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As much as we hate to admit it at one time or another we
will come across a rider who has gone down. How we handle the situation can and
will make a difference in the outcome sometimes. This is just intended as a
basic primer on what and what not to do.
1. REMAIN CALM, getting excited will not help the victim.
2. Get yourself, bike or vehicle away from any danger or
impact zones.
3. Secure or protect the rider, it's critical that you get
someone to go in both directions to slow oncoming traffic down, else you might
have a bigger catastrophe on your hands.
4. Call for emergency services or have someone in your group
call, if necessary.
5. REMAIN CALM, have one person in control of the area.
6. Check the downed rider for injuries. If they are
conscious talk to them calmly and reassure them that help is on the way. Ask
what parts of their body hurts. Do not attempt to move the the rider if they
can not do so themselves. KEEP THE RIDER CALM.
7. If the rider is not conscious assess what injuries you
can without moving the rider. UNLESS THERE IS A NEED TO PERFORM MOUTH TO MOUTH
OR CPR DO NOT REMOVE THEIR HELMET OR MOVE THE RIDER.
8. If the victim is bleeding assess the severity of the
bleeding. Most bleeding can be stopped by applying direct pressure to the
wound. As with any bodily fluids protect yourself as much as possible.
9. REMAIN CALM.
10. When professional emergency help arrives give them a
quick run down of what you have found or done. Then move out of their way
unless they ask you for help.
11. Answer any questions you can as truthfully as possible.
12. REMAIN CALM.
13. Determine what you will do when you leave the accident
scene. Whether you will continue riding for the day or whether you will call it
a day. This decision will be greatly influenced by your personal psyche and
circumstances of the accident. There is no shame in calling quits for the day
when you are distracted by the accident.
Again this is just intended to give you a bit of guidance as
to what to do if you happen upon a downed rider. It is not intended to give you
specific instructions on how to treat injuries or to render first aid. This is
just intended for you to able to help until QUALIFIED PROFESSIONAL HELP
arrives.
Accident Scene Management
As motorcycle riders we are all aware of the inherent
dangers and risks that we take when we mount our bikes and head out to enjoy a
good ride. Yes, it is that part of our shared passion that many of us don’t
want to think about. However, these dangers and risks become all too apparent
when we are faced with situations when a fellow rider is involved in an
accident. Whether you are riding alone or in a group and you find yourself in a
situation where a rider has gone down, ask yourself honestly, do you know what
to do? Well, I asked myself this very question recently and realized that no, I
do not. Aside from being able to contact 911 or flag down someone who could, I
realized beyond that there is little I know how to do to assist a fallen rider.
So, I have gathered some information that helped point me in the right
direction and felt it was information that could help a lot of people who may
not know what to do if such a situation were to arise.
I would like to share some tips on how to avoid being a part
of an accident and what to do should you happening upon one.
DO NOT BECOME A PART OF THE ACCIDENT:
If an accident does happen, DO NOT STOP!!!! , continue to
ride past until everyone has gone through. Do not target fixate and add to the
scene. This is very important for everyone to accomplish if there is one.
This basically applies to group rides when there is a train
of riders behind you. Suddenly stopping to assist in an accident can cause
riders behind you that are unaware of the accident to slam on there brakes or
swerve to avoid you and possibly add to the accident.
If you are riding alone be aware of your surroundings and
the traffic around you before pulling off to assist. You do not want get hit
from behind because you slowed too quickly and the car behind you did not have
time to react.
REMAIN CALM... THINK!
The first thing you need to do when arriving on an accident
scene is to stop, take two deep breaths to help you remain calm.
The idea of psychological management is that all the other
people who are pumped and want to help will do whatever they are told to do by
a calm person who seems to be in control and knows what he or she is doing. If
you're excited and out of control as well, everyone will run around wasting
precious time in an unorganized fashion.
1) Get to victim, reassure, establish communication.
After a person has gone down, they will be in a confused and
scared state. They probably don't know what happened when they went down. They
may be confused, frantic, etc., and often the only thing on their mind will be
their bike. It is important to reassure them and to make sure they will not try
to move or get to their bike. Something on the order of, "You've been in a
motorcycle accident. It is important that you do not try to move. My name is
(whatever your name is). "Tell them the ambulance is coming (assuming
someone has been sent to get one or has called for one!) If your name is
something like "Chainsaw'' or "Mega-death'', tell them your name is
John or Bob or Mike.
