Night crash: unconscious motorcyclist, live traffic and a smoking bystander
At 22:40 on a dry two-lane road outside a built-up area, Petros is first on the scene of a crash: a motorcycle has hit the back of a slow-moving tractor. The rider, a man of about 30, is lying face down on the road with his helmet on. The motorcycle's headlight is still on and points across the oncoming lane; there are no street lights, and traffic approaching from behind is moving at about 90 km/h. The rider is breathing but does not respond when spoken to. There is blood on his right forearm and a cut on his chin. A car has stopped 30 m behind and its driver is walking towards Petros, smoking a cigarette. Petros's car carries a warning triangle, a first-aid kit and a high-visibility vest; his passenger has already called 112 and given the location.
1. Set out the order of actions to secure the scene, with the reasoning for each.
Read the worked answer
Protect the rescuer first - an injured rescuer helps nobody.
- Park off the carriageway, as far from the wreck as possible, hazards on, headlights on to mark the scene. Put on the high-visibility vest before opening the door.
- Warning triangle well behind the scene - at least 50 m on an ordinary road, and effectively 100 m here, where traffic is arriving at 90 km/h in the dark. Walk on the verge, not in the lane.
- Stop the smoking driver immediately. Fuel may be leaking; a cigarette is an ignition source. Ask him to put it out and to move behind the barrier or verge.
- Switch off the motorcycle's ignition if it can be reached safely, to cut the risk of fire and to stop the headlight dazzling oncoming traffic.
- Move bystanders off the carriageway and ask one person to warn traffic with a torch or hazard lights if it can be done safely.
- Call 112 - already done - and stay on the line; state the road, direction, number of casualties and hazards.
The principle is scene safety, then triage, then treatment. The greatest danger at this moment is a second vehicle arriving at 90 km/h.
2. How should he treat the casualty - airway, helmet, bleeding, position - and what must he not do?
Read the worked answer
Airway first. He is breathing but unresponsive: the immediate risk is that his tongue, vomit or blood obstructs the airway, especially face down.
- Kneel at his head, stabilise the neck with your hands, and check breathing properly (look, listen, feel for up to 10 seconds).
- Do not remove the helmet unless you are trained and it is essential to clear the airway. A full-face helmet can stay on; if he vomits, turn the whole body as a unit rather than turning the head inside the helmet.
- If breathing is adequate but he is unresponsive, he needs to be turned into the recovery position - log-roll with help, keeping head, neck and spine aligned - because a face-down unconscious casualty cannot protect his own airway. Airway beats spinal caution when they conflict.
- Bleeding: apply direct pressure to the forearm with a dressing from the kit; do not use a tourniquet unless bleeding is catastrophic and you know how. Do not remove an object embedded in a wound.
- Keep him warm with a blanket or coats; shock and night cold are a real risk. Monitor breathing every minute and be ready to start CPR - 30 compressions to 2 breaths - if he stops breathing.
Never give food or drink, never let him stand up, and never move him unless there is immediate danger such as fire or traffic.
3. What should Petros hand over to the ambulance crew, and what does Greek law expect of him as a driver who stopped?
Read the worked answer
The handover should be short, factual and in time order:
- Mechanism: motorcycle versus tractor, rider thrown, time of the crash as best known.
- Time found and whether the casualty has been moved or turned, and how.
- Consciousness: unresponsive to voice, then any change (AVPU: Alert, Voice, Pain, Unresponsive).
- Breathing: rate, depth, any noise, and whether it has changed.
- Bleeding: where, how much, what pressure was applied.
- Other: helmet left on, pupils, skin colour, warmth, any medical bracelet or medicines found.
- Scene factors: fuel leak, smoking bystander, traffic still passing.
The legal side. Greek law requires a driver involved in, or present at, a road accident to stop, secure the scene, give assistance within their means and call the emergency services; failing to do so - and especially leaving the scene - is a serious offence. Petros has done the right thing: he stopped, protected the scene and called 112. He should also remain available to give a statement to the police, and should not discuss fault with anyone at the scene.