What to do at the scene of an accident.

[WildBill2566]

Thought I might include this, it could save you or one of your mates from making a bad situation worse. Its pretty basic stuff and I dont want to insult anyones intelligence, but it may help some so here goes.

The first and one of the biggest problems for anyone I have come into contact with, is to overcome the natural urge to rush over to a casualty and try and help them.

Don't do it, stop for a couple of seconds and look at the location. Your first job is to make the area as safe as possible, you will help no one if as you are giving first aid to your mate and a vehicle roars around the corner into you and the casualty. If you are in a group it should be a lot easier as you can post lookouts to slow approaching vehicles, or even stop them if necessary. HGV's are particularly useful as I find they are usually very helpful and you can use their vehicles as a phisical barrier. But again, make sure that the lookouts have a safe haven if some myopic fart dosent see them, so they can dodge out of the way. If possible work in pairs with one always looking upstream into the oncomming traffic to warn his / her partner. Think on this Traffic Police wear bright high viz jackets, work in this environment all the time, and receive specialist training to work in this environment. Yet more officers are killed on the roads every year than are murdered in 10 years. So what are your chances in your black leathers?.

If you are not in a group, you will have to make the best out of a bad job, and if you have absolutly no other option you should consider moving the casualty to safty before commencing first aid, but this is a last resort as you may compound their injuries. However if for example, there is a live high voltage cable bouncing around near them its the lesser of two evils, its your call, but think about what you are doing and why.

no 2.... You will need to quickly assess the casualty, as you will be asked these questions in No.3 below, and the answers you give will help the operator to advise you on basic treatment, and the operator may deploy helimed on your info.

No 3.... Get help running...999....and please be as accurate as possible, with modern mapping systems even getting a house or farm name can help. It is good practice to get the operator to repeat the location back to you to ensure that there is no mistake, as there is often more than one Church Road, High Street, etc., in an area. It may sound wrong but make sure help is on the way before commencing first aid proper, as they are the best chance the casualty has. Even if you have a non responsive casualty, get help running first, it is rare to revive a casualty using CPR, and you are really not likely to get someones heart going. The only people with the equipment to really help are the paramedics/ambulance service. Even a responsive casualty may have internal injuries which you cannot treat at the roadside. GET THAT HELP RUNNING FIRST, dont kill them with kindness.

No 4.... Got here at last....first aid. If I had my way it would be a requirement of obtaining a driving licence that everyone had to have some basic first aid. If you really want to help and be effective, you need to plan for the worst. That means getting a little basic first aid knowledge now, because if you don't have it now, when you need it it will be too late to learn. St Johns Ambulance who we all see and take for granted at events will be more than happy to point you in the right direction, and for a beer might even attend your local meet and offer some practical advice. You might even do the unthinkable and contact your local traffic police, they will usually be more than willing to visit your local group, offer advice and some will even help with first aid advice as part of their efforts to reduce casualties on the road. Believe it or not this sort of interaction with motoring/riding groups is one of the things looked on favorably by the powers that be.
I cant really help here as you really do need a little knowledge, to do a lot of good, BUT; If nothing else it really does help to reassure the casualty, a calm friendly voice (no matter how un-calm you really feel). If the casualty has a crash helmet on, it CAN be removed, the dont remove the crash helmet thing is a half truth. First if you have ever been in an accident you will know that you want that thing off, you want to know what is going on, it makes you uncomfortable. If the casualty can remove the helmet themselves and wants it off then let them remove it, slowly and carefully. If they are happy to keep it on then leave it on, they are already in distress so giving them orders isnt going to help.
If you think they are going to vomit, then really its got to come off, because if they choke and block their airway, it really dosen't matter if they have spinal injury. If they cannot breath they canot live. To remove a crash helmet from a casualty is really a two man job, and again get some training, any police m/c'st worth their salt should be able to give a demonstration if asked, as can fire, ambulance etc. Oh and make sure that the helmet goes to hospital with the casualty, the areas of damage can aid medical staff in treatment. And please be honest, dont come the old we were only doing 29mph officer......if there is a casualty we need to get them theebest treatment possible which means we need the best info possible, as knocking some poor bugger off for excess speed really isnt high on my list of priorities in this situation.
The casualty needs to breath, retain vital fluids, and not be involved in a secondary accident waiting for help. Learning CPR will help with the first. External wounds shoud be treated to stem the flow of blood, avoid tourniquet unless you really know what you are doing, direct pressure is preferable. Having said that if you really cannot think of anything else to do, then you must stem the flow of blood from a serious bleed by whatever means, I just cannot reccommend the tourniquet method.
Crush injuries..... this is a difficult one which will go against everything you want to do. If the casaulty has a limb which has been trapped to the extent that there has been no blood flow to that limb for more than 15 minutes, toxins may have built up in that limb, and releasing it could induce a heart failure, and other serious problems, as those toxins are flushed around the system.

There really is too much info to impart here, and I would be surprised if there were not someone else on the site who is more recently trained than myself, as the advice changes in relation to first aid.

