of
consciousness,
orthostatic syncope, chest pain that is clearly not chest wall in
origin,
the return of loss of consciousness following head injury, debilitating
pain, or evidence of a spinal cord injury such as intense neck or back
pain, arid numbness or weakness in the extremities. (1)
What if you are riding with just one other person? If you have no
communication
device then you are going to be forced to try to stabilize the
person
to the best of your abilities and get help as soon as possible. This
may
range from staying with the patient and hoping someone comes
along
that can go for help (obviously not an option in a remote area) to
leaving
an injured person alone and going for help. Follow the ABC's of
resuscitation
and keep in mind that you should not leave a confused patient who might
inflict further harm on himself or others, someone who is bleeding
copiously
without controlling the bleeding or an unconscious person who is
vomiting
or has an obstructed airway. Of course make sure you know where you are
going and how to get back.
References:
1) Wilderness Medical Society Practice Guidelines for Wilderness
Emergency
Care. Edited William W, Forgey, MD. IGS Books, Inc.,
1995
2) Medicine For The Outdoors, Paul Sauerbach, MD. Little, Brown and Co. 1986.
Julie Ballard, MD
Haralson Farm
5067 Smokey Road
Newnan, GA 30263
Dr. Julie Ballard is an emergency physician at Piedmont Hospital in
Atlanta, GA, a life long equestrian, who spent the first part of the
summer
in bed recovering from her own horse-related accident.
Julie Ballard has a great article on wilderness riding and first response. If you are reading this article, I assume you are "cursed" with the prospective that things do go wrong, how can I help prevent it, and what can I do when it happens.
The American Medical Equestrian Association mission is to educate the oblivious riders who see no consequences of their poor decisions. Follow the Boy Scout motto of "Be Prepared." The AMEA's goal is to educate and be a source of information to anyone who seeks help.
Unfortunately bad things happen. I was involved this past weekend with a barn fire with eleven horse deaths and burns to one of the rescuers. I do not think we can save the world but I feel we need to be the voice of safety in the horse community.
William Lee, MD
Desert Foothills Medical Center
PO Box 2150
Carefree, AZ 85377
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Drusilla Malavase replies:
Two in-depth studies compare ASTM/SEI helmets to British, EuroStandard, and Australian helmets. These studies show that the ASTM equestrian standard is more protective that the other standards. One Australian helmet does pass ASTM testing and is available in the United States. I will provide copies of these studies as they are multiple pages with drawings, tracings, tables, etc. for the research scientist who is interested. Mail me your address and what study you wish.
If you are more interested in the comparison of ASTM/SEI with what I call Vanity Helmets ( labelled "item of apparel only" ), I would suggest that you have a look at the video "Every Time, Every Ride", available from the Washington 4H Foundation, the American Association for Horsemanship Safety (www.law.utexas.edu/dawson/), and the USPC bookstore (bookstore@ponyclub.org ). There are huge differences in energy management and the retention systems of vanity helmets and protective ones. It is all very well to praise the small size and familiar fit of the former, but why strap on something which protects you from little more than the sun and the rain ?
If you want to know what particular ASTM/SEI helmets are most effective, all of them with the SEI seal surpass the ASTM equestrian standard, and your decision should really be made by your type of riding (competition? pleasure? hot weather? racing?) and the model within that category which fits you best. This presupposes that you are willing to go to a dealer who carries more than one manufacturer's products ( good service!) and that you are smart enough to read the manufacturer's fitting instructions carefully (and you would be horrified to know how many riders and tack store owners don't!) I have found that there is a model which fits each of us best, with the greatest degree of comfort possible; however, some of us lucky "average head" people can be happy in any correctly fitting model if we will give it a chance for a couple of rides.
Drusilla Malavase
Chairman, ASTM Subcommittee Equestrian Headgear
2270 County Road #39, RR #2
Bloomfield, NY 14469
e-mail address: drumalavase@hotmail.com.
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Let's pretend. It's something we all do as kids but tend to grow out of as we mature and become adults. But take a moment now and pretend that you own, run or are an investor in a stable of horses worth hundreds of thousands of dollars...maybe even millions. If you were in a conventional business you might consider these horses as inventory or equipment. Certainly all the tack and other support equipment counts as an asset. As such, you would probably have alarm systems, security guards and a comprehensive drug and alcohol testing program for the employees.
