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FigNewTon is offline
Join Date: May 2005
Location: GSO, NC
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Roadside Emergencies- Rider Down! What do you do?
The following was created by a friend of mine on another forum. He is a Nationally Registered Emergency Medical Technician-Paramedic and recently taught a class to local forum members regarding what to do if you have a rider in your group go down. I pray none of us will ever need this information but if the time did come it could prove to be invaluable.
Madison Sportbikes Safety and First Aid
January 29, 2005
Preface: This information is not to be taken as a substitute for a certification based first aid class, instead the intent is to teach you what you can do to make a difference in the outcome of someone in the event of an emergency while riding, or possibly even in a non-motorcycling emergency. This is not to be intended as a substitute for definitive medical care.
Kinesiology of trauma
I. An object in motion tends to stay in motion; every action has an equal and opposite reaction.
A. There are numerous impacts involved in any type of traumatic event
B. The type of accident, or Mechanism of Injury, is an excellent way of predicting the type of injuries that can be expected.
1. Up and Over
2. Down and under
3. Down and Crush
4. Blunt force trauma
5. Impact from behind
6. Penetrating Trauma
7. Other
C. Understanding the kinetics of trauma combined with key findings on the victim will help determine the need for immediate intervention, waiting for EMS, or waiting until you can get to the doctor’s office on your own, or even just going home having a few and pouting about it. (let’s hope for the latter)
1. Immediate Intervention
a. Trouble breathing
b. Lack of breathing
c. Lack of a pulse
d. Signs of shock (we will go over this in a bit)
e. Significant bleeding
f. Lying in a public roadway with no ability to safely block the road
g. Penetrating trauma
h. Fire
2. Wait for EMS
a. Broken bones
b. Minor bleeding
c. Numbness or Paralysis
d. Dizziness, Nausea, Sleepiness (keep patient awake)
e. Altered Level of Consciousness – Ask if they know who they are, where they are and the day and date. If confused to these questions, serious head injury is likely
f. Loss of Consciousness (Immediate intervention is needed if patient has trouble breathing, lack of breathing, lack of pulse)
g. Others ie: Large Abrasions
D. Wait til you can get to Doctor’s Office, or go to ER on your own
1. Muscle Strains
2. Muscle Sprains
3. Pulled Tendons/Ligaments
4. Very Sore Joints
5. Medium Abrasions
6. Small Burns
7. Others
E. Going home and pouting about it
1. Small Abrasions
2. Small Cuts
3. General Soreness
4. Hurt Pride
II. Scene Safety- Do not become a Victim yourself
A. Your own safety comes first
B. Protect the victim second
C. Park bikes facing traffic, running. White light is the easiest seen studies have shown. Park 25-35 feet from scene and no further. Oncoming traffic may come back into the scene otherwise.
D. If at all possible, have someone near the parked bikes to wave traffic down and get their attention
E. If a car driver is willing, have them park across the lane of traffic if needed to protect you and the downed rider, with their front wheels pointing away from the victim. This way if they are hit, their vehicle will travel away from the downed rider. If they are willing have them park with headlights facing oncoming traffic as well.
F. If patient seems uninjured and wants to get up- let them. Verify that they are “Alert and Oriented x 3†meaning they know who they are, where they are and what day/year it is. If they get these questions wrong, don’t let them up.
G. If no cars are willing to stop and help, and you have enough bikes, try to use the bikes to set a perimeter around the scene.
H. Make sure someone stays with the victim at all times.
I. One person needs to call the shots until authorities arrive. Do not announce yourself as being “In Chargeâ€, instead let the first arriving Public Safety Person know that you have been directing events until they arrive.
J. No matter what, do what the arriving authorities tell you to do. Do not risk being charged with obstruction. Once they have arrived, they are in charge. Offer to assist in any way you can.
K. If you are able, ascertain victim’s medications, allergies, and pertinent medical history (are they diabetic? Heart condition?) and write this down. Have it ready for emergency responders.
L. Be ready to provide an accounting of your observations of the patient. Were they more active and talkative before? Are they seeming to be confused now? Etc.
M. Be prepared to write a statement for law enforcement. Many times people leave the scene before giving information that could lead to the arrest of someone who may have caused an accident, or findings from the patient condition from the time of impact that could factor in to their ongoing healthcare.
N. Make notification to family members. Bad news is often easier to take from friends than from strangers, plus, it is better for them to get the truth on first contact rather than after the fact. The exception is in a fatality. Do not take this job on yourself, rather, let the professionals do this. They have access to Mental Health Professionals and Clergy to assist families in these instances.