Be careful what you say around the victim, even if they are
unconscious. Hearing works in the unconscious state and if you say something
like, "Boy, is this dude messed up bad! Maybe we shouldn't call an
ambulance after all!'', it's going to register at some level with the person
and can do nothing but harm. How you say things will be as important as what
you say; keep (or at least sound) calm and it will reduce the panic of everyone
else present.
2) Safety factors
An accident scene can be a hectic place with a lot of things
going on at once. It is important to keep safety in mind; if you are helping
someone lying in the middle of the road and a semi comes barreling down on both
of you, you aren't going to do that person much good.
a. Traffic
If people are available, get someone up road and down road
to wave down traffic. This is especially important in tight twisties where they
may not have time to stop after seeing the accident site.
b. Hazardous material spills (gas, oil, brake fluid)
People and vehicles will slip on this stuff. If ambulance
personnel slip on oil while carrying the victim, it is bad. Either clean it off
the road or indicate to everyone where it is.
c. Power lines
If power lines are down around or near the victim, ambulance
crews may not be able to get near the person until they are shut off. It is
important to call the local utility company to get these live wires turned off
at the same time an ambulance is called. If the ambulance arrives and they are
still live, they will have to call the utility company and wait for them to
come out, wasting a lot of precious time in the Golden Hour.
d. Fire
People who smoke tend to light up under stress. Ask these
people to either extinguish their smokes or move away from the flammable
materials and/or bikes. It is easy to forget something obvious like this in a
stressful situation like an accident scene.
e. Safety circle
Establish a few people around the immediate accident scene
to help direct traffic, to point out fluid spills, and to warn people who may
want to light up
3) Best-trained individual (medically-wise) attends to
victim (U-ABCC)
The person with the most training (first aid, CPR, etc.)
attends directly to the victim. Assuming the victim is lying on the ground, this
person should sit behind their head and should stabilize his or her head to
avoid unnecessary movement (i.e. hold their head still). Assume the person has
a back/neck injury and any unnecessary movement could risk paralysis.
This person should be doing "U-ABCC'' at the arrival on
the scene and every 5 minutes thereafter
U Urgency
Try to determine if the person's injuries are (a) minor or
(b) major, i.e. urgent. If unsure, it is urgent. See (6) on trying to diagnose
injuries.
A. Airway
Is there something to impede their airway? Gravel in the
helmet, something down the throat? This needs to be cleared immediately,
without helmet removal if at all possible.
B. Breathing
Is the person breathing? Determined by listening, watching
their chest, feeling for breath, etc.
C. Circulation
Check the pulse on the throat initially and subsequently on
their wrist. This is the carotid artery, right next to the wind pipe/adam's
apple on either side. If pulse is not present, remove helmet if necessary and
begin CPR immediately. When checking pulse on their wrist, do not check with
thumb; use the two fingers next to the thumb.
D. Cervical Spine Immobilization
Support the victim's head and make sure they don't move it.
CONSIDER EVERY MOTORCYCLE ACCIDENT A HEAD INJURY, CONSIDER EVERY MOTORCYCLE ACCIDENT
A CERVICAL/BACK INJURY! This is important even if they feel they can move their
head normally! When you talk to the victim initially, add on a short bit to
reassure them;
"You've been in a motorcycle accident. It is important
that you don't move. My name is (whatever your name is). Answer me without
moving your head. We don't know if you have a neck injury or not. An ambulance
is on the way.''
Again, make sure that the victim does not move at all, their
head or any other part.
4) The three questions
Ask the victim three questions and document their responses;
Who are you?
Where are you?
What time of day is it?
(Or asking what day of week it is would be fine also. Many
people do not know what time of day it is without a watch even in a normal
state.)
5a) If breathing is taking place normally, LEAVE HELMET ON!
It is very dangerous to remove someone's helmet if they have
some type of cervical/back injury. The only time it should be removed is if the
airway is blocked and cannot be cleared with the helmet on or if it is
necessary to perform CPR.
5b) helmet removal procedure if airway blocked or no
respiratory action.