Let's pretend that you do all of these things. Which program do you think is doing the most to protect your assets? Well there's no doubt that alarms and guards are valuable but they are basically like locks; they keep honest people honest. A determined thief will get in despite your security measures. But what about drugs? Not just cocaine and marijuana...but also alcohol, amphetamines/methamphetamines, heroin and others are all readily available. If you don't have a drug testing program in place you don't know if you have a problem or not. Suffice it to say, the odds are heavily weighted that drugs are being used/abused on your grounds and the potential for losses is tremendous!
If your employees live and/or work in an area where most employers perform drug testing and you don't can you guess what type person you are most likely to attract as an applicant? If the applicant can't pass the test they tend to look for the jobs that don't test. If you hire this person what are you getting for your money other than a warm body? How about a 300 % increase in their use of medical benefits, increased absenteeism, a 3x increase workers' compensation injury claims and decreased productivity (as compared to the non-abuser).
So how do you start a drug testing program and what does it cost? First and foremost you develop a comprehensive drug testing policy. Don't skimp and try to copy someone else's policy. You train your horses using your own methods and style so why do you want to copy someone else's style of employee management? A good, comprehensive policy can usually be prepared for you for under $500.00 in most cases by a knowledgeable attorney familiar with your states drug testing laws and benefits. In some states, compliance with the state regulations allows a discount on your workers compensation insurance. Once you have a policy you need to notify all of your employees of the date the policy will go into effect. This waiting period varies from state to state and can be as short as immediate to as long as 60 days before you can test current employees. New hires are subject to testing immediately. Look for a good Medical Review Officer (M.R.O.) to interpret all test results for you. If you are not a doctor, and you don't even play one on TV, leave this to the professionals. In fact, many are Certified Medical Review Officers from organizations like the American Association of Medical Review Officers (A.A.M.R.O.), American College of Occupational and Environmental Medicine (A.C.O.E.M.), or American Society of Addictionology Medicine (A.S.A.M.). The M.R.O. is an M.D. or D.O. that will interpret the test results obtained from the laboratory and will determine if an abuse of drugs is evident. Many M.R.O.'s can offer turnkey programs for multiple sites in multiple states. This offers the large employer the greatest control over their programs and is often the most cost effective method of running a drug testing program.
So you decide to set up a program and it's up and running. What should you expect? Expect the unexpected! You will catch people you never suspected of having a drug problem and will probably find that some of the people that you have a hunch are using drugs actually are not! One of the greatest benefits, however, is the overall improvement in your workforce and your workplace safety. You will see an improvement in both attitude as well as morale and, in the long run, for every dollar you spend on your drug testing program you can expect a return (a savings) of $3.00 or more. So what do you say, let's stop pretending and get real. After all, you live and work in the real world.
Other sites/Resources:
American Association of Medical Review Officers: www.aamro.com
Alcohol and Drug Testing Procedures: Office of Drug and Alcohol Policy
Compliance:
www.dot.gov/ost/dapc
Drug testing and Legal Issues Web Site: www.ol2.com
C. B. Thuss, Jr., M.D.
President and Certified M.R.O.
Absolute Drug Detection Services, Inc.
Certified by A.A.M.R.O.
Email: cthuss@absolutedrug.com
Web Page: www.absolutedrug.com
1400 Urban Center Drive
Suite 115
Birmingham, Al. 35242
800-878-7786, 205-969-1387 Fax
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The American Association for Horsemanship Safety, Inc. (AAHS) has made major strides in bringing horsemanship safety to the Navajo Reservation. Over the last two years, AAHS has been working with (one current and one former) nationally recognized PRCA bull riders to decrease horse related injuries on the Reservation through education. J. P. Paddock and Harry Begay originally became involved with AAHS when they participated in an AAHS Instructor Clinic in Arizona. Both earned Instructor status at that clinic, and were identified as potential AAHS Clinicians. Harry and J.P. were very concerned with the number of horse related injuries on the Reservation, especially those that involved children. They were drawn to the AAHS system since it was originally developed through the observation of rodeo horse and bull riders. In addition, the fact that it is a systemic approach to teach people to teach riding quickly and efficiently was very appealing.