O. Always remember, the downed rider needs you to remain level headed and calm, but also be sure to not lose sight of the fact that the downed rider needs to be calmed and reassured by a friendly face. Even if you do not know the ride personally, be there for them, even if all you can do is hold their hand while waiting for EMS.
III. Injury severity
A. Early recognition of injuries and their severity, or the likelihood of a particular injury is important in determining the need for EMS
B. If you are not sure, Call 911 immediately!!
1. Check A-B-C-D-E
a. Airway- is it open and clear?
b. Breathing- are they breathing? Is there chest rise and fall? Can you see/hear/feel air movement? Is the rate slower than 10 respirations per minute? Is the rate greater than 30 respirations per minute?
c. Circulation- check for a pulse at the wrist. If not present, check at the carotid artery (Neck). Is their skin normal color, warm, and relatively dry?
d. Disability- are they alert and oriented times three? (What is your name? Where are you? What day of the week is it?) Are their hand grasps equally firm? Can they push downward on your hands with their feet like pushing a gas pedal? If they are not alert, do they respond to loud voice? Do they respond to pain? (To test this, rub their chest in the center with your knuckle firmly, or pinch the skin on the back of their hand HARD.)
e. Expose- if you can, while preserving modesty, expose their chest area. (Open their jacket/leathers) This step is completely optional, and should not be done with female riders unless you can see that they are bleeding underneath or having difficulty breathing. Do not try to remove the clothing, but if you see and area of bleeding, provide direct pressure over their clothing with your gloved hand to stop the bleeding. Do not try to control bleeding in the area of an open fracture without sterile dressings, as bone infection will almost guarantee loss of that extremity.
C. Airway blockage
1. Without an airway, the rider will not survive. The airway can be blocked by broken teeth, the tongue, foreign objects, or blood. A healthy adult can live 6 minutes without an open airway, but as time passes within the six minutes, the increased risk of brain injury exists. The helmet must come off, and the airway must be opened. Without an airway, the rider is dead.
2. Using your gloved fingers, use the index and middle fingers to clear a blocked airway. If the blockage is lower (ie;choking) have someone hold their head inline and then you provide abdominal thrusts. Before doing this, be absolutely certain the rider is not breathing. A rider that can talk, can breathe. Providing abdominal thrusts unnecessarily can be injurious or even fatal.
D. Breathing Problems
1. There is not much you can do for this rider, try to calm them, and reassure them. Keep their airway open and open restrictive clothing. The helmet should come off. (we will go over safe helmet removal and the appropriate time)
2. try to get a rough idea of how many times per minute they are breathing, and let EMS know this immediately on their arrival. Count their respirations (in and out = 1 resp) over 15 seconds and multiply times 4. If over 30 or under 10, there is a serious problem, however, keep in mind that respiratory rates can be quite fast in the pissed off person! Try to calm them and see if they get better.
3. Note breathing patterns. Are they regular? Are they irregular? Do they go fast, faster, faster, faster, stop, slow, faster? Are they regular in depth and timing? Make a note of this for EMS.
E. Circulation (Welcome to the wonderful world of shock)
1. Shock- an interruption in the circulation of oxygenated blood. Signs of shock are:
a. Blue nail beds
b. Mottling or blue skin in the extremities (arms and hands, legs and feet)
c. Lack of a radial (wrist) pulse
d. Rapid respirations
e. Cold clammy skin
f. Altered mental status
2. Treating shock
a. raise legs, roll up your jacket and place under their feet
b. cover the rider, keep them warm
c. control any major bleeding you can see
****ANY DEFICIT IN ABC OR D IS AN IMMEDIATE LIFE THREAT AND REQUIRES IMMEDIATE EMS RESPONSE******************
MSB Rider Emergency Class 01/29/2005
Helmet Removal Post Motorcycle Accident
by Norman E. McSwain, Jr., MD, FACS, and Richard L. Gamelli, MD, FACS
American College of Surgeons
Committee on Trauma
April 1997
So, there has been an accident. Lets lay it out in sequence. (assume this is severe)
Get stopped safely
If rider is in the roadway, protect the downed rider after making sure you can do so safely by either blocking the scene or getting out of the road. (if any problems with A, B, C, or D, do not move)
Get a general impression of the situation (how many people are down, are they moving on their own?)
One person take the lead, designate the person present with the highest medical training to assess the downed riders. (if more than one person is available)
Assess riders- Check A-B-C-D, if two people available, remove helmet per instructions, and make sure one person per downed rider is available to keep the downed rider’s head immobilized. Treat immediate life threats.
