Chest Pain and Suspected Spinal Injury After a Collision
You arrive at a two-car collision on a dry road. One driver is out of the car, sitting on the kerb, pale and sweating, complaining of chest pain and shortness of breath; he says he has a history of heart problems. A passenger in the other car is still in the vehicle, conscious but complaining of neck and back pain after a rear-end impact; the car's rear is deformed. Traffic is still passing. You have a first-aid kit and a mobile phone. No fire or fuel leak is visible.
1. What are your priorities in order, and how do you handle the two casualties differently?
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Priority order: scene safety → alert emergency services → care.
- Scene safety first. Passing traffic is the biggest immediate risk. Switch on hazard lights where possible, position yourself and any helpers to warn traffic, and move only if it can be done safely. Do not move the injured passenger.
- Call emergency services (103/112) early, giving location, number of casualties, and the nature of injuries.
- Driver with chest pain: treat as a possible cardiac emergency. Sit him down, keep him calm, loosen tight clothing, monitor breathing and consciousness. Do not give food or drink. Be ready to start CPR if he becomes unresponsive and stops breathing normally.
- Passenger with neck/back pain: suspect spinal injury. Keep the head and neck still, discourage movement, and wait for trained responders. Do not remove from the car unless there is immediate danger (fire, fuel leak).
Do not leave either casualty unattended; delegate warning of traffic to a bystander if available.
2. The passenger says he feels fine and wants to get out and walk. How do you respond, and why?
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Explain calmly that he should stay still because neck or back pain after a rear-end impact can indicate spinal injury, and movement could worsen it. Keep him talking and still, support the head in line with the spine if you can do so without forcing, and reassure him that help is coming. If he insists, do not physically restrain him, but make the risk clear and keep him as still as possible. Only move him if a new danger appears (fire, fuel leak, traffic threat) - and then move him as a unit, keeping head and neck aligned.