EMS Cyclists Can Do It, Too

by Wren Nealy, PCI #860-B/EMSCI #154-B
Cypress Creek (TX) EMS
IPMBA President

Since the beginning of IPMBA, Police Cyclists have been trained to ride their mountain bikes anywhere they could walk.  Negotiating urban obstacles, riding up and down stairs, mastering slow speed skills, and performing dynamic dismounts, are all mainstays of the training program.  The first EMS Cyclists trained by IPMBA Instructors received the same training as their police counterparts because, at that time, the Police Cyclist Course was the only formal bike training available.  Soon, however, it became evident that the program did not take into account the unique needs of the EMS Cyclist and the differences in job performance.  Hence the birth of the IPMBA EMS Cyclist Course, the first discipline-specific training program for EMS.

In 1997, the IPMBA Board launched a standalone program, dedicated to the specific needs of the EMS Cyclist.  There weren’t very many EMS bike teams in operation at the time, but the ones which wanted to function at the Advanced Life Support level needed to carry a cardiac monitor and medications.  The need to carry this equipment required the EMS Cyclist to add panniers (saddlebags) to the bike.  The cardiac monitor of that era was the LifePak 5, which split into two parts that just so happened to fit perfectly in the EMS panniers.  Because of the fragile nature of this expensive equipment, it was essential to take measures to protect it.  The equipment and padding added a significant amount of weight and bulk to the rear of the bike.  

As a result, it was considered unsafe for EMS Cyclists to perform dynamic dismounts.  So when the EMS Cyclist Course was developed, the dynamic dismount was replaced with the stationary dismount.  As stated on page 181 of the Complete Guide, “the only responsible way for an EMS Cyclist who is carrying a heavy load that may be worth several thousand dollars to dismount is to stop with the left foot planted on the ground and step off the bike.” 

This stationary dismount requires the rider to come to a complete stop, disengage pedal retention, move forward off the saddle, and place both feet on the ground, straddling the top tube.  The cyclist then swings the right leg over the seat and rear of the bike, clearing the bags, to complete the dismount. 

While this type of dismount is practical under certain circumstances, it can be disadvantageous in others.  A stationary dismount fully commits the rider to stopping and can potentially cause balance issues.  The rider is at most significant risk for losing their balance during the process of swinging their leg across the rear of the bike and clearing the bags.  Standing flat footed, on one leg, is not the time to catch your foot on the bags and lose your balance.  The vertically challenged had an extra hard time with this skill. 

It also can be disadvantageous from the standpoint of scene safety.  While we would like to think that EMS personnel are not subject to aggressive behavior, it would be denying the reality that EMS personnel are increasingly entering hostile situations.  In the EMS Scene Safety workshop at the 2011 IPMBA Conference, I demonstrated how using the above stationary dismount to stop and talk to a citizen was potentially unsafe for the cyclist.  If the person made a sudden aggressive move towards the rider, it had dangerous consequences. 

At best it would result in a slow escape, and at worst, it would result in a loss of balance.  The simple science of Action versus Reaction only compounded the problem for the cyclist, further placing them at a disadvantage.  Often this movement resulted in a Flinch Response from the rider, which would contribute to the loss of balance.  Completing the dismount and disengaging the bike was difficult, at best.  If the rider stopped next to their partner, this almost always resulted in one of the riders getting tangled up in their partner’s bike. 

Finally, it is my personal opinion that straddling the top bar during a citizen contact is less professional in appearance than dismounting the bike. 

Getting back to the early days of EMS cycling, there were also concerns that the weight of the medical equipment would cause pinch flats, damage rims, and put the equipment at risk if the bike was ridden up steps.  As a result, the stair ascent was also removed from the EMS Cyclist Course curriculum.  In its place, EMS Cyclists have been taught various methods of carrying their bikes up steps rather than learning to ascend them using the lofting method favored by Police and Security Officers.    