Harry and J. P. traveled down to Golondrina Farm in Fentress, TX, to earn their pre-clinician status and to discuss potential methods for raising funds to increase safety awareness on the Navajo Reservation. In December of 1997, Jan Dawson and Dr. Betsy Greene wrote a grant to Indian Health Services (IHS) for funding that would allow for completion of Harry and J. P.'s Clinician requirements and the production of four "Keep it Natural" clinics to be presented in four locations on the Navajo Reservation. The grant was awarded, which allowed Harry and J. P. to assist with the largest clinic that AAHS puts on each year at Camp Stewart for Boys in Hunt, TX. At the clinic they became more adept in instruction of the system of teaching riders to develop Secure Seat(sm), evaluating potential instructors, and providing constructive feedback and solutions for instructors that were struggling in their efforts.
This past June, Harry, J.P., Dr. Greene and Jan Dawson gathered in Window Rock, AZ, to conduct the first of four clinics on preventative health care and natural, safe training and riding methods. The clinic, attended by many people including Ralph Fulgham (IHS grant administrator), his wife and child was well received by all. During the clinic, J.P. gave personal testimony of the value of Secure Seat(SM) . He described how his young daughter had quite an adventure on her first efforts at riding his big horse "Brownie" instead of her own pony. She and Brownie were riding when Brownie decided to run up a draw. She lost her reins and Brownie kept running, but his daughter maintained her seat until the horse stopped. J.P. was noticeably touched as he passed on the story, and you could tell that he had, at that point in time, totally bought into the value of the Secure Seat(SM) riding system.
Although the clinics were not advertised as "Safety Clinics," it became very clear to the attendees that safety was a number one priority since all clinicians were using certified safety helmets. Harry and J.P. gave riding demonstrations while Jan Dawson narrated the Secure Seat(sm) and "Keep it Natural" concepts throughout the clinics. As the clinics progressed, Harry and J.P. both became more active in the presentations, and often switched between English and Navajo languages when explaining concepts for the audience.
Throughout the clinics in Window Rock, Chinle, Kayenta and Tuba City, it became obvious that riding on the Reservation was not comparable to the "typical" lesson program. One of the unique aspects of "riding around home" on the Reservation is that "home" may include a five-mile radius of desert land. There seems to be considerably less arena riding and a great deal of open land, on which the youth often ride alone. This understanding of differences in riding habits and cultures made it clear that the most important thing to teach the young Navajos was to simply stay on the horse. The Clinicians came to the conclusion that the standard operating procedure would not be the most effective method of reaching this particular audience. This observation helped AAHS to establish a considerably different, but effective effort in horse safety education for this particular audience. Harry and J. P. have worked with AAHS to develop a mirror organization entitled Native American Association for Horsemanship Safety, Inc. (NAAHS).
Since rodeo is the third major industry on the Navajo Reservation, J. P. and Harry are heroes to many young Navajos, and this provides an excellent avenue for promoting helmet use and horse safety. Both endorse the use of approved helmets and their strong endorsement helped the audience to begin to accept helmet use. AAHS and NAAHS have plans to continue their joint efforts of increasing safety awareness and practices through the development of educational materials. Another method of delivery will include presentations by Harry and J.P. at schools and Chapter Houses on the Reservation. Overall, this has been a very positive step in reaching a new audience for safe horsemanship.
Elizabeth Greene, Ph.D.
Equine Extetnsion Specialist
Washington State University
Clark Hall 126
Pullman, WA 99164
"Secure Seat(sm) is a defensible and systematic METHOD of teaching the balanced seat, and has been successfully developed and field tested by American Association for Horsemanship Safety, Inc. This method of teaching is presented in "Teaching Safe Horsemansip" by Jan Dawson. Storey Publishing. (AMEA NEWS Vol VII No 2 May 1996)
Betsy Greene
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The JOCKEY NEWS reports Accidents and Mishaps for their membership's information. These following figures are from the reports for 1997. The reported accidents were for Jockey's Guild riders only.
Injuries were reported by 365 jockeys who were involved in 620 mishaps with 794 injuries. Five jockeys reported 6 accidents in 1997, 9 reported 5 accidents, 12 reported 4 accidents, 38 reported 3 accidents, 80 reported 2 accidents, and 221 reported one accident.
Percent is based on the number of jockeys injured.
There were 143 race tracks which reported these accidents. The track
with the greatest number of injuries was Charles Town with 48; second
was
Penn National with 38, followed by Beulah Park 27, Turf Paradise 26,
Calder
Race Course 24, and Evengeline Downs with 20 accidents.
All other race tracks have 30 or below Guild Jockeys in
accidents.
