First on scene at a motorcycle crash at dusk
It is 18:30 in late October, already dusk. You ride around a right-hand bend on a rural road outside a village and immediately see a motorcycle lying on its side in the middle of your lane, about 15 m ahead, its headlight still on. A rider in a full-face helmet lies face down roughly 8 m beyond the bike, motionless. A car has stopped on the opposite verge with hazard lights on; the driver is standing beside it on his phone, looking at his screen. Your lane is completely blocked; the opposite lane is still open and two cars have already passed without stopping. You brake to a stop about 20 m before the fallen bike. A small first-aid kit is in your top case. When you reach the rider you hear noisy, snoring breathing, and there is blood on the chin bar; the left leg lies at an unnatural angle. It is getting darker and the road is unlit.
1. Set out your actions in the first 60 seconds, in order, and explain why being a motorcyclist helps here.
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Protect the scene, confirm the call, then treat.
- Stop before the scene, as you did, and put your bike between the oncoming traffic and the casualty if that does not block the lane completely: headlight on, hazard lights on if fitted. Get off and warn drivers upstream with arm signals; at dusk on an unlit road the wreck is invisible until very late.
- Do not move the rider, and do not let anyone else move them unless there is fire or the risk of a second collision.
- Check the phone call. The driver on the verge may be calling, or may be doing something else. Ask him directly: 'Have you called 144, and what did you say?' If not, call yourself: 144 (ambulance), giving the road and nearest village or kilometre marker, direction of travel, one casualty, unconscious but breathing, noisy airway, deformed leg, and your phone number. Stay on the line until told to hang up.
- Then the casualty: check response (speak, squeeze the shoulders) and check breathing for up to 10 seconds.
As a motorcyclist you recognise what the helmet, the bike's position and the rider's line mean, you have a first-aid kit by choice, and you can describe the scene precisely to the emergency service.
2. The rider is unconscious with noisy, snoring breathing. What does that tell you, and do you remove the helmet?
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Noisy snoring in an unconscious rider means the airway is partly blocked, usually by the tongue, and the airway takes priority.
- The rule is: leave the helmet on unless the airway cannot be kept open with it in place. A full-face helmet does not by itself prevent you from ventilating or from placing the rider in the recovery position, and routine removal by untrained hands can turn a stable neck injury into a catastrophe.
- Do the non-invasive things first: kneel at the head, hold the helmet steady with both hands to keep the head in line with the spine, and use a jaw thrust (fingers behind the angles of the jaw, lift forward) or a gentle chin lift without tilting the head back. If the snoring stops and breathing becomes quiet and regular, you have won.
- If the airway stays obstructed, if the rider vomits, or if breathing stops, the airway wins: remove the helmet - ideally with a second person holding the head and neck in line while you pull the sides apart and slide it off - clear the mouth, and start rescue breathing or CPR if there is no normal breathing.
- Recheck breathing every minute. With a deformed leg, treat for shock: keep the rider warm, do not straighten the leg, and give nothing to drink.
3. What do you tell the bystander to do, and which well-meant actions must you prevent?
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Give the bystander a job, and stop the harmful 'help'.
- The driver: ask him to stay on the line with 144 and then to walk back up the road and warn traffic with his hazard lights and a phone torch, rather than standing over the casualty. Two helpers doing two jobs beats three people crowding the rider.
- Police: an accident with injuries must be reported to the police in Switzerland. The ambulance service usually alerts them, but if 144 has not been called, call 117 once the casualty is being cared for.
- No drink. An unconscious or deteriorating casualty cannot swallow safely, and any surgery needs an empty stomach.
- Do not straighten or pull the leg. A deformed femur can bleed litres into the thigh; splint it as you found it, using the other leg or a jacket and straps, and only if you have help and the ambulance is far away.
- Do not remove the boot unless the foot is cold, pulseless, or the boot is trapping the leg.
- Keep talking to the rider, note the time, and hand over clearly to the paramedics: what you found, what you did, and what changed.