First aid at a night crash scene
At 22:40 you come across a crash on a side road off Tunisia Street. A motorcycle has hit the side of a car. The rider is lying on his side, helmet on, conscious but confused and repeating the same question. The car driver is standing beside the car with a bleeding forearm. Fuel is dripping from the motorcycle, and the car's hazard lights are not on. Traffic is passing at about 60 km/h, and the street is poorly lit. You have a first aid kit, a phone with 30% battery, and a warning triangle. Another bystander is about to pull off the rider's helmet. You are alone; no other trained help is present.
1. What are your first three actions?
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First, protect the scene: switch on your hazard lights, put the triangle well back if it is safe, and ask someone to warn traffic. Do not stand in the road. Check for fuel, fire and traffic before approaching. Call 112 and give the road, nearest landmark and number of casualties. Then assess the rider: is he breathing, can he speak, is he confused? Keep him still and warm. Do not remove the helmet unless his airway is blocked or you need to start CPR. Ask the bystander to stop.
2. Should you remove the rider's helmet?
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No, not routinely. A helmet can be removed only if it prevents you from clearing the airway, giving rescue breaths or starting CPR, and then ideally by two trained people using a jaw-thrust technique. This rider is conscious but confused, which suggests a head injury; pulling the helmet off can move the neck and worsen damage. Leave it on, support the head in line with the spine, and monitor breathing. If he vomits or becomes unresponsive, call 112 again for advice and remove only if necessary to save the airway.
3. How do you manage the bleeding driver and the fuel leak?
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Put on gloves or use a barrier, then press directly on the driver's bleeding forearm with a clean dressing. Keep the arm raised if it does not cause pain and keep him sitting or lying down. Do not remove the dressing if it soaks through; add another on top. For the fuel leak, keep everyone away from the spill, stop smoking, switch off engines if safe, and do not use a phone near the fuel. Warn traffic and wait for the fire service and ambulance. Shock can develop, so keep the driver warm and calm.