A passenger becomes unresponsive after a collision
You are the driver of a car that has just been struck on the passenger side at a junction. It is daylight on a dry road. Your front-seat passenger is slumped forward, not responding when you call, and has a visible cut on the forehead. The passenger's seatbelt is still fastened. You have a small first-aid kit in the boot. Traffic is still moving past on the road behind you. Your own hands are shaking and you have a slight headache, but you are mobile and can think clearly. There is no smell of fuel and no fire.
1. List your actions in priority order from the moment you realise the passenger is unresponsive.
Read the worked answer
Priority order - safety, then ABCs, then help:
- Make the scene safe first. Switch on hazard lights, and if it is safe and you are able, place a warning triangle or otherwise signal to following traffic. You cannot help anyone if you are struck by passing vehicles. Do not move the car unless it is in immediate danger.
- Check responsiveness. Speak loudly, tap the shoulders. No response = treat as a medical emergency.
- Call emergency services immediately (or have a bystander call), giving location, number of casualties, and that one is unresponsive.
- Check breathing and airway. Open the airway (head-tilt/chin-lift if no spinal concern - but in a collision, suspect spinal injury and use jaw thrust/minimal movement). Look, listen, feel for breathing for up to 10 seconds.
- Control the forehead bleeding with direct pressure from the first-aid kit - a dressing pressed firmly on the cut.
- If not breathing normally: start CPR (30 compressions : 2 breaths) and send for an AED.
- If breathing: keep the airway open, monitor continuously, and keep them still - do not remove the seatbelt unless it is obstructing the airway or you must move them for safety.
Key point: unresponsive + collision = suspect head/spinal injury. Your job is airway, breathing, bleeding control and calling for help - not moving the casualty.
2. Should you remove the passenger's seatbelt or move them out of the car? Explain your reasoning.
Read the worked answer
Do not remove the seatbelt or move them unless there is a compelling reason.
Why keep the belt on:
- The passenger is unresponsive after a collision - a spinal injury is possible. Moving them or releasing the belt can worsen a spinal injury.
- The belt is not obstructing the airway in a slumped-forward position in most cases; if it is pressing on the neck and compromising breathing, then release it carefully while supporting the head and neck.
When you would move them:
- Only if there is immediate danger - fire, fuel leak, or the car is in a live traffic lane and cannot be protected. Here there is no fire and no fuel smell, and you can signal traffic, so the car is the safer place.
- If you must move them, support the head and neck in line with the spine and move them as a unit, ideally with help.
Monitoring: keep checking breathing every minute, keep the airway clear, and stay with them until help arrives. Note the time and any change in responsiveness to report to the responders.