This is the method recommended by the
Remove glasses and unbuckle the chinstrap. One person should
be to the side of the head of the victim and the other person should be
directly behind the head of the victim, stabilizing the head to avoid excess
movement (as seen in (3)).
The person on the side puts one hand behind the victim's
head supporting at the base of the skull (not on helmet). They put their other
hand on the jaw bone/chin (again, not on helmet). They will be supporting the
head, so it is important to get a good solid grip. Keep some tension in the arms
so that if the person pulling the helmet slips the victim's head won't drop.
The person sitting behind the head will then slowly pull the
helmet directly back and off of the head. Watch out for catching the nose on
the chin-guard on full-face helmets, as well as ears and earrings.
After the helmet is off, put a leather jacket or something
under the head of the victim! If the person supporting their head lets go,
their head will drop a good 4 inches or so. This would not be good. If
possible, it would be best to have a third person ready with something to place
under the victim's head once the helmet is off.
After the helmet is off, the person behind the head should
again hold the victim's head to promote cervical immobilization.
AGAIN, THIS IS ONLY TO BE USED IN SITUATIONS WHERE THERE IS
NO OTHER OPTION! Leave the helmet on until the ambulance personnel arrive if at
all possible!
6a) After initial evaluation of seriousness of injuries,
call for ambulance
After there has been a quick evaluation of the number of
injured people and just the most preliminary guess of seriousness, someone has
to be sent to get an ambulance. Remember that an ambulance can only support one
truly injured person.
It is important to remember that a lot of the injuries that
don't look serious to us could very well be life-threatening and injuries that look
fatal are relatively minor. Don't get fancy with the initial seriousness
evaluation. If you can't tell, assume it's Urgent!
If a cell phone is not available, send one or two bikes to
the nearest house. Send a woman if possible. The idea is that you don't have
time to be turned away from someone's house and they are more likely to be
receptive to a lady than some Scary Biker Dude. It may sound silly, but if you
are turned away from a country home due to looking like a Scary Biker Dude, you
may lose several minutes trying to find the next one. Selection of who goes to
call is very important. He also says to have the person going to the door
wearing light colors; if someone else has a white jacket trade jackets before
heading out for the house. Chances are the person going to the door will look
friendlier wearing a light-colored outfit than black leathers. In short, send a
female to the door if at all possible.
When you go to the door, REMAIN CALM... THINK! Take a second
and a couple of deep breaths. It will not help to have this biker person in a
very excited state on the doorstep of some person's home. The people will be
far more receptive to someone who looks like they have a grip on themselves.
Do not ask directly for entry into their house; something
like "There has been an accident. Please call 911.'' There is no need to
specify that it was a motorcycle accident to them (it is important to let the
Emergency Medical Services dispatcher know that it was a motorcycle accident,
however). It is less threatening to ask to call 911 than it is to ask to come
in and use their phone.
6b) Things to tell Emergency Medical Services dispatcher
1. There has been a motorcycle accident
2. Need an ambulance
3. The # of injured people (and how badly injured they are).
A severely traumatized person will require an entire ambulance to themselves,
so it is important to give the
4. Location of accident
(get help from the people whose phone you're using, they
should know how to describe their location best)
5. You (the caller) hang up last!
The
6c) Things that may be necessary for victim.
It is helpful if you know some special equipment is going to
be necessary to tell the dispatcher;
1. Helicopter
Most rural areas cannot handle severe trauma and they may
need to get the victim to a trauma center via helicopter. If they know there
may be a need, they can get the helicopter ready to leave for the rural
hospital when a doctor establishes the extent of the injuries. Slider says that
in
2. Fire
Should the fire department be called in?
3. Jaws of life
4. Utilities
See (2-C) about downed power lines above.
7a) Document personal information if possible (victim may
pass out)
Before the ambulance arrives, if possible, document
information about the victim. They may become unconscious and it will be
helpful to have information like;
Full name
Next of kin (plus phone number)
Age, date of birth
Doctor
7b) AMPLE documentation
There is AMPLE time to document this before the ambulance
arrives. Again, this will be very helpful to the paramedics if the victim
passes out.
A Are you allergic to anything?
M Are you on any medications? Street drugs?
P What's your past medical history?
L Last meal - when did you eat last?
(will help anesthesiologist if one is necessary)
E What were the events leading up to the injury?