The area of the body most often reported was the back with 15.8% of the injuries, followed by the leg 14.9%, shoulder 14.4%, ankle/foot/toes 12.9% with other areas of the body in the single digits. Types of injuries were reported in only 9% of the accidents. Of these reports 39.3% were sprain/muscle pull, 28.6% bruise/abrasion/contusion, 26.8% fracture with concussion, laceration, and dislocation each accounting for 1.8%.
The second column of figures are from the National Electronic Injury Surveillance System (1) and the third are from the survey by Joel Press of professional jockeys. (2)
The National Electronic Injury Surveillance System horse related
injuries
for the five years of 1992-1996 are given for comparison. Our medical
studies
have no standard by which findings are reported. In the Jockey study
the
leg includes the thigh, knee, as well as the ankle/foot and toes, and
the
arm contains the elbow, forearm, wrist, hand and fingers. The injury
listing
are different but some comparisons can be made. NEISS figures give 15%
for the lower trunk and 10.4% for the upper trunk which includes the
back.
The jockey's back has the greatest frequently of injury (15.8%) but
comparisons
are not possible. The leg, shoulder, and ankle/foot/toe, knee and neck
have greater frequency of injuries in professional jockeys. All other
parts
of the body have less frequency of injury.
Injuries
Total % Neiss 92-96 Nat'l Jockey
Injury Study
Dorsal/lumbar spine 98
15.8%
10%
Leg
92 14.9%
4.3%
24%
Shoulder
89 14.4%
7.7%
22%
Ankle/foot/toe 80
12.9%
9.8%
0%
Wrist/hand/finger 49
7.9%
14.4% 0%
Face
47 7.6%
5.2%
0%
Arm
47 7.6%
7.6%
19%
Chest/rib
43 6.9% 10
4%
12%
Pelvis/hip
42 6.8%
15.0%
3%
Knee
40 6.5%
3.7%
0%
Neck
36 5.8%
2.4%
0%
Head
33 5.3%
11.6%
9%
Abdomen
10
1.6%
0%
Dental
8 1.3%
0.6%
0%
Clavicle
7
1.1%
0%
Buttock
7
1.1%
0%
Thigh
5 0.8% 2.3%
Elbow
2 0.3%
2.8%
0%
None
6 1.0%
Not
known
53 8.6%
Total
794
338710 706
Type Injury
Total
% Neiss 92-96 Nat'l Jockey
Injury Study
Sprain/muscle pull 22
39.3%
16.5% 10%
Bruise/abrasion 16
28.6%
32.9% 10%
Fracture
15 26.8%
28.1%
64%
Concussion
1 1.8%
3.5%
8%
Laceration
1 1.8%
9.0%
5%
Dislocation
1 1.8%
2.2%
7%
Tear
5%
Puncture
1.2% 5%
Contusion
4%
Internal
Injury
2.8% 2%
Neurological
Injury
0.1% 2%
Total Reported
56
338710 1757
Percent Reported 7.l%
In reporting injuries immediately, more sprains and muscles pulls are remembered than when the injury is remembered some time later as in the Jockey Survey figures. After some time from the injury only the more severe injuries will be reported.
(1) NEISS Horse Related Injuries. AMEA NEWS, August 1998
(2) Press JM, Davis PD, Wiesner SI, et al. The National Jockey Injury
Study: An Analysis of Injuries to Professional Horse-Racing
Jockeys.
Clin. Jour. of Sports Med. 5:236-240, 1995.
Doris Bixby Hammett, MD
103 Surrey Road
Waynesville, NC 28786
Phone/TAX 704/456/3392
email: dhammett@primeline.com
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Introduction
A total of 136 accident reports of United States Pony Clubs members and 11 adults and one participant were received. Only Pony Club members appear in the following figures.
Accidents which cause concern were those related to horses bucking and/or rearing without discernible causes. Whether or not this was related to the rider is less important than the match of a youngster with a horse that rears or bucks with minimal or no provocation. The rider/horse combination should receive more attention from the instructor. The instructor will have means by which these unacceptable behaviors can be minimized. "Old horses teach young riders, old riders reach young horses" is excellent advise and one which we promote with the D and lower C levels.
The largest area of interest and concern remains the D level. Two horses refused or tripped doing grid work. Ten mounted accidents included the horse tripping or falling. Ten riders fell off because the horse refused a jump. Horses "spooked' in 13 accidents, reared in 5 and bucked in 17. An inappropriate match of rider and horse presupposes the increased likelihood of an accident.
