Spending several days at the International Police Mountain Bike Association conference, held this year in Richmond, Virginia , watching cutting edge training and spending hours exchanging ideas with EMS and Law Enforcement personnel from around the world I’ve taken a step back and reconsider my stance on using bike mounted medics in the special event and mass gathering environment.
It ‘s no secret that I’m not a huge fan of bike mounted medics and here’s why. Seventeen nearly eighteen years ago SEMS started as a bike medic based service but after two years we all but abandoned the bike medic concept. This ironically is about the same time the concept started to take root around the country. The reasons we abandoned the concept where numerous but safety and economics where at the top of the list.
Fact is it’s more costly to operate a bike teams than other options. Before you yell BS let me explain how we came to this conclusion. If a medic and his partner took a call in a crowd they could carry only a minimal amount of equipment and supplies. This in mathematical terms is the ‘X’ factor and changes, with experience, physical fitness, terrain and weather. If the area is very hilly or off road then a biker has to carry less weight as opposed to flat terrain on paved roads. The weight of the bike also effects dramatically the handling and stopping distance which is directly proportional to the ability to operate the machine safely.
Weight limitation dictates how much and what equipment can be carried. When a team takes equipment into a crowd and starts treating someone they still had to figure out how to get the patient, equipment and bikes out of the crowd not to mention weather or not they where carrying ample supplies and equipment. So its not outside of the realm of possibility that additional bike teams would have to response the same emergency to supplement services.
Dissect this scenario anyway you like but additional resources are required to support a bike team. Either someone is needed to drive a cart or walk a stretcher to the patient. Four bike medics and a cart totals a minimum of six people plus and ambulance crew makes eight. Instead assuming the cost of whats been coined as a “tiered response” we opted employ two medics and one vehicle that can safely handle the entire job from start to finish.
Crowd movement is unpredictable and a bike easily gets lost in a persons peripheral vision. It makes very little noise and adding warning devices such as whistles or lights and sirens packages runs the risk of “startling the heard” making the behavior of the crowd more erratic and dangerously unpredictable. It’s impossible to guarantee that can bike safely maintain a minimum safe speed for operation compare that to a cart that has no minimum safe operating speed and can come to a complete stop and then restart safely without any special skills or additional training for the driver.
The support needed for cart mounted medics versus bike mounted medics when you consider food, rest, hydration and operational range, cart mounted medic is far more cost effective. Remember bike mounted medics can burn upward or 600 calories and hour and will need, even if they are in Olympic caliber physical condition frequent rest period that will increase in number and duration with rising or falling temperatures. When you consider the physical exertion it takes to maneuver a bike add to the equation need for extra hydration, food and rest breaks, while cart mounted medics require the same thing but in far fewer quantities and a medic driving a cart doesn’t have to exert himself as stringently and a bike medic leaving them better physical shape to carry out their jobs.
After a local fire department hit several people using bikes at an event our insurance company effectively disbanded our bike team. I put up little fuss because by this point we had invested in a fleet of John Deere Gators which cut our operation cost by nearly 75%. Granted there is a high initial investment but that is quickly recouped. Instead of 2 medics on a bike and an additional 1 to 2 in the gator for patient transport not to mention the crews in the ambulance during the patient transports, add buying additional supplies for up to 6 – 8 bikes and then more supplies for a gator it just didn’t make sense to use bikes, 2 gator could do the work of 8 bikes.
In our analysis motorized vehicles were better suited for this type of work. Using a motorized vehicle also took away the physical fitness factor and lowered our potential workers compensation claims due to sprains, strains, bruises and falls.
That was 17 years ago and my how times have changed . IPMBA has developed training to better equip EMS personnel with the knowledge and skills needed to operate in the mass gatherings safely and efficiently. I believe IPMBA is onto something and has taken some great steps to improve delivery of services to the public. I’m reminded of something one of my martial arts instructors always says, “if you only have a hammer in your tool box then you will approach every problem with a hammer”. While I still hold that in most event settings use of carts (Gators) is still the preferred method but I can see that bikes can have a role. Events that come to mind are road races, parades, processions, and Walk-A-Thons.
While under the best circumstances navigating any vehicle through a crowd is difficult and Gator have the better per feral vision factor profile and if you combined with effective warning devices and a healthy dose of patience I still hold that it is my preferred method. When you consider the vast majority of emergency personnel have little to no training in delivering services in a mass gatherings and to operate a bike safely requires a minimum of 36 hours of training this unfortunately will remain a major hurdle. I am confident if you have the personnel that have been trained in IPMBA methodology and they maintain their mission readiness that these people can navigate as safely and any other method and deliver services.
The major drawback to bike mounted medic is unfortunately funding, training and maintaining mission readiness. But I readily admit if you have trained personnel that are mission ready in many situations bike mounted medic is a viable and responsible option.