First on Scene: Rider Down with Neck Pain
At 5:30 p.m. on a light-rain two-lane road, you are riding alone behind a 110 cc underbone motorcycle. The rider ahead hits a wet steel plate, skids, and falls; the bike slides to the shoulder. You stop about 15 m before the scene. The rider is conscious, lying on his left side, and bleeding steadily from a deep cut on his right forearm. His full-face helmet is cracked at the chin bar but still on. He says his neck hurts and that he cannot feel his fingers. A bystander runs over, reaches for the helmet strap, and says, 'Let's sit him up.' Traffic is passing close to the rider, and the road is curving. You have gloves, gauze, a phone, a first aid kit, and a reflective vest. The nearest hospital is 8 km away; the barangay road is narrow.
1. What do you do in the first 60 seconds?
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Protect the scene first: park your motorcycle upstream of the fallen rider, turn on hazard lights, put on the reflective vest, and set a warning triangle if you have one. Wave traffic around and ask a bystander to direct traffic from a safer spot. Put on gloves before touching blood. Call 911 or the local emergency number and give the location, direction of travel, number of patients, and hazards. Do not move the rider unless there is immediate danger such as fire or a vehicle about to hit him. Keep the rider still and talk to him calmly.
2. How do you manage the helmet, the bleeding, and the possible neck injury?
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Leave the helmet on. A cracked full-face helmet and neck pain suggest a possible cervical injury; removing the helmet can move the neck. Control the forearm bleeding with direct pressure using gauze, and elevate the arm only if it does not move the neck. Do not press on a suspected fracture or probe the wound. Keep the rider's head aligned with the spine and monitor breathing. If he vomits or stops breathing, that changes the priority, but do not let the bystander sit him up. Sitting up can worsen a spinal injury and cause fainting.
3. What information do you give dispatch, and what should you refuse to do?
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Tell dispatch: road name and nearest landmark, direction, one conscious patient, deep forearm bleeding controlled with pressure, neck pain, numbness in fingers, helmet still on, traffic passing close, and that you need an ambulance and traffic control. Refuse to remove the helmet, sit him up, give him water, or let him stand. Do not move him to the hospital in a private vehicle unless there is no ambulance and the scene becomes unsafe; a spinal injury needs proper immobilization.