Managing a double casualty
IT is of course not only the horse who may be involved in a fall, and training of event cover vets has advanced hugely in respect to managing incidents in which a rider is trapped by a fallen horse. If the message from control is clear that a rider may be trapped, the vet acts strictly under the instructions of the attending doctor. Rider safety is the priority.
The immediate handling of such a case is:
The vet assesses that the horse is still alive and that there has not been a sudden death.
If the latter is the case, the doctor will instruct the vet as to which direction to remove the horse. Rapidly applied strop systems should be used (forward slide, backwards slide, sideways slide, shoulder lift or quarter lift). It is very quick to move a horse using strops, hobbles and manpower (rapid availability of tractors is insufficiently reliable).
If the horse is alive, it must be immobilised rapidly to prevent further damage to a rider underneath.
If the horse has suffered an obvious fatal injury, it will be euthanised humanely and moved off the rider, as instructed by the doctor.
If there is no obvious fatal injury to the horse, the vet should induce general anaesthesia. The Royal (Dick) School of Veterinary Studies has established that the quickest and best way of inducing field general anaesthesia is via an intravenous catheter, using an “all-in-one” cocktail of specific drugs.
Under the direction of the incident controller, strops, hobbles, an introducer (a tool to help get webbing strops in place under a horse) and a “riot shield” must be rapidly available at the scene of the accident. A “riot shield” or a wooden board can be placed between the horse’s legs and an injured rider in close proximity to offer further protection.
The horse is moved away from the rider using rapidly applied strops. The rider can then receive necessary medical attention. A drag mat is used to move the horse to a horse ambulance for transport to a safe area to recover from the anaesthetic, under supervision. A full veterinary assessment is then carried out and any injuries treated as necessary.
Should a horse and rider be trapped in a crosscountry fence, the assistance of the fence repair team may also be required, to dismantle the fence to allow the safe extraction of horse and rider.
The timeline for such a scenario can be just a few minutes. It is essential for vets to be well organised and familiar with the regimes and protocols involved, including that for general anaesthetic.