Document the mechanisms of injury. If the doctors and
paramedics have some idea how the accident occurred, it will give them better
ideas on what kind of injuries to look for. Did the person low-side and slide
for a while on one of their sides? Did they go over the bars? Did they
head-butt a solid object, such as a car? If they went over the bars, is there
any obvious damage to the tank/handlebars which might indicate they hit the
lower abdomen/groin area? This kind of stuff could help the doctors/paramedics.
Wallets, purses, rings
Do not go rooting through personal effects of the person.
There should be no need to go through their wallet or purse for insurance
information; the hospital personnel will deal with all of that. If there is
some important reason that you need something from their wallet or purse, make
sure you have at the very least a witness! Preferably a law enforcement officer
if possible. If the person is conscious, ask first and if they say "no''
then don't push it.
If the person has rings on, the fingers may swell up and it
is important to get them off. Consent is paramount if the person is conscious.
Make sure there is at least one witness when removing them.
9a) Have person check pulse every 5 minutes & document
it
Every 5 minutes the pulse should be checked at the wrist. If
the pulse goes away at the wrist, check at the throat. This is a late sign of
shock (see 10).
Write down the number of beats per minute and the time you
took the measurement.
9b) Have person check breathing every 5 minutes &
document it
Just like the pulse, check number of breaths per minute, the
most reliable method being by placing your hand on the person's chest.
Obviously if the victim is female it would be best to have another lady do this
if at all possible.
Try to check their breathing rate without their knowing it.
If they know you are counting their respirations, they may unconsciously alter
their breathing rate.
Record this number along with the pulse every 5 minutes.
Also note the type of breathing; fast, shallow, yodeling, gurgling, labored,
easy, whatever. Even in layman's terms it may be useful to the paramedics.
10) Watch for signs of person going into shock
People invariably die due to shock. "you don't die by
the gunshot wound but by the shock of the gunshot wound."
Signs of shock:
1. Inability to answer the 3 questions coherently (Who are
you, etc.) (see 4)
2. Pale, cool, clammy skin
3. Delayed capillary refill press your fingernail so that it
turns white. It should turn back to pink in less than 2 seconds. If it takes
longer, that is not a good sign.
4. Radial pulse (pulse at the wrist) goes away but there is
still a pulse on the neck
There isn't much we can do once someone starts going into
shock, but a few minor things that may help:
1. Assure adequate breathing. This really comes with the AB
of U-ABCC.
2. Loosen restrictive clothing.
3. Reassure victim.
4. Keep the person warm (not too hot though).
5. Elevate the feet ~6 in.
This is actually a judgment call since you shouldn't really
do that with suspected spinal injuries.
6. Control bleeding.
This is probably obvious but if you don't realize the victim
is bleeding and they are rapidly going into shock, this should tell you
something.
7. Immobilize fractures.
This helps relieve pain and control bleeding.
11) Stop bleeding, using sterile bandages/dressings if
available
Two important things here are to (a) stop any bleeding as
soon as possible and (b) keep the wounds sanitary as much as possible. (a) is
far more important than (b). Peripheral limbs are commonly lost to infection,
but given the choice between stopping bleeding and using a nonsanitary cover,
using the nonsanitary wrapping is preferred. Blood loss is bad. Wounds can be
cleaned at a hospital.
If sterile dressings are not immediately available, women in
the group may be carrying sanitary tampons, or Kotex napkins. Either can be
used as a sterile dressing, although obviously the sanitary napkins would be
superior.
Carry some sterile dressings with me in my tank bag,
backpack or trunk space. They cost about $1 at your local drugstore. *
Personally, I carry a Backpacker's First Aid kit. They are compact and don't
take up too much space.
EXCEPTION: If there are cuts anywhere on the head, do NOT
apply pressure. If there is a bone chip it is possible to push it into the
brain. It is also possible that stopping the flow of blood or cerebral spinal
fluid can lead to a buildup of pressure on the brain which is not good. You
should still bandage the cuts loosely.
12) In case of femur injuries (extremely common in moto
accidents), check for blood loss
Femur (the "thigh bone'') injuries are very frequent.
There are huge arteries that run along the inner thigh; if these are
compromised the person can bleed to death in a very short amount of time. It is
important to minimize bleeding in this region! Use a pressure point above the
cut to control blood flow out of the femur artery.
