The Motorcyclist Down on the Bend
You are first on the scene of a motorcycle crash on a rural bend. The rider, wearing a helmet, is lying on his side on the road, conscious but confused, complaining of neck pain and unable to move his left arm. The motorcycle is on its side about 10 m away, its engine still running and fuel dripping onto the road. The bend is blind: you can hear a vehicle approaching from beyond the curve. There is no phone signal at the roadside; you saw a village about 1 km back. Two other cars have now stopped.
1. Set out your priorities in order for the first two minutes, and justify the order.
Read the worked answer
Priority order - scene safety before casualty care:
- Protect the scene. Switch on your hazard lights, position your vehicle before the bend to warn the approaching traffic, and send one of the stopped drivers back up the road to signal. A blind bend with an approaching vehicle is an immediate risk of a secondary collision that would injure you and the casualty.
- Kill the ignition of the motorcycle if it is safe to reach - the running engine and dripping fuel are a fire risk. Do not smoke or use anything that could ignite vapour.
- Do not move the rider. Confusion, neck pain and an unusable arm point to possible head and spinal injury. Leave the helmet on; removing it can worsen a spinal injury. Support the head in the position found and keep him still.
- Call for help. With no signal, send a specific person - not 'someone' - to the village to call the emergency number, and tell them exactly where the crash is and what injuries you see.
- Keep him warm and calm, monitor breathing, and be ready to act if he becomes unresponsive.
Justification: you cannot help the casualty if you become a second casualty, and fire or a secondary impact would kill him before any first aid could.
2. The rider becomes drowsy and his breathing becomes noisy. What do you do, and what must you not do?
Read the worked answer
Do:
- Treat a falling level of consciousness as deterioration. Open the airway using a jaw-thrust or chin-lift while keeping the head and neck aligned and supported - do not tilt the head back sharply.
- Check breathing for up to 10 seconds. If he is breathing, place him in the recovery position only if you can do so while maintaining spinal alignment, and keep monitoring. If he is not breathing normally, begin CPR and send for an ambulance and, if available, a defibrillator.
- Keep talking to him, keep him warm with a blanket or jacket, and record the time of any change.
Do not:
- Remove the helmet.
- Give him food or drink.
- Leave him alone.
- Move him 'to make him comfortable' - comfort is secondary to spinal protection.
Reporting: when help arrives, hand over what you saw: the time, the mechanism, the changes in consciousness, and what you did. That handover is part of the emergency procedure, not an optional extra.