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InFocus

Unsung heroes at equestrian events

JOHN PERIAM spent a day with Mike Crockford, senior paramedic at The All England Jumping Course at Hickstead in Sussex to see firsthand how the vets and paramedics work side by side

VETERINARY surgeons in the equestrian world attend many shows across the UK from small gymkhanas to national events. Of course their interest is the horse, but are they fully aware of the regulations now in place relating to the safety of the rider?

It is important that organisers of such events are aware of the high standards they now need to keep to and this is where veterinary surgeons can also advise them.

Sometimes things go wrong and the rider may have got concussion or a small fracture and in the odd situation a more serious injury. Most shows are now covered by private ambulance companies (more later).

With international events the rules and regulations state that there must be senior qualified paramedic staff on site as well as veterinary surgeons to deal with any horse injury. For example, at The All England Jumping Course at Hickstead both can be seen situated with the course designers and judges in the centre of the International Arena.

Life-saving treatment

Most of the time their services are not required. However, should anything untoward happen they are there immediately to commence life-saving treatment should a rider require it or a horse need veterinary attention.

Mike Crockford is one such person. I first met Mike many years ago when he was one of the duty paramedic team working on the Sussex police helicopter.

I flew with them on what was to be the first of many trips to write a feature on how the helicopter crew work and what was involved. I remember it well. We sadly had a suicide victim to collect after he decided to jump off Beachy Head in Sussex.

This was followed by a house siege near Arundel and on the way back from that we had a call to assist a fallen rider on the Sussex downs who had injured her back.

The team were there within minutes and the helicopter landed as close as possible to the casualty. Mike assessed the situation and before long she was airlifted to Worthing hospital for an examination which turned out fine. They had to leave me on the downs due to limited space but I will always remember the helicopter returning to collect me – how’s that for service, I thought to myself!

Mike left the Sussex Ambulance Service seven years ago to form his own company: Event Medic Services. It is a one-man organisation but the larger the event the more staff required. He has up to 50 paramedics, ambulance technicians, nurses and doctors he can call on as and when required.

“Because equestrian is a high-risk sport, this seems to be for me the main source of my work. I did ride when I was young and know about horses and it has been a natural progression into this field for me. After a while the organisers of events get to know one and then recommendations seem to follow. I have been working at Hickstead now for a while and love working there and to be paid watching from the best seat in the house is always good.”

Essential service

Those who work at Hickstead are one large happy family and that is what makes the venue the success it is. Lizzie Bunn who, with Edward Bunn, runs the showground, said of Mike, “He provides an essential service to both competitors and the general public visiting our international equestrian events. Mike and his team are thorough and professional and carry out their duties in a friendly and reassuring manner.”

What are the main sorts of injuries you come across, I asked? “For example, if a rider falls off a horse the first thing to check is the airway, making sure that is clear. The neck is the second part to check, making sure there is no cervical damage to the spine. I would ask a series of questions in order to ascertain that there is no serious cervical/spinal injury. These are priority and can save a person’s life and override all other initial questions.

“It is the one out of the hundred that is our concern and why a qualified paramedic is required. It is the way they are looked after at the initial stages as to how they recover from it. Then we have the more run of the mill injuries, broken arms and collar bones, and severe bruising as well as the odd laceration.

“Any injury in the main arena comes under my remit and following that I will assess the follow-up requirements, if need be passing onto my other paramedic who is working in the outer rings at Hickstead alongside the St John team.

“A lot of injuries can be avoided with the right protective clothing. The rider’s helmet is top of the list. There are many out there now and it is well worth looking at the market place. Don’t cut corners on cost as it could cost you your life.

“The popular air jackets have proven themselves 10-fold and it is something we have noticed that riders wearing them certainly come off a lot better following a fall than those who don’t wear them.”

Check on cover

One point Mike mentioned was that when paying to enter an event, the first question you should ask is what type of medical cover the organisers have. Who are they, what are their qualifications, are they Care Quality Commission registered.

“All private ambulance companies now have to belong to the Care Quality Commission which is a government agency that is there to make sure that people are registered. They must adhere to health and safety and vehicle cleanliness, with trained staff CRB (Criminal Records Bureau)- checked and qualified to do the job that they are advertising they do.

“If not I would not enter my child into that event as there’s a good chance they have little or no qualifications and would certainly be ill-equipped to deal with a trauma patient who may be fitting, unconscious, choking on blood or vomit. Who would you want to look after that patient: a firstaider with a four-day firstaid course under their belt or a professional qualified NHS paramedic or ambulance technician?

“One cannot call oneself a paramedic unless one is registered on the HPC (Health Professions Council) website. We have the latest equipment and it is checked and serviced regularly. Not having the right working equipment at the time can be a major setback and it has been known to happen.

“It takes a long time to become a paramedic and when working for one of the local NHS Trusts ongoing training is very much part of one’s work. It does not mean that because I, for example, work for myself that I don’t do this refresher training. I do and it is so important to keep up with the latest emergency procedures and policies.

“At the end of the day it is the experience in the field that counts and being able to assess any injury with speed before the casualty is moved. If this is not adhered to from the start, then major problems can happen and this is why the paramedic’s background is so important.”

Several top riders have fallen and suffered major injuries. Peter Charles and Nick Skelton can both bear witness to this and will be the first to tell you that the on-site team followed by the surgical support at the local hospital resulted in their full recovery. Had this not been right at the scene of the fall, things could have been a lot different.

This feature cannot conclude without mentioning The Mark Davies Injured Riders Fund. It is a registered charity started up to support injured riders and is a force to be reckoned with in the equestrian world. A lot owe their thanks to this charity for aftercare and support following severe injuries as a result of an equestrian accident. Their advice is also worth reading when it comes to using the right protective clothing.

The dedication of Mike and many like him to their job is a glowing testament to the number of riders today who are back on their horses as a result of professional paramedics being there at the right time.

It is important that equine vets are made aware of these safety issues so they can bring it to the attention of the organisers if they see they are not in place. Cutting corners to save money can endanger both horse and rider.

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