First‑Aid Basics (Trail)

You are not a paramedic. Your job is to keep the injured rider alive and stable, stop things getting worse, and get help moving early. In hard enduro that gap can be long: AdventureSmart UK warns that mountain rescue "may take several hours to reach you".

This page follows the European Resuscitation Council (ERC), Resuscitation Council UK, St John Ambulance, the British Red Cross, the NHS and the FIM.

Work through these in order. The order keeps you calm.

Leave it on. The UK Highway Code's first-aid guidance, compiled with St John Ambulance and the British Red Cross, says: "DO NOT remove a motorcyclist's helmet unless it's essential." The FIM's concussion guidelines for motorcycle sport say: "Do not remove a helmet or any other equipment unless trained to do so safely, or for reasons of immediate risk to the injured e.g. airway management." The same applies to a neck brace and body armour.

Take the goggles off. With an off-road helmet on, you can still see the eyes, talk to the rider and watch their breathing. Removal becomes essential only when the airway is at immediate risk and you can't open or clear it with the helmet on. The same basis applies to a chest protector when CPR needs the chest.

Safe helmet removal is a hands-on skill. Learn it before you need it. UK fire and rescue services run Biker Down courses covering "crash helmet removal – when and how".

If they are on their back and breathing normally, keep them there. The ERC's 2025 guidelines say: "Persons with a known trauma should be kept in supine position." Resuscitation Council UK puts it as: "In cases of agonal breathing or trauma, do NOT move the person into the recovery position." Kneel behind the head and hold it still with a hand on each side. If the airway needs opening, use a jaw thrust. St John Ambulance describes it as putting "your fingertips at the angles of the jaw" and gently lifting, without tilting the neck. Resuscitation Council UK is clear on the priority: "Airway opening, if required, always has priority over in-line immobilisation."

If you can't keep the airway open, for example because they're vomiting, St John Ambulance says to put them in the recovery position even with a suspected spinal injury, keeping the head, neck and spine in line. Use every helper you have.

If they're face down, Resuscitation Council UK says to check the airway and hold the neck steady. If you need to open the airway, roll them "as a unit onto their back, while keeping their neck in line with their body".

If they are not breathing normally, start CPR. St John Ambulance: call 999 or 112, push in the centre of the chest "to a depth of about 5-6cm" at "a rate of 100 to 120" compressions a minute, and give rescue breaths at 30 compressions to 2 breaths if you're trained. Follow the call handler's instructions. Resuscitation Council UK says to continue until professional help takes over, the person "becomes responsive", or "the rescuer becomes exhausted".

Direct pressure first. The ERC says to "apply firm direct manual pressure to the bleeding injury". Use a dressing, a clean cloth or a gloved hand. Press hard and keep pressing. Don't keep lifting it to look. The ERC advises "against the use of pressure points".

Leave embedded objects in. The British Red Cross says not to remove an object stuck in a wound: "it's helping plug the hole". Press around it.

Life-threatening limb bleeding. If pressure doesn't control heavy bleeding from an arm or leg, the ERC recommends a tourniquet "as soon as possible". Resuscitation Council UK says to place it "5-7cm above the injury, but not over a joint" and tighten it until the bleeding stops, warning: "This may be painful for the person." Write down the time and never release it. The ERC also recommends haemostatic (clotting) dressings for first-aiders. Training makes both far more effective, and the British Red Cross notes that "the 999 operator will be able to tell you what to do".

Shock. Heavy bleeding, or a broken thigh or pelvis, can cause shock: pale, cool or clammy skin, dizziness or confusion. Keep the rider lying flat and warm, call for help, and monitor. St John Ambulance says "do not raise the legs if either are suspected to be broken or there is injury to the pelvis or a hip".

Limb injuries are the most common injuries in enduro, as the safety overview shows.

• Don't move a suspected fracture. St John Ambulance: "Do not move the casualty until the injured part is secured, unless they are in immediate danger." The British Red Cross says to "support the limb above and below the injury". Pad around it with spare clothing. Don't try to straighten it.
• Don't put a dislocation back. St John Ambulance: "Do not try to put the dislocated bone back into its socket, as this may cause further injury." Support an arm in a sling, and check the circulation beyond any bandage "every 10 minutes".
• Open fractures (bone through the skin): cover the wound with a clean dressing. St John Ambulance says to "apply pressure around the wound, but not over the protruding bone". Call 999 or 112.
• Suspect a spinal injury after any big crash. The ERC lists "a sporting accident" among the events that should make you suspect a neck injury. Keep the rider still and hold the head in line. Don't make a collar out of anything: the ERC advises against routinely applying cervical collars because they "may impair respiration and swallowing". And "never force an uncooperative person into any position".

Riding needs both hands and both feet. A rider with a suspected fracture or dislocation shouldn't ride out. Walk them to a track with a partner, or wait for a pick-up.

Treat any hard knock to the head as a possible concussion, even with a good helmet. The NHS says to call 999 if someone has hit their head at "high speed, such as in a road accident", has "been knocked out and has not woken up", has a seizure, "has fallen from a height of more than 1 metre", has "clear fluid coming from their ears or nose", or has "new numbness or weakness in any part of their body". The UK's concussion guidelines add red flags such as deteriorating consciousness, repeated vomiting and severe neck pain.

For a milder knock, the rule is simple: if in doubt, sit them out. The UK guidelines say anyone with a suspected concussion "should NOT drive a motor vehicle (e.g. car or motorcycle)" within 24 hours. So the rider doesn't ride out: they walk out or get a lift, and someone else takes the bike. The NHS adds that an adult should stay with them "for at least the first 24 hours", and not to drive "until you feel you have fully recovered".

Trail riding is a sport with a risk of head injury, so come back to it through a graduated return, as the UK guidelines set out. They allow "no return to competition before 21 days". FIM racing excludes riders for at least 10 days after a diagnosed concussion (20 days for riders aged 17 and under). Replace the helmet after any real impact, as the gear guide explains.

Not every trail emergency is a crash injury. Here's what the NHS and resuscitation bodies say to do.

Resuscitation Council UK says a kit "should be based on the setting, expected risks and the users". The ERC says that for "extreme weather outdoor settings" first-aiders should consider "a compact survival bag, splinting, wound dressings, a flashlight, and a whistle". This list builds on that and the American Red Cross kit guide, cut down to fit a hydration pack.

Any one of these ends the ride for the injured rider, and usually for the group. Call it early.

A hands-on course is what makes you useful at a crash. The Highway Code's advice is to "learn first aid" with "St John Ambulance, St Andrew's First Aid, British Red Cross, or any suitable, qualified body". Choose an outdoor or remote first-aid course if you can, add Biker Down for helmet removal, and get your riding partners to do the same.