Motorcyclist Down: Scene Control and First Aid at Dusk
At about 18:15 on a two-lane road in Kandal province you are driving a 10-tonne truck at 50 km/h when a young motorcyclist pulls out from a dirt side track directly across your path. You brake hard but strike the motorcycle's rear. The rider, a man of about 22, is thrown onto the road and lies on his back, breathing but not responding to your voice. His helmet has come off. There is heavy bleeding from a wound on his left thigh and his left lower leg is bent at an unnatural angle. Your truck's fuel tank is dripping onto the road and the motorcycle is jammed under your front bumper. A crowd of about 15 people gathers, some taking photographs, and two men try to lift the rider. Your phone shows 5% battery. The nearest health centre is 4 km away; the ambulance number is 119.
1. Set out the order of actions for the first two or three minutes and justify the order.
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The order is dictated by what can kill someone next: fire, then traffic, then the casualty's bleeding and airway.
- Stop and secure the truck. Parking brake, hazard lights, engine off. The engine off matters here because the tank is dripping - do not restart it and do not let anyone smoke or use a lighter near the spill.
- Stop the two men moving the rider. A casualty with a possible spinal injury who is lifted by untrained hands can be paralysed by the movement. Unless there is fire, he stays where he is.
- Push the crowd back and use them. Ask loudly for someone to direct traffic at both ends of the scene. Fifteen people standing around a crash in failing light is a second collision waiting to happen.
- Call 119 for an ambulance and 117 for police before your battery dies, giving the road, district, direction, number of casualties and the fuel spill.
- Then treat the casualty - airway, breathing, bleeding - and stay with him until the ambulance arrives.
2. What first aid can you give, and what must you not do?
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Breathing and airway. He is breathing but unresponsive. Kneel at his head, keep his head in line with his spine, and monitor breathing continuously. If he vomits or his breathing becomes noisy, support the head in line and turn him as a unit onto his side only if you cannot keep the airway clear any other way. Do not tilt the head back sharply or twist the neck.
The thigh wound. Apply firm direct pressure with the cleanest cloth available - a folded shirt, a gauze pad - and keep pressing without lifting to check. If blood soaks through, add another layer on top rather than removing the first. Elevate the leg only slightly, if at all, because of the fracture. A tourniquet is a last resort for spurting arterial bleeding that direct pressure cannot control.
The deformed lower leg. Do not straighten it. Do not test whether it moves. Leave it in the position found; if you have padding, support it where it lies.
Do not give food, drink or cigarettes, and keep him warm with a blanket or clothing while you wait - shock and heat loss are real risks after a road crash.
3. What are your legal and administrative duties after a collision involving injury?
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A collision with injury is not just a first-aid event; the driver has obligations that begin at the scene.
- Stop, stay and give assistance. Leaving the scene of an injury crash, even briefly, is a serious offence under the road traffic law. Do not drive off to fetch help unless there is genuinely no other way to get it.
- Protect and report. Notify the police (117) and the ambulance service, and remain until they arrive and release you. If the vehicles must be moved to prevent a further crash, note or photograph the positions first where it is safe to do so.
- Exchange particulars with the other party or their family: names, addresses, phone numbers, plate numbers, licence details and insurance details.
- Report your fuel spill to the police and, if the truck is leaking badly, to the fire service (118).
- Notify your employer and insurer immediately, and record the time, weather, road conditions, speed and what you saw in writing while it is fresh. Do not admit fault or negotiate compensation at the roadside - that is for the police and insurers to determine.