Anytime humans and horses meet accidents are going to happen. The unacceptable behavior of rearing, bucking or spooking should be monitored closely because these actions have resulted in the most serious injuries. Children should experience the thrills of victory, even if the victory is simply completing the task at hand, not the agony of an injury which may have been avoided. We should encourage positive experiences on which horses and riders can gain confidence.
Rating Data 97 Accidents % Known 92-96 Accidents
Unrated
8
6.6%
18.2%
D?
7
5.8%
19.1%
D1
15
12.4%
8.0%
D2
33
27.3%
11.6%
D3
21
17.4%
11.9%
D Total
76
62.8%
50.6%
C?
2
1.7%
7.7%
C1
18
14.9%
9.3%
C2
8
6.6%
6.4%
C3
7
5.8%
5.3%
C Total
35
28.9%
28 7%
B
1
0
8%
1.2%
HA
1
0.8%
0.7%
A
0
0.0%
0.5%
Total Known
121
89.0%
561
Unknown 15
TOTAL 136
The records on ratings before 1992 did not break down the D and C ratings-into levels 1, 2, and 3. As one reviews the above percent the figure for D rated accidents in 1997 (62.8%) appears to be much higher than in the 5 year report (50.6%). However, if the unrated are added to the D's the figures are the same (69.4% vs 68.8%). The conclusion is that Pony Club is succeeding in getting the unrated members rated quickly.
C rated percent of accidents remain the same and the numbers of accidents with B, HA, and A are so small that any comparisons are not valid.
AGE
Ages are easier to record than ratings so we have comparison with the membership for 1997 and with the 15 year accident study. If these figures are valid, the USPC gave closer supervision in 1997 for the members below the age of 9 years so that this group has a lower percent of accidents than the membership would predict and that occurred during the previous 15 years of accident records. The ages above 17 years also had fewer accidents than their membership would predict and less than the 15 year figures. The over 17 year Pony Clubbers have developed maturity, knowledge of safety and skills to avoid-accidents.
AGE Accidents %
Known
%
Known
82-96
Number
1997
USPC
Accidents
0-5
0
0 0.4%
6-8
5
4.3%
6.3%
6.1%
9-11
33
28.2%
23.5%
25.3%
12-14
35
29.9%
35.0%
35.2%
15-17
37
31.6%
24.6%
25.9%
18 & over
7
6.0%
10.2%
7.5%
Total
117
11953
906
Unknown
19
226
TOTAL
136
12179
Location
Accidents %
Known
82-96
Number
1997
Accidents
Outside Course
31
40.3% 29.2%
Arena
13
16.9%
23.8%
Outside Ring
11
14.3%
7.4%
Barn
Area
6 7.8%
Ring
5
6.5%
11.6%
Pasture
4
5.2%
6.5%
Trail
2
2.6%
4.6%
Other
5
6.5%
11.0%
Total
77
Unknown
59 43.4%
TOTAL
136
730
The outside course location remains the area where most Pony Club accidents occur. The Arena and the Ring follow at a much lesser percent. Only 77 accident locations are known with 43.4% unknown in 1997. Although the percents are different, this same frequency of location of accidents occurred in the 15 year report.
MOUNTED/JUMPING
Pony Clubbers were mounted in 79% of the accidents, 12.6% were not mounted and 7.9% of the accidents were Pony Club activities but were not horse related. In the 16 not mounted accidents, 37.5% were stepped on, 18.8% were kicked, 12.5% were bitten, and one accident occurred in each of the following: vaulting, saddling, loading, horse trampled handler, horse raised head hitting the handler. In the 10 not horse related accidents three cuts were reported (cut on games equipment, cut finger with knife, picking up glass in warmup area), two had foreign matter in the eye, one each of bee sting, burn on a heater, fall from trailer moving jumps, and heat illness.
Of the mounted accidents the PC was jumping in 50% and 50% of the accidents occurred in other mounted activities.
Gender Accidents %
Known
1997 82-96 82-96
Number 1997
USPC
USPC Accident
Male
11
8.2% 9.0%
11.3%
9.0%
Female
123
91.8% 91.00% 88.7% 91.0%
Total
134
l2179
957
Unknown 2
TOTAL 136
The percent of male/female accidents continue to show that males have fewer accidents than their membership would predict. The percent of males in the: membership has decreased as have their percent of accidents compared to the previous 15 years.