In order to ascend a set of stairs of any length, EMS Cyclists have been taught to first perform a stationary dismount and then carry the bike up the stairs using one of three methods: pushing the bike, reaching over the top tube and grabbing the chain stay, or grabbing underneath the top tube and lifting the bike up to shoulder height (top tube carry).  Once at the top of the stairs, they set the bike down, remount, and continue riding. 

While this is the only practical solution if the stair ascent is beyond the rider’s capabilities, there are times that it may not be the best choice if the rider is comfortable with an ascent.  Coming to a complete stop, dismounting the bike, and carrying it adds a number of steps, increasing the time needed to perform the skill, delaying the response time.  An associated consequence is the potential of not using the proper carrying technique, which can result in the excess weight making the bike more difficult to control during the carry.

For the reasons addressed above, we at Cypress Creek EMS opted to continue to teach EMS Cyclists both dynamic dismounts and stair ascents.  Extra training is not prohibited as long as the students are taught and tested on the required skills.  This was proof of concept for me that EMS Cyclists (even novice riders) can both perform and benefit from possessing these skills. 

In IPMBA’s Bicycle Response Team Training (BRT), embedded EMS Cyclists are trained to perform cyclo-cross mounts and step-through dismounts, skills they adapt to more easily if they already know how to do crossover dismounts.  This is further validation that EMS Cyclists can safely and competently perform these skills.  

The ease with which EMS Cyclists can perform this skill has also been affected by changes in the equipment they carry.  The Automatic External Defibrillator (AED) has replaced the cardiac monitor.  AEDs are smaller and lighter than ever before, a lot smaller than the LifePak 5 cardiac monitor, and they perform the same functions.  New bag designs have decreased the bag profile, making it easier to clear the bag while swinging your right leg over the rear of the bike.  The thinner pannier also makes it easier to sweep the kickstand. 

Just as the equipment continues to evolve, so should the training.   In anticipation of these skills being added to the curriculum in the future, EMSCIs are strongly encouraged to master and begin teaching Crossover Dismounts and Stair Ascents in their EMS Cyclist Courses.  

Should EMSCI’s choose to teach Crossover Dismounts, they should adhere to the standards set forth in Police Cyclist Course Skill Station 21. 

Should EMSCI’s choose to teach Stair Ascents in their classes, they should adhere to the standards set forth in Police Cyclist Course Skill Station 19.  There are multiple types of stairs.  Stairs with a short rise and medium to long run present an easy obstacle to ascend with minimal risk of a pinch flat.  Regular rise and run stairs, no more than two or three, are also acceptable.  Anything with a higher rise and more than two stairs should not be attempted. 

The Stair Ascent does NOT replace the dismount and carry technique.  The carry technique will still need to be performed in testing and rightly so.  Should the rider encounter an oversized curb, a set of stairs, or any obstacle too large to ascend safely, the carry technique will still be the preferred method to negotiate the obstacle.

Call to Action

So Instructors, train your EMS Cyclists to a higher standard.  Having the ability to perform dynamic dismounts and stair ascents will enhance your team members’ skills and help them maintain safety and effectiveness on the job, and will prepare them to take on new challenges and roles, such as Bicycle Response Team member.  Civil disturbances, riots, and protests are here to stay, and your Police Cyclist counterparts need medical force protection. 

We look forward to seeing you at the 2018 IPMBA Conference, June 4-9, 2018, at Washington University in Saint Louis, Missouri!

Wren has had experience as a paramedic, police officer, tactical officer, and tactical medic since 1994.  He is currently the Special Operations Director for Cypress Creek EMS and a Reserve Lieutenant and former Assistant SWAT Commander with the Waller County Sheriffs Office, for which he founded the bike unit in 2009.  Wren has been an IPMBA PCI and EMSCI since 2005, working and teaching both disciplines.  He holds instructor certifications for TCOLE, TASER, Specialty Impact Munitions, Basic/Advanced Tactical Operational Medical Support, PHTLS,and TCCC.  He was elected to the IPMBA Board in 2012 and currently serves as President.  He can be reached at wnealy@ccems.com

(c) 2017 IPMBA.  This article appeared in the Fall 2017 issue of IPMBA News. 

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