Introduction
Clinical practice guidelines are developed to guide practitioners on the best approach to adopt when solving complications arising in their line of work. Medical practice guidelines were initially commissioned in the late twentieth century. Before then, treatment of complications relied purely on the practitioner’s best knowledge. It soon became a major problem as research intensified into various medical fields. Each region of specialization adopted different methods. Consequently, the need for standardized guidelines became apparent.
Clinical practice guidelines are developed using evidence-based approaches (Melnyk & Fineout-Overholt, 2011, p. 167). Only the most promising recommendations become part of the guideline. It is the work of a multi-disciplinary subcommittee in a given region to determine the best evidence-based approach to any medical complication. In this report, the author will develop a nursing practice guideline touching on safety with regards to the use and handling of bicycles. Among others, the paper will highlight the scope of the guideline, the target audience, development committee, and bicycle-related injuries in general.
Safety Issues Related to Bicycles: A Nursing Practice Guideline
Scope of the Guideline
Since the invention of bicycles, people around the globe have embraced cycling for both sport and recreational purposes. Like any other activity, cycling comes with its own dangers and risks to the user. The number of deaths related to bicycles has increased over the years. Most casualties are children (American Academy of Pediatrics, 2001, p. 1). The rising number of casualties has prompted the initiation of major campaigns around the world. The aim of these campaigns is to educate people on the safety measures they should adopt while riding bicycles.
A number of studies in this field reveal that most bicycle riders are youngsters below the age of 21 (Airaksinen, Luthje & Nurmi-Luthje, n.d. p. 2). Individuals within this age bracket tend to ignore protective measures during cycling. There are various factors behind these accidents. For example, they may occur as a result of intrinsic factors that include situations where riders exceed their abilities and level of expertise. Accidents are also attributed to extrinsic elements, such as collision with an object (American Academy of Pediatrics, 2001, p. 1).
The purpose of this guideline is to provide nursing practitioners and other stakeholders with information on bicycle-related injuries. The guideline also provides recommendations on how to effectively minimize risks of injuries during bicycling.
Target Audience
The people targeted by this guideline include:
- Medical practitioners.
- Parents with cycling kids.
- Cyclists in general.
Development Committee
The individuals who made this guideline a success include:
- Noora Airaksinen, a civil engineer and author of a journal article on injuries related to cycling.
- Peter Luthje. He holds a PhD in Medicine. He is also an author of a journal article touching on injuries related to bicycles.
- Ilona Nurmi-Luthje. He has published a journal article highlighting the plight of bicycle riders and injuries related to this activity. He holds a PhD in Public Health.
- American Academy of Pediatrics. The organization is dedicated to the health and wellbeing of children in the country.
An Analysis of Bicycle-Related Injuries
Wearing protective gear is not a guarantee that one will not incur injuries in the case of an accident involving a cyclist. A number of studies have been conducted on specific bicycle-related injuries. It is important to highlight the findings and recommendations made in these studies. The issues addressed in most of these studies include, among others, head injuries, cervical spine injuries, and injury to limbs.
Head and Face Injuries
Head injuries are the most common in the world of cycling. In countries like the UK, these injuries are the leading cause of deaths and disabilities among people below 40 years (National Institute for Health and Care Excellence, 2014, p. 4). In severe cases, victims may experience mild traumatic brain injuries and persistent symptoms. It is important to note that brain damage is not always visible. As such, nursing practitioners and other caregivers should look for specific signs and symptoms. Some of the symptoms associated with brain injury include loss of coordination and speech, visual disturbances, relapse into unconsciousness, and seizures (Boy Scouts of America, 2009, p. 13).
Helmets and other safety gears can be used to reduce injuries associated with bicycle-related accidents. The major objective of helmets is to protect the head of the rider. As a result, the face remains unprotected and exposed in case of an accident. The situation may result in facial bone fractures, soft tissue injuries, and damage to dentoalveolar (Carmont, 2008, p. 108).
Cervical Spine injuries
Cervical spine refers to the neck region of the spinal cord. It is observed that accidents that are severe enough to cause brain damage also lead to cervical spine injuries. A person suspected of having incurred this form of injury should not be moved. The reason is that mobility may worsen the damage. Some of the signs and symptoms that may indicate the possibility of injury to the spine include difficulties in breathing, swelling and bruising, as well as tenderness. The patient may also feel numb in their arms and legs (Boy Scouts of America, 2009, p. 14).
Limb injuries
Injury to the arms and legs constitute around 20% of all injuries caused by cycling (Airaksinen et al., n.d, p. 2). They are the most affected regions during an accident. The injuries are classified as those affecting the upper and lower limbs. The upper limbs are some of the most vulnerable areas in a bicycle accident. The observation can be attributed to the fact these limbs are used for support in such situations. They are also used to protect vital parts of the body, such as the head (Carmont, 2008, p. 109). Modern bicycles are fitted with quick release pedals. The function of these additions is to hold the foot firmly on the pedal. In case of an accident, riders of bicycles fitted with these elements have little time to free their legs to maintain stability. Ultimately, this increases the risk of injuries to the lower limbs even in the most unlikely accidents (Carmont, 2008, p. 110).
