Collision with a Motorcyclist: Scene Management and Care
You are the first vehicle to arrive at a collision on a straight road outside town at dusk. A motorcycle has collided with a car at a junction. The motorcyclist, wearing a helmet, is lying on the road about 5 metres from the bike, conscious but confused and complaining of neck pain and tingling in the fingers. His right thigh is bleeding through torn trousers. The car driver is standing beside his car, shaken but uninjured. The motorcycle's fuel tank is leaking onto the road. Traffic is still passing on both sides. You have a first-aid kit and a warning triangle in your car. There is no telephone signal at the roadside.
1. Set out your priorities in order for the first few minutes.
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Scene safety first, then care. 1. Protect the scene: switch on your hazard lights, park clear of the wreckage, and place the warning triangle well back - further back than usual at dusk, because stopping distances are longer and visibility is poor. 2. Do not create a second collision: keep yourself and bystanders out of the traffic lane. 3. Assess the casualty: conscious, confused, neck pain and tingling in the fingers suggest possible spinal injury; the bleeding thigh is a serious but controllable injury. 4. Call for help - no signal here, so send a specific bystander to a known point to telephone the emergency services and report the location, number of casualties and the fuel spill. 5. Keep the casualty still and warm, control the bleeding, and monitor breathing until help arrives. The uninjured car driver can be asked to direct traffic if it is safe to do so.
2. How should you manage the motorcyclist's helmet, neck and bleeding?
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Leave the helmet on. Removing a helmet from a casualty with neck pain and tingling can worsen a spinal injury; only remove it if it is blocking the airway and you cannot manage the airway with it in place, and then only with a second trained person using a proper technique. Tell him not to move, support his head in the position found with your hands, and keep him still. Do not sit him up or roll him. For the thigh bleeding, apply firm direct pressure with a clean dressing from the kit - press on the wound, not on any obvious embedded object - and keep pressing. If bleeding soaks through, add another dressing on top rather than removing the first. Keep him warm with a coat or blanket, talk to him calmly, and watch his breathing and consciousness continuously.
3. What should you do about the leaking fuel and the passing traffic while you wait?
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Treat the fuel as a fire risk. Do not smoke, and stop anyone else from smoking. Do not start or run engines unnecessarily near the spill, and do not use a phone right at the spill if it can be avoided - move away to use it. Keep bystanders back and upwind if possible. For the passing traffic, the warning triangle and hazard lights are your main tools; if the car driver can safely stand well back from the wreckage and signal traffic to slow, that helps, but no one should stand in a live lane. If the fuel is spreading toward the casualty or a heat source, move him only if leaving him is more dangerous - and if you must move him, keep his head and neck aligned and move him as a unit.