Crash scene with a trapped motorcyclist and fuel leak
At 21:15 on a dark, wet stretch of the Nairobi–Machakos road, a 33-seater PSV bus carrying 29 passengers and a conductor strikes a motorcycle that pulled out of a side road. The rider is trapped under the front bumper, unconscious but breathing, with heavy bleeding from the right leg. The bus has stopped partly in the left lane; its fuel tank is leaking and traffic is passing on the right. Several passengers are shouting, one elderly woman has chest pain, and a child has a cut on the forehead. The driver has a reflective triangle, a fire extinguisher and a first-aid kit. There is no ambulance in sight and mobile coverage is weak. The conductor wants to drag the rider clear immediately. The driver smells petrol and sees people lighting cigarettes near the roadside.
1. State the driver's first actions in the first 60 seconds, before treating anyone.
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The first priority is to prevent a second crash and a fire. The driver should stop safely, switch off the engine, apply the handbrake and switch on hazard lights. He should tell passengers to stay calm and not to smoke or use lighters. He should get the reflective triangle out and place it behind the bus and, if safe, on the traffic side to warn approaching vehicles. He should move passengers away from the fuel leak and the traffic lane to a safer assembly point, while keeping them supervised.
He should then call the emergency number, give the location, the number of casualties, the fuel leak and the fact that the rider is trapped. He should not move the rider unless there is immediate fire danger. The conductor's instinct to drag the rider clear is understandable, but it risks worsening spinal or leg injuries. The driver should assign one passenger to keep people away from the fuel and another to watch for traffic while he checks the scene.
2. Prioritise first aid for the motorcyclist and the elderly passenger. Explain what should not be done.
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For the motorcyclist, the priorities are airway, breathing and severe bleeding. He is unconscious but breathing, so the driver should support the head and neck in the position found and check that the airway is clear. The helmet should not be removed unless it is blocking the airway or CPR is needed. Heavy bleeding from the right leg should be controlled with direct pressure using a sterile dressing or clean cloth, and the leg should be kept still. He should be kept warm and monitored until help arrives. If fire breaks out, an emergency move is justified, but it should be done with as much spinal care as possible.
For the elderly woman with chest pain, the driver should sit her down, loosen tight clothing, keep her calm and monitor her breathing. She should not be given food or drink, and no random medicines should be given. The child's forehead cut should be cleaned and covered after the more serious casualties are stabilised. The driver should not crowd the injured, remove the rider's helmet routinely, or allow untrained passengers to move him without need.
3. How should the driver manage the scene, the passengers and the reporting duties?
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The driver should keep the scene safe until police arrive: hazard lights on, warning triangle placed, passengers kept away from traffic and fuel, and no smoking. He should account for all passengers and note who has minor injuries. He should preserve the scene as far as possible, avoid moving vehicles unless necessary, and not admit fault or discuss blame with bystanders. He should exchange details with the other party if possible and record names of witnesses.
He should notify the operator and report the crash to the police as required by the Traffic Act. The report should include the location, time, vehicles, casualties, fuel leak and actions taken. A replacement bus should be arranged for uninjured passengers. The driver should stay at the scene until police permit him to leave and should complete the operator's incident report afterwards, including first-aid actions and passenger lists.