Dusk collision with a cyclist: 34 passengers, one casualty in the live lane
At 18:20 in October, in dusk and light rain, you drive a 49-seat coach with 34 passengers on a single-carriageway main road outside a built-up area where the limit is 90 km/h. A cyclist without lights comes out of a farm track 30 m ahead. You brake hard, the coach stops 25 m beyond him, and he is lying in your lane, unconscious, breathing noisily, with heavy bleeding from the right forearm and the right lower leg bent at an unnatural angle. Your hazard lights are on; traffic is still passing in the opposite direction, and one car has already swerved around the casualty. Two passengers are shouting and one is trying to open the emergency door. There is a high-visibility vest, a warning triangle and a first-aid kit on board; your mobile phone shows 46% battery.
1. Set out the order of actions for the first minute, with reasons.
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1. Secure the coach. Stopped, hazard lights on, parking brake applied, engine off. If possible, position the coach between the flowing traffic and the casualty - 13 tonnes of coach is the best protection available at the scene.
2. Quick assessment. Anyone else hurt? Smell of fuel or any sign of fire? The answer decides whether the passengers stay on board.
3. Protect the scene. High-visibility vest on, warning triangle out. On a 90 km/h road at dusk, place it well back - the faster the road, the further; on a motorway the rules require roughly 150 m - and, if needed, stand where you can wave traffic down. A second collision at dusk is the biggest risk to everyone here, including you.
4. Call 112. Location with a kilometre marker or GPS coordinates, number of casualties, whether the cyclist is conscious and breathing, the hazards (dark clothing, no lights, wet road).
5. Then the casualty. The rule is: do not move an injured person unless there is immediate danger. He is lying in a live lane, which is danger - but the correct sequence is to remove the danger first (triangle, warnings, coach as a shield) and only drag him clear if a vehicle is actually bearing down.
Delegation matters: one passenger to keep the others on board, one to help flag traffic. You cannot do all of it alone.
2. Give the first-aid sequence for this casualty and explain each decision.
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Airway first. Unconscious with noisy breathing means the airway is partly obstructed - tongue, blood or vomit. Kneel at the head, check response, and open the airway. In a cyclist thrown from a bike, assume a spinal injury, so use a jaw thrust or only minimal head tilt rather than a full head-tilt/chin-lift.
Recovery position. Once you have cleared visible debris from the mouth, turn him onto his side, protecting the neck, so that fluid drains and the tongue falls forward. Noisy breathing in an unconscious person on his back is a countdown to a blocked airway.
Recheck breathing continuously. If he stops breathing, start CPR - 30 compressions to 2 breaths, 100–120 per minute, 5–6 cm deep - and send someone for the AED if one is available.
Bleeding. Heavy forearm bleeding: firm direct pressure with a dressing or clean cloth and keep it there; if it soaks through, add another layer on top. A tourniquet only if bleeding cannot be controlled and the limb is otherwise at risk of exsanguination, and then note the time.
The leg. Do not straighten it, do not move it; it is a fracture and manipulating it increases bleeding, pain and the risk of shock.
Nothing by mouth, keep him warm against shock, and hand over to the ambulance: mechanism, time of the collision, what you found and what you did.
3. How do you handle the 34 passengers and what must you report, to whom?
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The passengers. They are safest on the coach, not standing on a 90 km/h road in the dark. Unless there is fire, a fuel leak, or the coach itself is blocking a live lane, keep them seated with the doors closed and put one responsible passenger in charge of the group.
The passenger trying to open the emergency door must be stopped calmly: the emergency door is for evacuation, and an uncontrolled evacuation onto a dark carriageway creates more casualties than it prevents. If evacuation is necessary, use the door away from the traffic and marshal people behind the coach, not in front of it or in the road.
Reporting. Call the operator's dispatcher immediately: vehicle, location, casualties, whether the coach can be moved, whether the passengers need a replacement vehicle. The company also has accident-reporting duties towards the authorities.
Legal. You must stay at the scene, give your details, and not move the vehicles until the police allow it, unless the casualty requires the lane to be cleared.
Evidence. Take names and phone numbers of witnesses - your passengers are the best witnesses you will ever have. Write your own notes (time, weather, speed, what you saw) before discussing it in detail with anyone, and do not speculate about fault at the roadside.