The Best First Aid is Preparation

Written by ​Joshua Hudson, LCSW, NEMT

Do you know what makes me so frustrated that sometimes I just want to eat a bunch of cheese and sit on a rat? The way people ignore safety. It is like buying cereal without any milk. You don’t need to but when time comes to eating you are gonna wish you had some.

On the other hand, I get that we must be reasonable. We don’t need MotoGP leathers on scooters riding around the back yard, and we won’t let the fact that every dual sport rider isn’t an EMT stop us from going “braap braap” up a poorly marked hill climb.

It is a balance.
​
When it comes to motorcycle safety, there are three areas to be aware of: what injuries are mostly likely, what training is most helpful, and what gear are the “must haves.”

​Injuries
 
Injuries happen. No one is perfect, and roads/trails are even less perfect. When you are out in the woods on two wheels, things happen. In 2025, I was up in Allegheny National Forest. I returned from the trails when two other riders at base camp grabbed me.
 
“Are you the EMT?” one asked. “My buddy might have broken something.”
 
Looking their friend over, he had certainly broken his collarbone in multiple places. It happened going slow on a rock garden up a hill when he fell. Most people would have seen the challenging terrain ahead combined with their injury and decided that they needed help to get out. That man was not most people.
 
Instead, he somehow risked further injury and rode out of the woods and all the way back to base camp. At any time that injury could have gotten worse, and if it was worse, it would have taken the entire group of riders to help get him to a dirt road where an ambulance could have reached him.
 
Tenacity and a lack of knowing the risks (combined with a “just gotta do it attitude”) worked out in favor of everyone that day. We got him to a hospital and there were multiple fractures, combined with a lot of stories at the campfire that night.
 
Most of the data that is shared to the motorcycle community is from NHSTA and deals with riders on the street. This is where we learn that most accidents happen from riding too fast into turns or from drivers making left hand turns clipping or running over motorcyclists.
 
Most injuries on the road are lower extremities and head trauma. The most vulnerable body parts are broken legs, road rash, and head injuries. During my attendance at the 2025 National Motorcycle Safety Conference last year, I wanted to discuss off-road injuries. I was given a large amount of street crash data, but they didn’t have anything for riding trails.
 
We generally get off-road data from hospital visits and not police traffic reports. That means that the data is less comprehensive, but it is still there. It is estimated that there are significantly fewer fatalities riding off road per month (10 vs 528) than on the street. We can make educated guesses why, but I suspect it is that most off road riders are not going at higher speeds within a trail and generally with less competing traffic.
 
Unlike roadside injuries, most breaks are higher up around the torso shoulders and arms. Roadside injuries often have higher risk for traumatic brain injuries than on the trails (even when considering the more likelihood of a street motorcyclist wearing more gear). 

Josh Hudson from Roll Model: Trust, Try, Triumph acting as the Appalachian ADV Medic on the 2025 Allegheny Backcountry Adventure Loop Guided Tour.

​Training
 
The challenge with off/backroad riding is usually access to EMS when there is an injury. The national average response of an ambulance is 5-15 minutes and includes a truck for transport, lots of trained professionals, lots of life saving equipment, and good communications with a hospital full of specialists.
 
On a Triumph demo ride in 2021, the rider in front of me went wide on a steep hill with a sharp right at the top. He ended up kissing the front of a Toyota Sienna. The rest of the riders rushed to the down man screaming about his leg. When they got there they all just stood looking.
 
It wasn’t heroic, it was needed action and an automatic reaction. I sent people appropriate distances up and down the hill to control traffic. I could tell by the lack of guarding of the abdomen that he likely didn’t have any stomach issues, but he would not flex his back, which made me worry there might be a spinal injury. His one leg was pulled close to him so he could try and hold it steady.  Someone tried to help take off his helmet to make him comfortable.
 
I had enough training with the fire departments in the UK to do a quick assessment. We did not remove the helmet. We held his neck stead to stop further neck injury. We kept him still and focused until the ambulance came within five minutes less than a mile down the road.
 
Even with little training (I was not an EMT yet), the goal is to ensure no further harm happens when there is an accident as we do what we can to get a downed person to the right care.
 
If someone is on a rough remote trail, every one- or two-man carry is about 1 mile per hour. Communications may be limited to specialized satellite devices, which will only contact the nearest EMS who may not be able to reach the injured individual. Life flights do not fly when they can’t land, if there are high winds or poor weather conditions.
 
This is why it is important to encourage every rider in the woods to take first aid training. These classes can be the difference between life and death considering a serious bleeding injury can result in mortality within 3 minutes. These classes can be done through the Red Cross, local EMS or organizations like mine (i.e. Roll Model), Road Guardians and others like Survival Med.
 
The Red Cross information states that even basic first aid can reduce death by shock, spinal injury and traumatic bleeding. That is a possible 60% reduction in fatalities.
 
It does take some time and investment, but as little as four hours of training could make a significant difference in a "not if but when” injury. 