Abdominal Injuries
Majority of individuals involved in cycling accidents develop liver haemotomata (Carmont, 2008, p. 109). The condition occurs when the rider receives blunt blows on the right side of their abdomen. The blows are inflicted by the bar ends on the bicycles (Carmont, 2008, p. 109).
Recommendations: Measures to Avoid Bicycle-Related Injuries
It is not possible to fully eliminate the risk of accidents. However, riders can put in place a number of measures to minimize the chances of accidents. In addition, such moves can reduce the severity of injuries in case of an accident. Some of those measures include:
Wearing Helmets
Helmets are the single and most effective way of preventing head injuries among cyclists (Children Safety Network, 2011, p. 3). Research reveals that these safety gears reduce the risk of facial and brain injuries by more than 80%. However, most riders above the age of 14 tend to disregard this practice (Airaksinen et al., n.d, p. 3). A helmet consists of shock absorbing foam covered by a single layer of plastic. The foam should be breakable to ensure maximum shock absorption. In case of an accident, the impact directed towards the head is absorbed and distributed evenly across the helmet (American Academy of Pediatrics, 2001, p. 1). In most cases, surplus shock, which is not absorbed by the head gear, is weak. As such, the brain’s protective mechanisms are able to neutralize it.
All helmets should be fitted with a chin strap. Cyclists should make sure that they are wearing the right size of helmet. In addition, the safety gear should be approved with regards to quality assurance. One of the organizations that test the safety of helmets is the Snell Memorial Foundation. The foundation recommends that the gear should be replaced at least after every five years or as recommended by the manufacturer (American Academy of Pediatrics, 2001, p. 2).
Visibility Aids
Majority of bicycle-related accidents are as a result of collisions with other traffic. The occurrences can be attributed to poor visibility and failure to use hand signals on the part of the cyclist (Carmont, 2008, p. 110). The aids are fluorescent reflectors and lights that improve the visibility of cyclists on the road (Children Safety Network, 2011, p. 3). Hand signaling is important when changing lanes or turning. It informs other road users of the movements that the cyclist intends to make. The use of reflectors and signals reduce accidents by up to 20% (American Academy of Pediatrics, 2001, p. 3).
Use of Training Aids
The additions are important to kids who are learning how to ride a bicycle. Parents are encouraged to fit training wheels into the bicycles used by their children for training purposes. The wheels should only be removed after the rider gains stability. An adult may also act as a training guide by holding the bicycle as the child trains. It is advisable for an adult to accompany a child to all training sessions.
Enforcement of Bicycle-Related Laws
Governments should support the formulation and enforcement of bicycle-related laws. Such legislations include those stipulating the arrest of cyclists who disregard safety measures, such as wearing a helmet and riding on the right lane (Children Safety Network, 2011, p. 4).
Designated Cycling Grounds
Authorities should introduce paths and lanes dedicated to cyclists in major towns. The aim is to decongest traffic on the motorways (Carmont, 2008, p. 110). The move will ultimately reduce cases of collisions between cyclists and motorists. Consequently, the number of accidents will be reduced.
Conclusion
Implementation of the guidelines involves the adoption of the safety procedures recommended. Such measures include wearing helmets and using hand signals. Bicycle-related accidents are closely related with the attitudes held by riders and the public towards cycling and safety practices. However, accidents are always likely to occur in spite of adoption of best practices. As such, medical practitioners should be prepared to handle any complications arising from bicycle-related accidents. Clinicians and nursing practitioners should operate on the basis of the guidelines put in place. However, it is equally important to have guidelines for a specific specialty.
References
Airaksinen, N., Luthje, P., & Nurmi-Luthje, I. (n.d). Cyclist injuries treated in emergency department (ED): Consequences and costs in South-eastern Finland in an area of 100 000 Inhabitants. Web.
American Academy of Pediatrics. (2001). Bicycle helmets. Pediatrics, 108(4), 1030-1033.
Boy Scouts of America. (2009). Wilderness first aid curriculum and doctrine guidelines. Web.
Carmont, M. (2008). Mountain biking injuries: A review. British Medical Bulleting, 85, 101-112
Children’s Safety Network. (2011). Promoting bicycle safety for children: Strategies and tools for community programs. Web.
Melnyk, B., & Fineout-Overholt, E. (2010). Evidence-based practice in nursing & healthcare: A guide to best practice (2nd ed.). Philadelphia, PA: Wolters Kluwer/Lippincott, Williams & Wilkins.
National Institute for Health and Care Excellence. (2014). Head Injury: Triage, assessment, investigation and early management of head injury in children, young people and adults. Web.