Never mind …
Just a small point of clarification, in the US, USEF is not really engaged with most endurance rides since the vast majority are sanctioned by AERC. USEF is only involved in the relatively small number of FEI sanctioned events.
Having access to a human medic at a typical endurance ride is unfortunately pretty uncommon, though horses have excellent vetting available.
Think of it this way if you already have that medical professional sitting there and a bad fall happens they can help stabilize and call 911 and provide the needed information to get help. It’s way less chaotic. My husband does this role at schooling and recognized events. His check is usually less that 5 minutes if you’re standing talking and not seriously injured. I think the role is also really important to force a short break before getting back on and make sure a trainer and/or parents aren’t pressuring an injured rider back on who should recover.
They provide more than just examining riders, they make sure the show is setup in a way that an ambulance or helicopter has a clear path ahead of time. He’s helped cone off a path in the parking area so an ambulance can drive through when needed. Obviously we all want to never need it but when a bad injury has happened it helps to have all of this pre-organized.
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Yup, I was concussed after doing an emergency dismount and gracefully landing on my feet. Lost memory of 30 minutes of my life and I was awake. I remember mounting up and taking the first 2 jumps of a 7 jump course and then wondering why I was in my friend’s car and heading for the hospital. I did jump all 7. Told it was a great round. My friends only knew there was a problem because I just got off and walked away from the horse.
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But, HOW do you know, for sure and 100% absolutely certain?
I’m not talking the obvious fracture, broken helmet, etc, injury, but the insidious, hidden injury that shows up later (hours or days even) that could have been dealt with IF it had been checked out immediately upon the ‘unplanned dismount’
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Had no idea you could be that injured when landing on you feet. This thread has been educational for me.
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This.
My first concussion was in college when a horse I was on fell over, and I was wearing a helmet. That made me a voluntarily helmet wearer forever.
My most recent really alarming reality check about concussions was a post by Ken Block (lead singer of Sister Hazel.) His daughter was playing soccer and she and another player ran into each other. No one thought anything of it except the medic who was watching. She checked her out and made them go straight to the hospital. If I remember correctly, the ER essentially told them that she had a minor brain bleed and medication would stop it from being a problem since they got there so quickly. The implication was she might have been dead by morning if not for that immediate checkout when she hadn’t even thought she hit her head.
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But what can it hurt to get a five-minute check?
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Pretty sure the reason is that the shock travels through the body and is not limited to your feet.
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I think part of the issue is that the general public does not understand that you do not have to hit your head to get a concussion.
Since a concussion is basically bruising your brain. Abrupt stops or changes in direction can cause it - basically if your brain keeps moving at the rate of speed it was and slams against your skull, you get a concussion, since your brain is floating inside your skull. The most commonly understood example is whiplash - it is not always just your neck, but can also cause a concussion.
I realize most people here understand the distinction, but the general public often believes you have to hit your head for a concussion to even be a possibility.
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How likely do you really think this “hidden injury” is to be caught by the event medic? Only asking because every time I’ve been checked by a medic on cross country, if I insist I’m more or less ok, am able to walk, and satisfactorily answer their questions/show no signs of concussion, no one has ever checked me further. Usually this encounter lasts no more than 5 minutes and is just a conversation. Once or twice I’ve gotten a ride on their vehicle to recover my horse. And I’m sad to say I’ve fallen off many times at many different venues over the years.
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Sounds to me like the system worked? You didn’t have a concussion, as evidenced by you passing the tests and not having an obvious issue later.
We had a girl slip off her horse at a local barrel race and land on her bum. Broke her neck and had a concussion even though she didn’t hit her head on landing.
We’re smarter now about brain injury and no competition or even horse or rider training moment is worth lifelong impairment.
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Yes, the system for screening for concussion and major injury worked. I don’t argue that, and I’m perfectly happy to submit to a quick review at shows.
I’m specifically questioning the commenter who says that a quick medical exam by the show’s EMT staff could discover some serious injury lurking underneath the surface during the typical post-fall review. I can’t for the life of me figure out how to easily quote posts on my phone, but Fanfayre mentions an “insidious, hidden injury that shows up later” that the rider doesn’t realize has happened, will not become a big issue if discovered quickly, and that somehow the very brief EMT check would discover?
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If your question is “can trained medical professionals pick up on signs of concussions that a layperson wouldn’t” the answer is yes. They can look out for subtle signs that there might be something wrong, make sure the riders aren’t off balance or dazed or anything, check that their answers make sense, etc. They’ll also typically check with the fence judge or other witnesses about how the rider fell and if there’s anything from the description they find concerning they might push for a more thorough evaluation. If nothing else, making people pause for 5-10 minutes to let some of the adrenaline wear off can reveal more serious injuries if there are any.
