Collision Scene With an Unresponsive Casualty
You come upon a two-car collision on a rural road at dusk. One car is in the ditch, the other is blocking your lane with its hazard lights on. A passenger is sitting on the grass, pale and breathing fast, complaining of thirst and dizziness. The driver is slumped over the wheel, not responding when you shout, and you can see blood on the steering wheel. There is a smell of fuel. Traffic is approaching from a bend about 80 m away. You are alone. You have a first-aid kit, a warning triangle and a mobile phone, but no signal at this spot.
1. List your actions in priority order for the first two minutes.
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- Make the scene safe first: switch on your hazard lights, stop before the scene, and place the warning triangle at least 80 m back toward the bend so approaching drivers get warning. Do not smoke or create sparks near the fuel smell.
- Call the emergency number. If there is no signal at your spot, note that you may need to move a short distance to get a signal - but do not leave the casualties unattended for long; flag down another driver to call if possible.
- Check the slumped driver: is the airway open, is there normal breathing? If breathing is absent or clearly abnormal, start CPR after calling for help. Do not move the driver unless there is immediate danger such as fire.
- Attend to the pale, breathless passenger: keep them still and warm, reassure them, and monitor breathing. Thirst, dizziness and rapid breathing suggest developing shock; lying them down with legs slightly raised helps if injuries allow.
- Keep monitoring both until help arrives and report what you saw.
2. Why should you not give the pale passenger food or drink, despite the thirst?
Read the worked answer
Thirst with pallor, rapid breathing and dizziness points to shock from blood loss or internal injury. Giving anything by mouth is risky: the casualty may deteriorate, vomit and aspirate, and if surgery is needed an empty stomach is safer. It can also worsen nausea and does not treat the underlying circulation problem.
Instead, keep the casualty warm, still and reassured, loosen tight clothing, and monitor breathing and consciousness continuously. If they become unresponsive but are breathing, place them in the recovery position. Report the thirst and pallor to the emergency services, since these are useful signs of internal bleeding.