Passenger collapse on the motorway hard shoulder
You are driving a 13 m coach with a trailer at 80 km/h on a Danish motorway. There are 44 passengers, mostly teenagers, and one teacher. A 16-year-old boy collapses in the aisle, is unresponsive and breathing abnormally. The next exit is 2 km away; the hard shoulder is 2.5 m wide with a concrete barrier and fast traffic. There is an AED behind the driver's seat and a first-aid kit in the overhead locker. Your co-driver is not on board. A passenger screams and another tries to open the emergency door. It is raining and visibility is poor. The trailer's rear lights are working. You must decide whether to stop on the hard shoulder or continue to the exit, and how to manage 43 other passengers.
1. What are your immediate priorities and where do you stop? Justify the decision.
Read the worked answer
Stop on the hard shoulder as soon as it is safe, not at the exit 2 km away. A collapsed, abnormally breathing passenger needs CPR within minutes; driving on while someone attempts CPR in a moving bus is unsafe. Switch on hazard lights, stop as far right as possible, apply the parking brake and switch off the engine. Call 112 immediately and give the motorway name, direction, nearest kilometre marker and the patient's condition. Do not move the patient unless there is fire or traffic danger. Keep the hazard lights on and put the warning triangle at about 100 m behind the combination if it is safe to do so. The trailer stays attached; do not try to uncouple it. The priority order is: protect the scene, call help, start first aid.
2. Describe the first-aid sequence and how you organise passengers and traffic warning.
Read the worked answer
Check response and breathing. If unresponsive and not breathing normally, start CPR: 30 chest compressions to 2 rescue breaths, or continuous compressions if unwilling or unable to ventilate. Send someone for the AED, switch it on and follow its voice prompts; do not delay compressions while pads are applied. Send the teacher to keep the other passengers seated and calm, clear the aisle and keep the emergency door closed on the traffic side. If the bus is at risk, evacuate through the door away from traffic to a safe point behind the barrier, but do not leave the patient alone. Use the first-aid kit for bleeding or airway support. If breathing returns, place the patient in the recovery position and keep monitoring.
3. What do you report and record after the emergency services arrive?
Read the worked answer
When the ambulance arrives, give a clear handover: what happened, when, whether the patient was breathing, how long CPR was performed, shocks from the AED and any known allergies or medication. Give the patient's age and the teacher's contact details. Then secure the scene, account for all passengers and inform the operator and school. Record the time of the incident, the location, the first-aid actions, the AED downloads if available and the names of witnesses. Do not discuss the patient's condition with others. Complete the company incident report and tachograph manual entry for the interruption. If the hard shoulder stop created a traffic hazard, report it to the police or traffic centre.