Trauma on the Farm: Injury Prevention Advice

Dr Jason van der Velde, Pre-Hospital Emergency Medicine Specialist and Clinical Lead HSE National Telemedicine Support Unit (Medico Cork)

The agri/aqua-food sector is Ireland’s most important industry. There is however an unpalatable truth, muttered about with due reverence at marts, co-ops and gatherings throughout rural Ireland; fatality rates associated with injury in the sector remain too high; up to eight times higher than any other Irish Industry.

Parents helping on the family farm aged over 65 years make up 50% of all annual fatalities; our sons and daughters living on the farm 23%. In those that sustain life threatening or life changing injury on farms, about 200 per year, 27% are over 65 years and 6% are children.

Whilst we try our best to put the pieces back together in the Emergency Department, we must adopt a family first preventative approach to keeping safe on the farm.

 

Stay Connected

A farmer or their family member badly injured in a remote part of their farm, who is not found until they’ve failed to return for dinner, is an all too common scenario.

More distressing, is finding an isolated farmer (of all ages) lying injured or ill where they’ve fallen or collapsed a number of days previously.

A strategy to staying connected has to be more robust than simply owning a mobile telephone. Lack of mobile coverage aside, you have to be conscious and able to use technology. Look after your community and family by checking in at regular intervals during the day and ensure that someone knows where you will be working.

 

Communicate your Location

Considerable effort has been put into improving emergency service response in rural Ireland, from first responder schemes to Aeromedical services.

We literally can land next to you in minutes, but only if we know your exact location. Valuable time is lost because people don’t either know their Eircode (or the Eircode closest to the field they are working in). If you’re a contractor, take a moment to note the Eircode of the location you are working in.

 

Have a Rescue Plan

Farmers know their working environment and machinery best. What would you do if a family member got struck by a cow in the milking shed? How would you manage a bull that has just attacked? How would you dismantle a piece of machinery should someone get stuck or pinned?

The simple mnemonic D.A.R.T. is helpful to remember when someone is trapped in a machine.

  • Disengage. STOP the machine and Disengage whatever is pulling the limb into it.
  • Analgesia. This is usually a chain or drive belt – cut it. Wait for the emergency services if you can to administer Analgesia.
  • Reverse – manually reverse the mechanism to release the limb.
  • Tourniquet – be prepared to manage bleeding, as the limb comes out of the machine.

Be slurry aware. Be vigilant to anyone collapsing near any source of slurry. DO NOT rush into rescue them without a plan and proper ventilation of the area. If in doubt, await the Fire Services.

 

Know how to Save a Life or a Limb

The Prehospital Emergency Care Council (PHECC) tightly regulates the first aid industry; do one of their approved first aid courses. As unpalatable as it is, the statistics make it clear that farm families need to be able to perform First Aid.

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