No.... 5 Keep an area clear for the emergency vehicles to park in, preferably as near to the scene as possible. The sooner they can park and deploy the sooner they can help

If you remember nothing else............Work in slow time, your natural inclination is to rush about, but more hast often means less speed. Think about what you are doing, why you are doing it, what you hope to achieve, and think about your safty first, and the casualty second.

Please be safe, and plan for the worst but hope for the best.

WB

[kiwidave]

GREAT post.

[Spice]

Some excellent advice there mate
all I would like to add / Reiterate
Is get some first aid training either red cross or St Johns
they both know their stuff.
you may be able to get your firm to pay for it.
as Dave has already said
Great Post

[Frog]

Good post.

Just to add my penny worth. Go for help, send for help early, but at the appropriate time.

DR ABC

Danger - To yourself or the casualty.
Response - Is the casualty conscious?
Airway - Is the airway clear? Have a quick look. (No fingers please)
Breathing - Is the casualty breathing? Look at chest is it going up and down, Listen can you hear them breathing, Feel can you feel brath on your cheek. If the casualty is unresponsive and breathing place into recovery position.
Circulation - Is there severe bleeding? Are there signs of life?


For severe bleeding think RED

Rest - Sit or lay casualty down.
Elevate - Raise bleed above heart.
Direct Pressure - Aplly pressure to the wound.


How to put someone into the recovery position.

Put the right hand by the head (as if they were waving)



Put the left arm across the chest, so that the back of the hand rests against the cheek



Hold the hand in place and lift up the left knee


Turn the person on their side by pushing down on the knee

[usabear]

I'd be concerned about moving a person who is breathing, but unresponsive. If there are broken bones or internal injuries, they could be made lethal by being moved by a non-professional.

[BaZa ®]

Originally Posted by usabear

I'd be concerned about moving a person who is breathing, but unresponsive. If there are broken bones or internal injuries, they could be made lethal by being moved by a non-professional.

You have to move someone if you are gonna be the next casualty Bear. But of course with the greatest care bearing in mind of what you said. But an extra broken bone is better than being hit again and your 1st aider getting struck down as well.

What if you come across someone say laying down on the pavement. You don't just send for help and get on with 1st aid you look why they are there it could be one of many reasons. (diabetic, jumped, mugged), or if it is because things are falling off a building from above then you have to move them and put yourself in safety. Otherwise you are no good to them and when the ambulance arrives there could be two casualties.

The worst scenario (on a mountain walk etc) is when you have no mobile line and you are on your own: put the person in the recovery position if poss make sure they have a clear airway. Now bugger off and get help. You can't start mouth to mouth of CPR on your own without help being on the way. You must leave them. That is the hardest thing to do. But the only sure way you know you are gonna get help.

Another one if you come across a multi RTA and there are bodies everywhere, you can't start giving first aid you must assess the situation and report back to the services that you are calling. Giving them an over all picture. If you stop at the first one making the loudest screams then you are leaving the weak that can't scream. Tough call but that's the way to do it.

[Frog]

Originally Posted by usabear

I'd be concerned about moving a person who is breathing, but unresponsive. If there are broken bones or internal injuries, they could be made lethal by being moved by a non-professional.

If someone is breathing but unresponsive, your first priority should be to place then into the recovery position, as this preserves their Airway and Breathing and should take priority over everything except catastrophic haemorrhage.

However if they are conscious, then you should only ever move a casualty to protect them or you from danger.

[Frog]

Originally Posted by BaZa

Another one if you come across a multi RTA and there are bodies everywhere, you can't start giving first aid you must assess the situation and report back to the services that you are calling. Giving them an over all picture. If you stop at the first one making the loudest screams then you are leaving the weak that can't scream. Tough call but that's the way to do it.

Quite correct Baza, however a good way of getting that initial Trage sieve is to get all those that can move to move. This immediatly leaves you with a clearer picture of the more seriously injured.

And I totally agree, if they are strong enough to scream they ain't gonna depart on you straight away, beware the silent casualty.

One big thing that they never seem to teach on first aid courses is that sh1t happens and some people can and do die. The adage is do the most for the most, and remeber if you do first aid and someone dies in the time before the emergency services arrive, they probably would have died anyway. Sad but true

Oh as an aside and a bit of a contradiction - there isn't a sad smiley

[Spice]

Originally Posted by usabear

I'd be concerned about moving a person who is breathing, but unresponsive. If there are broken bones or internal injuries, they could be made lethal by being moved by a non-professional.

Mr Bear
Frog (Ricki)
Is a proffessional of the highest order and I think he knows what he is talking about.
and as he says to maintain a casualties breathing /airway is top priority
broken bones can be treated in hospital with the use of scans x rays etc by doctors, you as a first aider dont have that ability.

[BaZa ®]

Originally Posted by Frog

Sad but true

Oh as an aside and a bit of a contradiction - there isn't a sad smiley

You can always import one..

or even the frown is a bit sad..