Josh participating in one of many training clinics, in general, as well as his 4th Appalachian ADV Clinic! He also has his trauma kit right on the front of his DR.

Gear “Must Haves”
 
No one needs to go crazy shopping. Without any knowledge of what you need could result in $200 band aid kits. Once you do your first Google search, there will be endless advertising campaigns to “spend, spend, spend” on gadgets.
 
As a former boy scout, and a man over 50 years old with some money to buy the fun toys, when I started shopping for my medical kit, I made some unstrategic purchases. Social Media ads will try to sell these amazing, packaged trauma kits or field emergency bags. This is only to find it has a subpar tourniquet and scissors about as useful as those found in any kindergarten classroom. They also had overpriced packets of sunscreen and aspirin that cost more than you would find behind the counter at a quick-mart gas station. A big $200 bag of goodies that could have been purchased for $30 at Wal-Mart, and I still left over half of the materials at home.
 
Most big medical kits are good for your house but not what you need on the trail. Let me save you the money I wasted by sharing what gear you must have and what gear just takes up space.
 
Trauma Kit vs First Aid Kit
 
Everyone should have what I call an “ouch pouch.” This is the first aid kit with band aids, aspirin, allergy pills, etc. These are the things you would keep in your medicine cabinet at home. Nothing is needed more than what could fit in a pocket.
 
A trauma kit is a specialized bag of serious first aid. It should be able to be grabbed off the bike within a few seconds. This kit does not need to be big. The big concerns are bleeding, spine injuries and shock.  I think there are multiple levels of kits to create but the small kit is all that would be the minimum needed to be effective
 
Small: A quality tourniquet, trauma scissors, permanent marker, duct tape, and emergency blanket.
 
From this kit just about anything can be transformed into the tools and supplies needed to save a life. Clothes can be repurposed into bandages. Chest seals can be made from plastic bags with duct tape. There are no limits.
 
Medium: Add sterile gloves, gauze, triangle bandages, chest seal, and a flexible splint.
 
This is my minimal trauma bag. Flexible splints do not take up much room but can be a neck brace as well as secure broken bones. Gauze (especially hemostatic gauze) is better than a t-shirt for packing a wound. It absorbs more, packs smaller and may help quick clotting. Bandages are good for securing things, and a triangle bandage is perfect for keeping an arm secure when a collar bone or ulna breaks.
 
Large:  A large bag will have more of the same as the small and medium bag, but may also have sterile water, Israeli bandages, different size dressings, disinfectants, glucose, lights and whistles.
 
This is the bag you would normally find at camp or in the car. Not that you can’t take them (I normally have a large bag when I am sweep for a group) but it takes up space carrying everything and the kitchen sink.
 
Remember it is about risk management and a give and take on guessing how much gear you are likely to need. So it is more likely I will have a small kit in the woods behind my house and a larger kit when I do my trip around the world. 

Josh tackling the Farmlands Loop at the 2025 Fools Ride!

​Be Prepared Within Reason 
 
Life is risky. Some sports and activities are riskier than others. It doesn’t take a lot of training and gear to significantly increase survivability. At the same time, not everyone wants to study first aid and be a volunteer medic. That is the choice we make and the risk we take.
 
I started taking first aid classes in high school for the boy scouts, and then to be a lifeguard. I was required to do TCCC trauma training for my military service. I took biker down classes in the UK in case I had an accident, I would know what to do.
 
I didn’t decide to be an EMT until I started riding the trails. I attended rallies, and noticed the number of injuries that happened daily. Luckily, nothing life threatening; however, these people were nowhere near EMS to get care. Everything from heat exhaustion to broken ribs and legs.  I felt if I got trained, I could help.
 
It was my first tour getting experience on an ambulance team that I realized how powerful simple training can save a life.
 
We came to a home with an elderly man who was non-responsive. His heart wasn’t beating. His mouth was gapped open and arms were stiff. We started CPR. I sat over him doing chest compressions humming “Baby Shark” to keep the pace. His ribs cracked and each push felt like I was doing something unnatural. We transported him to the hospital within minutes when I was told to stop compressions. To my surprise, he had a pulse and breath and he was aware.
 
After 40 years of taking CPR classes every two years and never thinking about if I would use the skill, I did. A man is alive. I was prepared.
 
That is the point. We may never need a trauma kit. We may never use the skills. It may seem to have been a waste of education and training.
 
Then again, someday you might make the difference between life and death.

Epilogue by Kane Wagner of Appalachian ADV

Josh has been a huge supporter of Appalachian ADV from attending just about every event and clinic that we run to acting as our Medic at our Tours and Rallies to performing his Biker Down: Now What?! presentations at multiple rallies. He is always seeking out skills, whether on a motorbike or Wilderness First Responder and even running as a volunteer EMT on ambulance runs around the Pittsburgh area. And he is eager to share his trauma and first aid knowledge with the ADV & Dual Sport Community. Look for his Biker Down presentation at our Rallies as well as a bunch of other ones in the region!

@Ride_Safer724 on Instagram