Injuries
% of Injured
Number
1997
82-96
Ankle/foot/toe
20
15.4%
12.2%
Wrist/hand/finger 17
13.1%
13.0%
Head
15
11.5%
18.5%
Dor/lum spine
15
11.5%
11.8%
Face
10 ..
7.7%
12.0%
Shoulder
7
5.4%
8.3%
Leg
7
5.4%
6.6%
Pelvis
5
3.8%
7.3%
Knee
5
3.8%
7.3%
Neck
5
3.8%
6.6%
Upper
Arm
4
3.1%
6.6%
Buttock
4
3.1%
2.0%
Chest/rib
4
3.1%
4.3%
Abdomen
3
2.3%
2.9%
Elbow
3
2.3%
5.7%
Dental
2
1.5%
l.0%
Forearm
2
1.5%
7.9%
Clavicle
1
0.8%
4.9%
Thigh
1
0.8%
3.6%
130
None
22.1%
TOTAL
REPORTS
136
Injuries
130
1097
DENTAL included in FACE in first 10 years
BUTTOCK included in PELVIS/HIP first 1O years
Two areas of injury could be reported.
PERCENT is figured on the number of injured Pony Clubbers
Body
Part
% Injuries
1997 82-96
Upper Extremity
25.4% 33.3%
Lower Extremity
25.4% 29.8%
Head
24.6% 31.5%
Trunk
20.8% 41.5%
Neck
3.8% 6.6%
Number
Injury
30 72
# PC
Injured
106 768
Total
Injuries
130 1097
In 1997, the most frequent body parts injured are the ankle/foot/toe and the wrist/hand/finger with the head and the trunk third and fourth in frequency. When the body is divided into areas (the clavicle, shoulder and pelvis are listed as part of the trunk, face and dental as part of the head) the upper and lower extremities are equal in the percent of injuries. The head, which includes the face and teeth, has almost one fourth of the injuries (24.6%).
When the 15 year figures are compared, every region of the body has
decreased in the percent of areas injured. There may be two reasons for
this: in the early stages of the United States Pony Club study, only
the
more severe accidents, with injuries were reported, and secondly the
injuries
with accidents are less severe today and involve fewer parts of the
body.
Injury
Types
% Total
Number
1997
82-96
Bruise/abrasion
46
39.0% 37.5%
Closed
FX
22
18.6%
12.3%
Sprain/muscle pull
17
14.4% 13.8%
Laceration/no
10
8.5%
4.4%
"Shook
Up"
8
6.8%
8.0%
Concussion/unconscious
5
4.2% 8 4%
Laceration/Sutured
3
2.5% 3.2%
OTHER
2
1.7%
0
Sunstroke/Exhaustion
2
7.7% 2.6%
Open
FX
1
0.8%
1.3%
Internal Injury
1
0.8%
1.7%
Dental
Chipped
1
0.8%
0.7%
Dislocation/Sept
0
0 2.9%
Injuries
118
1070
Total PCs with Injury
104
756
NO
INJURY
32
?
TOTAL
136
939
Percent is on the number of PC injured
Several types of injury may be reported
In 1997 the most frequent injury is a bruise or abrasion. At a much lower percent closed fracture followed by sprain or muscle pull and laceration not requiring sutures.
As the figures for 1982-1996 are compared, the more severe injuries have decreased (concussion/unconscious, open fracture, internal injuries, heat illness, laceration with sutures, sprain and muscle pull, heat illness, "shook up" ie emotionally upset) whereas the less severe injuries of bruise/abrasion and laceration requiring no sutures have increased. One serious injury, closed fracture has increased in percent. These figures speak well for the safety education of Pony Club.
Treatment
Number
1997 % Known 82-96 % of Change
Hosp Drs Office/
Unable to return
43
31 6% 37
7%
16.2%
RX Grounds/
Returned to Ride
27
19.9% 13.8%
-44.0%
RX Grounds
Unable to return
12
8.8%
6.9%
-27.1%
Hosp Drs Office
Returned to Ride
10
7.4%
10.9%
32.5%
Hospitalized
2
1.5%
7.5%
80.3%
Expired
1
0.7%
0
No Treatment
41
30.1% 23.2%
-30.0%
Total
136
936
Percent is on total reports.
