Immediate Action: First Aid for Dressage Volunteers
Jim Gehris | Published on 6/3/2025
This article covers two basic topics and was written primarily for volunteers at Dressage shows because they typically do not have the same level of professional medical support as an event that includes cross-country. However, the tips may be of value to any volunteer, especially to those without any formal First-Aid training.
What would you do, especially if you have never had any real training in First Aid, if a rider didn’t appear “right” on a hot day, or if you were in the vicinity when a rider was bucked off their mount?
Panicking and screaming is not an option.
The first topic deals with the most common problem a volunteer might encounter at a horse show. This is heat exhaustion or heat stroke. The second discusses a problem that is not very common in the Dressage world, but can have very serious consequences no matter where it occurs. This is a rider and horse parting company during the event.
My hope is that this article provides you with a few basic tips that may help you to calmly and effectively manage the situation and give the rider a better chance of quick recovery.
First Aid has 3 basic objectives. They are:
1. Preserve life;
2. Prevent the situation from worsening and,
3. Promoting recovery.
Let’s take a look at the first, and most common problem: the heat of summer.
1. HEAT RELATED PROBLEMS
We’ve all been out in the ring during those hot, clammy days in Northern Virginia summers. Sweat running down our faces, clothing completely soaked, the horse lathered up just by walking down the path to the warm up. Sometimes, the rider just wants to “gut it out” and carry on.
This could be dangerous.
Heat, especially when coupled with dehydration, can be a serious health concern.
Beginning with the most common, heat exhaustion, here are a few things to look out for and what you should do:
Symptoms can include:
• Heavy sweating
• Fast, weak pulse
• Nausea or vomiting
• Muscle cramps
• Tiredness or weakness
• Dizziness
• Headache
• Passing out
• Cool, pale, clammy skin
• Elevated body temperature, but typically less than 103 degrees F
WHAT TO DO
• Drink cold beverages that don’t contain any alcohol or caffeine. (For eventers – leave the beer in the cooler until you have recovered.)
• Cool off in the shade.
• Remove excess clothing.
• Rest is also key because it reduces strain on the cardiovascular system and helps stabilize body temperature.
A more serious, but less common problem is heat stroke. Heatstroke is a life-threatening condition that requires emergency treatment. Without medical intervention, the condition can quickly cause brain, heart, kidney, and muscle damage or failure, and it can be fatal.
When caring for someone you suspect has heatstroke, the first thing you should do is call 911.
Here is what to look for and what you should do. Symptoms can include:
• Hot, red, dry, or damp skin, if the person has been exercising.
• Fast, strong pulse, becoming weak as heatstroke progresses.
• Headache.
• Dizziness, Weakness.
• Nausea.
• Passing out.
• Movement and balance issues.
• Lung crackles or abnormal breathing.
WHAT TO DO while waiting for the 911 response:
• Move the person to a shaded or air-conditioned area to cool down.
• If possible, place them in a cool bath or shower or cool them with water from a garden hose. If it’s possible to submerge them in cool or cold water, this is the most effective method to lower core body temperature.
• Do not give a person with heatstroke anything to drink. Many people with heatstroke have an altered mental state. This could make it unsafe for them to drink fluids.
The bottom line regarding heat related injuries:
Heatstroke is far more dangerous than heat exhaustion because it can lead to organ failure and even death. Heat exhaustion can lead to heatstroke, and we need to take care to prevent both in extreme heat, especially if very active as most riders are.
Because it may be difficult to differentiate between the two, do not hesitate to call 911 if someone is showing symptoms. It’s better to be safe than sorry!
Heat-related injuries are more likely than fall-related injuries, especially at a Dressage show. However, there is a risk that a rider could be bucked off, so let’s discuss that situation in this next section.
2. FALLING OFF
(Note: As mentioned, this is primarily written for Dressage volunteers at a Dressage show where there may not be a Safety Officer or emergency medical personnel as is mandatory at an event that includes Cross Country.)
Imagine that you are the warm up steward at a dressage show and a horse gets a bit frisky and without warning, dumps the rider – or that you are a volunteer at Show Jumping or a Cross-Country judge and the rider and horse part company.
Let’s get started.
In most cases, especially in dressage warm up, the rider will pop back up, say a few choice words, and go collect their horse. If they seem “OK,” they probably are, but it wouldn’t hurt for you to approach the rider and ask them while making a few observations.
• Do you remember if they landed on their backside, sideways, or head-first? If you don’t, ask them how they landed.
• Observe their movements to see if anything looks out of sorts.
• Ask how they are feeling. “Are you OK? Do you hurt anywhere (Other than your pride)?”
In the majority of cases that I have seen, the rider is fine, the horse is fine, and many want to hop back on and continue their dressage warm up.
If they come off during Cross Country, they are eliminated – and in most cases, a Safety Officer will come to the scene and take charge.
But the rider isn’t always “OK”.
So, what if the rider has become a lawn dart and plows head-first into the ring (or jump)? What if they have been launched fairly high and hard and crumple when they hit the ground – or worse, the horse has also landed on the rider?