Doing this check won’t catch every single injury but it’ll catch more than doing nothing would, and it’s so easy I can’t think of any good reasons to oppose it.
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No, my question is NOT whether I think EMTs are better trained and therefore better equipped to pick up subtle signs of concussion. I’m not really sure how you took my posts as questioning that? That’s pretty much the whole point of getting checked out by an EMT- check if you have a concussion and check if you have a major injury.
One or more posts seem to insinuate that an EMT check is more thorough or subtle than checking for concussion and major injury (unless of course the rider requests a more thorough examination- but in the proposed hypothetical, the rider has hurt herself and doesn’t realize that it will become a haunting future issue). So my question, once again, is in the brief conversation that occurs with a medical team post-fall, how likely are they to really discover an “insidious, hidden injury”?
Statistically, they are unlikely to discover an insidious, hidden injury, because statistically, it is rare that there is going to be an insidious, hidden injury. However, in the unlikely event that there is one, it’s much more likely that a trained medical professional would spot it than a layperson…and a lot of those really serious hidden problems are likely to be tied to brain trauma, as was the case in the example of the brain bleed that was originally cited.
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Just to add another layer to this: in 2023 my horse spooked and kicked me, which resulted in a broken rib and a grade 3 liver laceration. I was able to get up, catch him, get him back to the barn, untack him, put away all of my stuff, and drive myself 45 minutes to urgent care (I thought he had just bruised my ribs, I just wanted an x-ray to make sure nothing was broken).
The x-rays at urgent care did not find the broken rib. It broke at just the right place where the standard films couldn’t catch it. I had to do a urine test and there wasn’t significant blood that would indicate the level of internal bleeding that I had going on. The doctor on duty at the urgent care center pretty much begged me to go to the ER at the hospital a few minutes away, because he couldn’t prove it with the tests and imaging that they did but he had a feeling that something significant had happened.
Fast forward past a full-body CT scan (which found the broken rib and liver bleed), all hell breaking loose as a result, me being transferred to the hospital in town with a level 1 trauma clinic, and a rather unpleasant night in the ER, I was woken up by my brother’s old roommate who was a resident on his trauma rotation at the time. He proceeded to ask me a whole bunch of questions, most of which seemed pretty normal to ask someone that you knew of but had never actually met before, and then went on his way to pretty much imbed himself in my trauma team even though he wasn’t supposed to be on it.
I (miraculously) didn’t end up needing surgery, didn’t require any pain meds, and was home after a couple of days of frequent blood draws. I saw him a couple of months after the fact and he proceeded to inform me that he didn’t want to tell me at the time but they regularly had to open people up to repair bleeds much less significant than mine and that every question he asked me that morning (after the initial “Hey, I recognized your last name, are you X’s sister?”) was specifically intended to help him identify if I was showing any cognitive signs that would point to a restart of the internal bleeding. He said if I had answered any of those questions even a little bit wrong, I would have been sent off for another CT at minimum and very well might’ve ended up in surgery too.
Yes, he’s an MD and his training is more extensive than that of an EMT, but the questions and that quick checkup matter for things even beyond a concussion. They may seem like they don’t when we’re genuinely fine, but they know what they’re looking for. If I hadn’t gone to urgent care, that doctor hadn’t relied on his feeling as a trained medical professional that something was wrong after spending five minutes with me, and I hadn’t listened to him, I probably would’ve gone straight home, and while I definitely wouldn’t have been on my horse the next day, I doubt I would have waited eight weeks to get back on (and I would have paid for it because cantering even ten weeks after the fact still made my ribs hurt, and that’s before you account for something else possibly going wrong).
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Nope.
The medical check required by the rule is the SAME as the one the EMT gave you.
No, there are no a LOT of serious injuries that aren’t caught by the rider (but woud be caught by the EMT, who knows what to look for).
But even one is too many.
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I guess I’m not sure what the confusion is then, you’re answering your own question. They’re trained to evaluate these situations knowing there might not be visible symptoms. They aren’t looking to make a definitive diagnosis in the field, just determine if additional follow up is warranted. Someone cited a case above where there were no obvious signs of injury but just based on the circumstances the EMT sent them to the ER where they found a brain bleed that had no physical symptoms. Again, they’re not going to catch everything but they’ll catch a lot more than leaving it up to riders.
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Or the rider’s coach, I might add, who still might be of the school of “hospital or on.” (I’m not saying most trainers are like that now, but a medical professional has more training and is also more objective about the situation and likely to prioritize a rider’s health than perhaps a trainer or a horse owner.)
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