In 1997, nearly one third of those injured did not require treatment. Of those treated, most went to the hospital or the doctor's office and were not able to return to the activity. In some cases the activity was completed. The next most common treatment was those who were treated on the grounds and returned to the ride. This may be a Band-Aid, ice, or cleaning of the abrasion.
There was one death in 1997 in Pony Club activities (USPC NEWS Summer 1997 Number 74). During the over 20 years I have followed USPC accidents, there have been no deaths in the Pony Club horse activities.
These figures indicate that safety education in Pony Club brings results. Hospitalization percent decreased 80% over the preceding 15 years. Treated at the hospital or the doctors office and returned to the ride decreased by 33% and those not able to return to ride decreased by 16%. In contrast the lesser treatments; treated on the grounds and returned to ride increased by 44% and unable to return to ride increased by 27% while those receiving no treatment increased by 30%.
This trend of lesser severity of injury has been occurring every year. The United States Pony Clubs have a program of instruction for the leaders and members which is modified every year as indicated by needs. The Safety Committee gives input into the instruction council relative to needed changes for safety. Education concerning the safety and health of the Pony Club member is one of the chief contents of instruction.
Doris Bixby Hammett, MD
Safety Committee
United States Pony Clubs
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The majority of serious injuries incurred in horseback riding fit into three categories.
First, it is the inexperienced rider who buys a country place and a horse and then puts the horse out to pasture. The owner goes to the county every few weeks and on one weekend decides to ride the horse. The rider is either frightened or overconfident. In either case, the horse gets going at too great a speed and the rider falls, or the girth isn't fastened and the rider falls, or the stirrup straps are not inspected and they break.
Secondly, a youngster is having a birthday party. The mother thinks it would be nice for all the children to ride around on a horse as a part of the entertainment. She knows a neighbor who owns a horse, but she does not know the horse and usually does not know the essentials of safety in riding. The most frequent cause of the resultant broken wrist or broken arm is a loose girth, which allows the child to roll off the horse, even at a walk.
The third example involves teenagers who rent horses from a riding
stable
which rents horses by an hourly rate to anybody who wants to ride,
without
inquiring about the person's riding ability, and where the rider does
not
know enough to ask any questions about the horse and equipment.
The
result is usually an inexperienced rider on a horse that is accustomed
to galloping vigorously for the entire hour, or on a horse accustomed
to
turning back and heading for the barn at the first opportune
moment.
Such horses are often untrained or incorrectly handled; and
frequently
the riding equipment is in poor condition....
Fox hunting, show jumping, pony clubs, one day events of the United
States Combined Training Association, and general horse shows seldom
involve
injury. Why are injuries in these areas so infrequent? The answer
lies in the proficiency of skills attained by the riders and horses
participating
in these activities.
The first attempts at protective headgear for U.S. equestrians used
the
Snell motorcycle helmet standards. The only passing model, the
Buco, was made in Mexico in 1974, and was never put into
production
In 1978 the U.S. Polo Foundation paid Wayne State University's Dr.
Voight
Hodgson to develop a standard for their sport. The resulting
helmets
from both these standards were bulky, heavy, and sometimes poorly
balanced.
They were not accepted by the equestrian community.
The United States Pony Clubs appointed an ad hoc headgear committee in 1979 which used the NOCSAE football and United States Polo Association standards to test helmets to what became known as the the United States Pony Club standard. The USPC Standard helmets were lighter and smaller than the Snell and USPA models, and were mandated by the USPC in 1983 and by other organizations in 1984.
The American Society for Testing and Materials developed its equestrian helmet standard from 1984 to 1988, when it was published. It replaced the USPC standard starting in that year.
An industry wide meeting of the equestrian community, organized by Haborview Injury Prevention Center, Abraham Bergman, MD, and held in Washington, DC, in 1994 and attended by representatives of many national horse organizations including the American Medical Equestrian Association. Since then many medical studies of horse activities have been done including the USPC which is now in its 17th year. Many of these studies appear in the AMEA NEWS with other studies being summarized in the publication..
These studies give more figures than were available to Dr. Jack Hughston in the 1960's. Different recommendations for prevention are now made from these studies. His examples still may occur, but we know that ASTM SEI protective headgear measurably reduces injuries, and experience does not prevent accidents and injuries. Rider knowledge has a better effect on accident reduction than experience does.
Doris Bixby Hammett, MD
Editor AMEA NEWS
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The American team was glad it had Dr. Ferrells' services when an American dressage rider suffered a significant knee injury the night before her competition ride.
