First on Scene: Motorcycle and Pedestrian, 21:30
It is 21:30 on an unlit rural road about two kilometres outside Vieux Fort. You come over a gentle crest and find a collision. A motorcycle lies on its side near the centre line with its headlight still on and pointing across the road. The rider is on his back on the wet tarmac, conscious but confused, with a bleeding forearm and his full-face helmet still on. A woman is sitting on the grass verge holding her shoulder and saying she cannot catch her breath; she was the pedestrian. There is broken glass across the lane, a smell of petrol, and the road is still open, with traffic emerging over the crest behind you at about 50 mph. Your phone has a signal, and there is a first aid kit and a warning triangle in your boot.
1. Set out your actions in the first sixty seconds.
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Scene safety comes before casualty care, and it comes in a fixed order.
Park your car before the scene, not at it, with hazard lights on and headlights dipped so you are not blinding anyone. Get the warning triangle out and place it well back beyond the crest, on the shoulder and upstream of the debris, so approaching drivers get warning before they see people. If it is safe to do so, switch off the motorcycle's ignition to reduce fire risk from spilled petrol - no smoking, no naked flame. Do not attempt to move the casualties unless there is an immediate danger such as fire.
Then call the emergency services on 911. Give the road and the nearest landmark, the number of casualties, that one is confused and one is short of breath, and that the road is unlit and still open. Stay on the line and follow instructions until help arrives.
2. How do you manage the rider, who is confused with a bleeding forearm and a helmet still on?
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Leave the helmet on. Removing a full-face helmet from a confused casualty risks moving a damaged neck, and it is a job for trained crews with two people and the right technique. Your job is to keep the airway open, control bleeding and prevent further harm.
Kneel beside him, on the side away from traffic, and introduce yourself. Talk to him steadily and ask simple questions to gauge how his level of consciousness is changing. Note whether he is breathing normally and whether his breathing is becoming noisy or laboured.
Control the forearm bleeding with direct pressure using a dressing from the kit; if it soaks through, add another on top rather than removing the first. Keep him still and warm - a coat or blanket against the wet ground - and keep him talking. If he becomes unresponsive but is breathing, be ready to support the airway. Report any deterioration to the ambulance crew.
3. The woman has a painful shoulder and says she cannot catch her breath. What do you do, and what are your duties as the driver who stopped?
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Sit her down where she already is, on the verge, well clear of the traffic, and do not move or straighten the shoulder - an injured shoulder may accompany chest or rib injury. Shortness of breath after a collision is a warning sign, not a complaint to brush aside: it can point to chest injury or shock. Help her into the position she finds easiest to breathe in, loosen anything tight at the neck, reassure her and stay with her, monitoring her breathing and colour until the ambulance arrives. Do not give food or drink.
As the driver who stopped, you must stop and remain at the scene, give your name, address and vehicle details to the police and to anyone with reasonable grounds to ask, and report the collision to the police promptly. Leaving the scene of an injury collision is a serious offence. Signal to the approaching traffic as well - your triangle and hazard lights protect everyone still lying on that road.