Call 911, if no cell phone available, send someone to the nearest phone. Person calling needs to be able to tell the dispatcher how many people are involved, immediate problems with A, B, or C, and precise location.
If available, or possible to ascertain, the Lead person should obtain AMPLE information:
A- Allergies
M- Medications
P- Pertinent Medical History
L- Last Oral Intake
E- Events Leading Up to Injury (Mechanism of Injury)
*These items with the exception of last oral intake and mechanism of injury would be really good to have on an emergency card in your wallet, as well as emergency contact information*
Law Enforcement arrives.
Lead Person make contact, advise what you have done so far, give a brief synopsis of the accident, and offer to help in anyway you can. If they state no help is needed, stand back out of the way. People immobilizing the heads of the downed riders should not stop doing so.
Do not leave the scene until you are told
EMS arrives. Pass on all information you have obtained including AMPLE history and your findings related to A-B-C-D, and all of your treatments to the lead EMT/Paramedic.
Transfer care to EMS, stand back out of the way, Do not leave the scene until told to do so. You may have to fill out statements, and EMS may have questions or need lifting help.
****DO NOT MOVE, KICK, THROW, OR OTHERWISE CHANGE THE LOCATION OF ANY PARTS OF THE BIKE(S) ON SCENE. DO NOT LIFT THE BIKES UPRIGHT IF POLICE WILL BE ON THE SCENE. UNTIL DEEMED OTHERWISE, THIS IS A CRIME SCENE, AND MOVEMENT OF ANY OF THE WRECKAGE WOULD BE DETRIMENTAL TO THE INVESTIGATION, AND IS A CRIME IN ITSELF****************************************
Name______________________________________________ ______
Address___________________________________________ _______
Phone_____________________________________________ _______
Emergency Contact_________________________________________
Allergies_________________________________________ __________
Medications_______________________________________ _________
Pertinent Medical History____________________________________
Blood Type______________________________________________ __
Name______________________________________________ ______
Address___________________________________________ _______
Phone_____________________________________________ _______
Emergency Contact_________________________________________
Allergies_________________________________________ __________
Medications_______________________________________ _________
Pertinent Medical History____________________________________
Blood Type______________________________________________ __
Name______________________________________________ ______
Address___________________________________________ _______
Phone_____________________________________________ _______
Emergency Contact_________________________________________
Allergies_________________________________________ __________
Medications_______________________________________ _________
Pertinent Medical History____________________________________
Blood Type______________________________________________ __
Name______________________________________________ ______
Address___________________________________________ _______
Phone_____________________________________________ _______
Emergency Contact_________________________________________
Allergies_________________________________________ __________
Medications_______________________________________ _________
Pertinent Medical History____________________________________
Blood Type______________________________________________ __
Name______________________________________________ ______
Address___________________________________________ _______
Phone_____________________________________________ _______
Emergency Contact_________________________________________
Allergies_________________________________________ __________
Medications_______________________________________ _________
Pertinent Medical History____________________________________
Blood Type______________________________________________ _
Recommendations on what to carry with you
Tape
Gauze
Antiseptic Wipes
Latex or non-latex exam gloves
A spare cell phone, charged, need not be an activated phone.
CPR Mask or a freezer grade Ziploc bag
Your own emergency information paper clipped to your driver’s license
Anything else you may think you would need
I want to thank each and every one of you for coming to this class. It is my sincere hope that you never have to utilize any of these skills, but if you do, I hope that they serve to benefit a downed rider until help arrives. Your commitment to each other is commendable, and second to none. It means a lot to me to know that you all are willing to attend a class like this to be there to help your fellow rider.
Thank You,
Jim Lilly
Nationally Registered Emergency Medical Technician-Paramedic
Also added:
ICE YOUR CELL PHONE
his is not a bad idea.....ICE your phone now!!!
>
>Paramedics will turn to a victim's cell phone for clues to that
person's
>identity. You can make their job much easier with a simple idea that
>they are trying to get everyone to adopt: ICE.
>
>
>ICE stands for In Case of Emergency. If you add an entry in the
contacts
>list in your cell phone under ICE, with the name and phone no. of the
>person that the emergency services should call on your behalf, you can
>save them a lot of time and have your loved ones contacted quickly. It
only
>takes a few moments of your time to do.
>
>
>Paramedics know what ICE means and they look for it immediately.
>Hopefully they'll never need it, but ICE your cell phone NOW!
__________________
"Using no way as way. Having no limitation as limitation."
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