The indispensable Dr. John Lloyd Parry, Medical Advisory to the FEI, coordinated discussions about medical problems at the equestrian events. In addition, he is helping the FEI develop a consistent policy on drug testing for equestrian athletes at international competition. The next world games will be held in Spain, 2002.
Julie E. Ballard, MD
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1. Suit the horse to the rider.
2. Don't put riders on injured or sick
horses.
3. Make certain that all riders are
adequately
supervised.
4. Advance students appropriately.
5. Assess which students may be at higher
risk of injury and adjust instruction accordingly.
6. Make fitted secured ASTM SEI safety
helmets mandatory.
7. Verify that all subordinate trainers
[coaches or instructors] are qualified for their job level.
8. Inspect/clean tack on a regular basis.
9. Set forth written procedures and
policies
and review and update them regularly.
10. Post safety instructions conspicuously
and have all riders sign a copy of the instructions.
[To learn more about the newsletter Horse Law News – Horse Law for
Horse
Lovers, visit www.piebaldpress.com or call 1-888-NAGS-001.]
Johanna Harris
from "Equestrian Athlete"
118 Lower Sand Branch Road
Black Mountain, NC 28711
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A proposal for the testing to be included in a standard for evaluating rodeo helmets will be presented at the ASTM winter meeting on December 9, 1998. Feed back from the members of ASTM will be collected and reviewed for possible inclusion in the standard. In early 1999 a draft standard will be prepared by the rodeo helmet task group chaired by Karen Strumlock and sent out to the headgear committee for a vote to accept the standard. Discussion of the vote by the ASTM F09 Headgear Committee members will take place in spring of 1999. If there are no negative votes from the ASTM committee members on the content of the standard (this is sometimes difficult to get; my guess is that we will have to go through the process twice to get out all the negative votes. ) we should keep the publishing date for the standard. Also the possibility of SEI accepting and offering certification to the standard might be included. After the publication of the standad manufacturers can submit for voluntary testing to the standard as early as the year 2000.
Karen Strumlock
Intertek Testing Services
3933 US Route 11
Cortland, NY 13045
Ph - 607-758-6357, Fax - 607-756-4173
E-Mail - kstrumlock@itsqs.com
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By the time most of you read this issue of the AMEA News, the Annual Meeting will be upon us. My first year at AMEA has been informative, exciting, and disappointing. Working with the excellent individuals on the Board has been a pleasure. Responding to calls, letters and email from members and from members of the public and media has also been very interesting.
The greatest disappointment for 1998 has been the failed efforts to involve more industry organizations in safety programs. Two separate attempts to hold a Rider Safety Summit attracted attendance from many organizations already active in this area and from a few other breed associations and show disciplines, but -- with two exceptions -- the organizations representing English riding had too little interest to participate.
The second major disappointment is the difficulty in getting out the message about approved protective headgear to riders (and the parents of young riders). The office has received many calls this year from parents who have just learned about the ASTM/SEI helmets. Most learned in time, and were primarily interested in information about different types of headgear or proper fit of helmets (see accompanying article by Dru Malavase). In two cases, a member of the family had suffered a head injury, and wanted to learn about head protection.
There are many myths and a great deal of misinformation circulating in the horse world. "Helmets cause heat stroke." "The weight of a helmet can increase the risk of neck injuries." "All helmets give some protection, regardless of whether they meet the ASTM standard." Tragically, much of the bad information is coming from trainers, coaches or other riders.
A major riding program (hunter/jumper) I visited recently does not require helmets for riders over 18, and does not require ASTM helmets for the younger riders because, "they don't fit well and they are too heavy." This program had a riding fatality last year from a head injury, but learned nothing!
As members of ASTM, I urge you to redouble your efforts and to speak out about rider safety. If you talk with riders -- particularly novice riders -- be certain they understand the value of a protective helmet. If you do not have copies of AMEA's brochure "When Can My Child Ride a Horse?" please contact the office for free copies. If you have an opportunity to use a video, the Washington State 4-H Foundation video Every Ride...Every Time can be purchased for $15, or members may borrow a copy from the office for 30 days for a rental of $3. The AMEA's Rider Safety Video is available for $17.95, and covers a variety of safety issues.
The AMEA is slowly making a difference, but the daily involvement
of
AMEA members can help speed the process, and that can mean many lives
saved.
Michael Nolan
AMEA Executive Secretary
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