On the day that the Evening Standard publishes a letter from two trauma surgeons, urging action to separate cyclists from HGVs at junctions –
One of the immediate dispatch criteria for the aircraft or fast response car is when someone is trapped under a vehicle. This scenario all too frequently occurs when cyclists are trapped under a vehicle that has turned in front and then driven over them. These patients are often young women, travelling to or from work and are caught under the wheels of vehicles turning in front of them. A report by TFL in 2008 found that 86% of cyclist deaths were female despite there being three times as many male cyclists as females. At the scene of a road traffic collision, the team are often asked by the police if the injuries are deemed to be ‘life threatening or life changing’. The experience of being involved in a road traffic crash is life changing for all involved. Some will never cycle again for fear of suffering further injuries. This may be a manifestation of PTSD. Some people do not survive to make a choice.
Their mechanisms of injury include devastating chest injuries (rib fractures and underlying lung injury), abdominal injuries (splenic injuries and bowel injuries) and pelvic fractures and leg fractures. These patients are often initially conscious but are in danger of quickly bleeding to death on the roadside. The London Ambulance Service and Air Ambulance response is geared towards timely recognition and delivery of roadside intensive care. Patients may be given a general anaesthetic to help them breath, their pelvic fracture and limb fractures are splinted to reduce blood loss and they are given drugs to promote blood clotting. These patients are the most challenging on scene and result in an augmented response from the receiving hospital. If they survive their first day they are still at risk from overwhelming infection and organ failure. Their hospital stay is a long one and they may never return to their pre morbid state and may never work again.
These patients are sometimes deemed to be those who ‘talk and die’. They are initially conscious and able to talk to you and tell you their fears and tell you of their pain. One of the on scene standard operating procedures includes giving them a general anaesthetic. This is done to ease their pain and suffering for humanitarian reasons, assist with breathing, expedite their transfer from scene and speed up their time to definitive care. One always remembers these patients, when we are the last ones they ever speak to.
Both of us are cyclists, covering thousands of miles a year. We are both aware of the obvious health benefits of cycling to the individual and also benefits for the community and the environment as a whole. We believe that there are inherent dangers when cyclists and heavy goods vehicles share road space.
I thought I would share with you this passage from Boris Johnson’s execrable book, Have I Got Views For View –
D is for Death. Every successful bicycle journey should be counted as a triumph over this.
Unlike our ‘cycling Mayor’, who on the evidence of this passage seems to have a rather devil-may-care attitude towards simply staying alive while making a journey in his capital, I have somewhat higher aspirations for what a ‘successful’ bicycle journey should involve.
Boris has ruled out facilities that will keep cyclists apart from HGVs at King’s Cross. Every cyclist passing ‘successfully’ through that junction will doubtless continue to arrive at their destination toasting their triumph over death.