Road Pizza: A Most Unwelcome Roadside Treat

 By Gerde Applethwaite

“Once again I race toward Dr. Flash Gordon’s brilliant motorcycle
first aid book entitled Blood, Sweat and 2nd Gear: More Medicine for
Motorcyclists.  I suspect it is no coincidence that his first chapter
starts with road rash, pavement dermatitis.”

The Weather on the Left Coast at the time of writing is still mostly dry and mostly warm. In other parts of the country the cold havoc reigns supreme. The scooter evolution is in full swing here and for reasons somewhat beyond my understanding scooter riders seem to have a penchant for Teva’s and cargo shorts. The vast majority of motorcycle/scooter accidents occur at under 30 miles per hour. The bi-product of the under dressed and the over-accelerated is road rash or as we affectionately call it – road pizza (you will know why if you have ever seen it.)

Once again I race toward Dr. Flash Gordon’s brilliant motorcycle first aid book entitled Blood, Sweat and 2nd Gear: More Medicine for Motorcyclists.  I suspect it is no coincidence that his first chapter starts with road rash, pavement dermatitis. This is a really common condition for the under dressed who ride – whether it be on bicycles, skateboards, scooters or motorcycles. What I wasn’t aware of were the complications that can ensue from an improperly treated road rash. Yeah, you should wear the right clothing and we sell the right clothing but for right now let’s just focus on a few select notions from Blood, Sweat and 2nd Gear.

(Picture Taken from Wiki How)

You need to get as much of the dirt out of the wound as you can. Any leftover dirt can produce scarring at best and complications from a serious infection at worst. I knew a guy in high school who did a face plant while on his bicycle; he hit a poorly designed road grate. They didn’t get all of the gravel out of his road rash wound and years later you could still see the occasional dark bits of gravel on the side of his face. Sometimes a little chunk of gravel would work its way to the surface causing intense itching until it finally broke loose of the skin – some bits stayed where they were. The broken skin is incredibly sensitive to stuff like Betadine or even tap water. It alone will send your nerve endings howling. Saline solution is better.  Contact lens solution is actually good. I now carry a bottle of it under the seats of both bikes, along side the small first aid kit.  Again, this is thanks to having read the Flash Gordon MD. book/s. Read them – no foolin’. The idea in this first phase is to get as much of the dirt and germs out of the wound as possible. The longer the microbes party in your road pizza wound the more you will pay for it later. If all you have is tap water then use that – get the wound clean.

Yes, the next phase is to protect the wound. Dr. Gordon no longer recommends antibiotic ointments like Neosporin for this. I didn’t know this. I knew enough to try clean the wound but then my first reaction would have been to slather it all up with something Like Neosporin then put down gauze 4×4′s and finally pave it all over with tape. Wrong. The wound needs to be cleaned but not dried out. The ointment will actually dry out the wound. You have a couple of ways to go here.

One is something called a semi-occlusive dressing like Tegaderm or Opsite for example. You apply the film onto and around the wound. It adheres to healthy skin around the wound both protecting the area and allowing the wound to breathe. This can be packed into your first aid kit as well as the saline solution and your other stuff. It really doesn’t take up that much room and if you don’t need it for yourself you may one day need it for someone else.

An alternative means to protect the cleaned wound site is to spray on some stuff out of a can that films over and will rapidly give you some protection. The products noted in Blood, Sweat and 2nd Gear are 3m’s Nexcare or something called Medi-Stat. I have the Nexcare in my kit. I haven’t seen the Medi-Stat in my local pharmacy. Gordon mentions that the added advantage of using the spray is that if you are the wounded one and you find yourself without help you will have an easier time of it by spraying something onto the wound site than you will applying a sheet film because you can one-hand it. Good tip.

You’re not out of the woods yet. You still risk serious infection and the potential consequences of infection turn out to be more than a little startling. I’m not going to go into it here because I want to keep this piece brief. Read the book (have I said that already?) or at least go online and do some research. At some point, either at the time of the initial accident or later when you suspect infection you may need to seek medical help. Do not hesitate to get it.

Finally a word, directly from my experience, about hospitals. Not all hospitals are created equally. I am given to understand that ambulance crews are not obligated to take you to your hospital of choice – they are obligated to take you to the nearest hospital. Now its roulette. If you are unfortunate to be taken to a crappy hospital or to one that has an overburdened emergency room (often one and the same) then you are really at the mercy of the fates. I happen to live in an area where the local hospital — the one that I would be taken to in the event of a neighborhood accident — has a stupefyingly poor reputation for everything except gun shot wounds – they appear to be good at that and they get a lot practice. If you show up with a road pizza shoulder and/or face you could realistically wait for 12 hours before you are seen depending upon who got shot before you showed up – or while you waiting. Do you want to risk that just so that you can feel the warm breeze blowing up your cargo shorts? Buy some riding gear, fool!

Gerde Applethwaite