If the rider is laying on the ground, and especially if they don’t appear to be moving, you should remain CALM and approach them. On the way, if it isn’t already captured, ask someone to grab their horse.
When you get to the rider, if they are conscious and seem alert:
• Ask them to remain still for a moment. Let them know that their horse is OK.
• If you aren’t experienced in First Aid, ask if someone in the vicinity is and ask for their help assessing the rider. If no one is available:
• Visually check for any abnormalities (a funny bend in a wrist, arm, leg, or foot). If you spot something that is out of the ordinary, DO NOT attempt to “fix” it. Have someone call 911.
• Ask them “How do you feel? Does anything feel abnormal?” Ask them to describe what they are feeling.
• Ask if they can wiggle their toes and their fingers and whether or not either of them seems numb.
• If they say that something feels abnormal, and especially if they have numbness or lack of motion in their feet and fingers, tell them to remain still. DO NOT TRY TO MOVE THEM. Reassure them that they will be OK and have someone call 911.
• If the Rider hit their head, they may have suffered a concussion. Only a trained medical professional can diagnose a concussion, but a simple quick test can be done if you suspect one.
While not all-inclusive, here are some simple tests to determine if a concussion may have occurred:
Ask the rider their name, where they are, the time and date and what just happened.
Ask if they have a headache, feel dizzy or nauseous.
Ask if there’s any weakness or numbness and tingling on their body.
Notice if their speech is normal or slurred.
Ask them to follow your finger movement with both eyes. Draw a large “X” in front of their eyes.Are both eyes following your finger motion? If not, they may be concussed.
• If you have any suspicions that they may have suffered a concussion, inform the event organizer, the rider, and their support team. They should probably not continue that day’s competition, but rather, advised to seek proper medical attention.
Now we must address the scary situation. While this is more likely to happen in Show Jumping or Cross-Country, there is a chance that it could happen in a Dressage ring.
In this situation, the rider has been launched and is lying motionless on the ground. The Cardinal Rule for the layman, is DO NOT MOVE THE RIDER unless it is absolutely necessary to save their lives.
This could include a situation where:
• The rider is face down in the ring and doesn’t appear to be breathing.
• The rider has suffered a compound fracture and is bleeding.
Try to remain calm, and again ask if there are any trained first-responders. If not, quickly assess the rider’s condition using the mnemonic “CABC."
Have someone call 911.
1. “C” - CATASTROPHIC HEMORRHAGE: This is rare, but if a compound fracture has occurred, the rider may be bleeding severely. Make sure someone has called 911. Locate the source of the bleeding and apply pressure to stop the bleeding. Use any sort of bandage or cloth available. If nothing else, use your hands to apply pressure and stop the bleeding. At this point, don’t worry about keeping a sterile environment – the key is to stop blood loss that can quickly result in death. Once the bleeding has been addressed, check the airway.
2. “A” - AIRWAY: Is the airway clear of obstructions. In a Dressage situation, it generally will be clear. Check by placing 2 fingers an inch from the rider’s nostrils. If you feel little to no air coming out, or if it is irregular, check the airway for obstructions. If the airway seems clear, check that the rider is breathing.
3. “B” – BREATHING: Is the rider breathing? If the rider is not breathing, it’s time to start Cardio Pulmonary Resuscitation (CPR). (Note: It if the rider is unresponsive, but breathing at a normal rate, you don’t have to start CPR, but check the breathing regularly until the paramedics arrive.) If CPR is necessary, carefully place the rider on their back – this is one time when moving the rider, even though it involves risk, must be done. If you don’t know how to perform CPR, hopefully someone in the crowd that has assembled might – so ask! If no one knows, start chest compressions.
• To do this, place one hand over the other to start and interlock your fingers. Place your hands on the center of the chest, just below the breastbone, straighten your arms, apply your whole-body weight, and press firmly at least two inches deep with compressions at a rate of 100 to 120 per minute. Allow the chest to rise between compressions.
• Rescue breathing is part of CPR, but if you are not trained, and no one in the area is, chest compressions will suffice until paramedics arrive.
4. “C” – CIRCULATION: Check for a pulse at either the carotid artery (neck) or radial artery (wrist). If there is no pulse, start chest compressions (CPR).
Prioritizing Catastrophic Hemorrhage, Airway, Breathing and Circulation, in that order, gives you a systematic way to assess and respond in critical situations. It doesn’t matter if you are a trained medical professional, a concerned bystander, or a volunteer at a Dressage show; knowing the CABC’s gives you the foundational knowledge to effectively and confidently respond to a crisis.
CONCLUSION
Understanding the symptoms of heat related injuries and what to do if a rider is symptomatic may save a life. They aren’t hard to detect if you know what to look for.
Checking the “CABCs” of first-aid only takes a minute and can make a big difference in emergencies by helping you provide immediate assistance and possibly saving a life.
Finally, there are many resources available that teach CPR and basic First Aid. If you have never attended a course, you may consider doing so because what you learn won’t be restricted just to the Dressage ring. It could help you save someone’s life.