CRASH! BOOM! BAM!   Many of us have crashed, me more than once - in races, into cars, and from dogs. For those of you who haven't had the pleasure, your time may be coming. So what's the first thing you do after a crash?

             a) check out your bike

             b) check for a carotid pulse

             c) yell at/flip off the driver that caused it

             d) do jumping jacks standing on your head

If you answered a, you are certified bike-obsessed - good for you. If you answered b, you're not into medicine - without a carotid pulse, you'd be dead. If you answered c, your adrenaline system is working. If you answered d, congratulations, that's the right answer!

         First of all, check to see if all your limbs are in place. Then it would be good to check for spurting arteries. Apply pressure if that is happening. Clavicles (collarbone), wrists, and ribs are the most common bones to break in a cycling accident. You can ride gingerly with a rib fracture, but you'll need a ride to the hospital if you have a possible clavicle or wrist fracture (unless you're Kelly). A near universal injury with crashes is "Road Rash". Try to clean out as much crude as you can at the scene. As soon as you get home (if you're not in the ER), rinse it thoroughly with sterile water or bottled water if you have it. If not, tap water is OK. My experience is that most antiseptics are very painful and not all that necessary. Hydrogen Peroxide is probably the most appropriate if you feel compelled to use something other than water. Then you can clean it with regular soap. Hopefully the road rash is within your reach, because it's much better if you clean it yourself - you're in control and it's more tolerable. After it's clean and dry, apply antibiotic ointment (bacitracin or neosporin) and then bandage it Non-adherent gauze is best because it won't stick - much less painful for removal. If it's on an arm or leg, you should hold the bandage in place with kerlix/cling wrap. This is like gauze in the form of an ace wrap. You wrap it around the bandage and your extremity and then tape it to itself. That way you don't have to apply tape to your skin. And, therefore, that's not a reason for the guys to shave their legs. Remove the bandage once a day and clean with soap and water. You should keep it covered until there's no more drainage on the bandage and the wound has dried out. And when you crash again, try to avoid getting road rash in the same area - it'll hurt!

  Rock On!  Dr. Bob