13) Ambulance arrives
Before the ambulance arrives, send people to the
intersections in all directions to watch for/direct the ambulance.
When the ambulance arrives, it is important to stay out of
their way as much as possible. Meet them and identify yourself as being
"in charge'' and to be the person to contact if they need anything (bikes
moved, people moved, whatever).
Make sure you:
1. Provide accessible parking for ambulance
2. Let EMT's know who's in charge
3. Give factual account of accident ("And then the car
comes along at 154 feet per second and hits our buddy here!'' is probably not
going to help anything). At 40 MPH, there are 60,000 units of kenetic energy.
At 50MPH, there are 120,000. It is IMPORTANT for medical personnel to have an
HONEST estimate of the speed and circumstances at the time of the accident.
4. Give them all of the information that has been written
down (periodic vital signs and the three questions from U-ABCC at 5 minute
intervals, personal information about the victim, etc.)
5. Give EMT's an honest evaluation of patient's drug/alcohol
consumption
6. Stay back or leave if told
7. Give EMT's time to work
It is important to give the ambulance people the most
accurate information possible! If the person just had 10 beers in the past
hour, tell them! They are not the law enforcement officials and their only
immediate concern is the safety of the patient. By underestimating, trying to
cover up, or not telling the whole truth, you are only keeping important
information away from them which may be necessary for the safety of the
patient.
If the helmet was removed, send it along in the ambulance.
The doctors may use the visible damage to the helmet to assist them in what to
look for in terms of injuries.
If there were leaking fluids, let the medical personnel
know. The fluids may have gotten on the patient and they need to know if there
was oil, gas, brake fluid or something like that on an open wound.
14) At the hospital
Only have one or two people in the Emergency Room at a time.
If the doctors have questions and neither of the people in the ER know the
answer, send one of them out to the other people to find out the answer.
Crowding everyone into the ER will only make it more stressful and difficult
for the ER staff to do their jobs.
15) Dealing with law enforcement
As with the ambulance, when law enforcement arrives identify
yourself as being "in charge''. Let them know that if there is anything
they need, such as bikes moved or people moved, you are the person to talk to.
For them, walking on to a scene of bikers who are all in a
very excited state is intimidating and this will help calm them and give them
some easy way to control the bike people. Again, this is the psychological
management.
It is obviously important to do whatever the law enforcement
officials ask.
Before the officers do arrive, try to not move motorcycle
parts any more than necessary! They may need to take accident scene notes and
by moving things around you may confuse the situation for them. Parts will need
to be moved off the road to avoid further accidents, but move them directly to
the side so the law enforcement officials can determine roughly where it
stopped if necessary. Try not to disturb the bike any more than necessary.
(Electrics turned off, bike propped up vertically, etc.)
16) Thank you
A good number of the ambulance people are volunteers.
Officers often get little or no recognition for helping out on the scene. It
will cheer all of them up to no end to receive some kind of thanks for their
help.
Any of the following are appropriate:
1. cards
2. in newspaper
3. in person
It will improve our image as bikers and rewards all those
people who take time out of their own lives to help others. It is important!
17) Couple of miscellaneous notes
Leathers will have to be cut off by medical personnel. Be
mentally prepared for it. If they do not cut off your clothes, they will not be
able to do a proper assessment of the wounds and you are not being treated
properly! If you are conscious and insist that they do not cut your leathers,
they cannot by law. If you are unconscious, it is implied consent and they will
remove them if in doubt.
Over 50% of fatalities are alcohol related. I know it's a
cliche' but don't let friends drink and ride unless you're prepared to lose
that friend.
Many accidents involve going over the handlebars. If your
bladder is full, the extreme pressure can easily cause it to break. Make a pit
stop by the bathroom before you leave.
In an emergency situation, psychological management is
important. If a central person takes charge and is remaining calm, this will
transfer to all of the other people on the scene and will help the victim far
more than if everyone is overly excited and pumped with adrenaline. Take two deep
breaths when you feel yourself losing it.
Take basic first aid and CPR courses! They are offered
through the Red Cross and several other organizations periodically. Go with
some riding buddies or get your club to have a class!
Nothing beats proper training
