By A.P. Crawford (ap.crawford@skipatrol.ca)
In July 2023, Jacques Blais was on one of his frequent bike rides along the St-Laurent River, in Longueuil, Quebec, when he came upon a serious injury incident. He saw that two cyclists had fallen from their bicycles and that bystanders were attempting to assist. The first patient lay in a pool of blood with a bystander attempting to stop the bleeding; the other had a broken ankle with another bystander assisting. The patients were spouses on their first outing with their electric bicycles. The time was 4:10 p.m.
The first patient had got his bike’s handlebars caught in the pillars of a fence beside the track, causing the bike to suddenly stop. He pitched over the handlebars, catching his groin on the left brake handle and tearing the flesh down to the inguinal artery, resulting in a major bleed. The second patient had tried to avoid the incident which led to his fall, resulting in a fractured ankle.
Jacques immediately triaged the scene and assessed that the second patient was receiving sufficient attention from onlookers and asked other bystanders to control traffic and protect the scene.
He assessed that the first patient, Pierre, had lost somewhere between 500 and 750 ml of blood based on what was visible on the ground and that probably his clothes contained more. Pierre was alert and conscious. The onlooker first assisting had attempted to make a pressure dressing out of a synthetic material t-shirt, which continued to let the blood flow. Immediately Jacques examined the wound and noted that the artery was still bleeding profusely, and so placed his gloved hand (he always carries gloves in his cycle saddle bag) directly on the wound over that patient’s bib shorts to apply firm pressure and asked the assisting bystander to move to the head to provide axial immobilization. Pierre responded to Jacques questions correctly but slowly; he agreed not to move.
Jacques asked another bystander to call EMS and gave the bystander the necessary information. He even spoke directly with the EMS call centre to give the most important details, all while keeping direct pressure on the wound.
Approximately 15 minutes later a passing doctor arrived at the scene; she was provided with another set of gloves again from Jacques’ cycle saddle bag. Immediately the doctor took a pulse at the ankle of the uninjured side (good pulse found) followed by assessing the pulse on the injured side where one was not detected. This meant that the direct pressure was working. Jacques and the doctor took turns applying direct pressure and the doctor also assessed the second patient.
45 minutes after the EMS were called, a team of firefighters arrived to assist. One took up position at the patient’s head, relieving the bystander but asked Jacques to stay in position since his pressure was effective. The doctor then proceeded to open the bib shorts with scissors, all while Jacques kept applying pressure to the wound. The wound was a deep avulsion in the shape of three-quarters of a circle. Although they tried to add dressing and bandages, they found that the only effective way to control the bleeding was to maintain the direct pressure, which they did until paramedics arrived. Fifty-five minutes had elapsed since the EMS call.
The bike path was 10 feet lower than a highway that runs beside it. Both the firefighters and paramedics arrived by road and used ladders to reach the scene. The paramedic in charge immediately replaced Jacques at the wound and, once his assessment was complete asked for a firefighter’s basket and vacuum mattress. The doctor then intervened and demanded that steps be taken to rebuild the patient’s fluid levels before he was moved, given the amount of blood that had been lost.
Working with the firefighters, Jacques was responsible for preparing the vacuum mattress and once stabilized, Pierre was placed into the basket while the paramedic continued to apply direct pressure to the wound. Using two ladders, the basket was hauled up to road level using one ladder with the paramedic climbing the other to continue to apply direct pressure to the wound. By the time this had all been completed, it was 5:55 p.m.
The doctor pointed out that without Jacques’ efforts, Pierre would have lost too much blood to survive. The bystanders also added their appreciation for his professionalism and efficient handling of the scene.
By his own account, it wasn’t until Jacques had gotten back on his bike and was a few miles down the road that he realized he had just saved a life. It was already too late to collect the names of the other bystanders who had assisted on the case with him.
For all of his work using the skills honed by his AFA training, the CSP was honoured to present Jacques Blais with the John D. Harper Lifesaving Award.
(photo by Jessie Gravel)