Helmet On, Fuel Leaking, Leg Pinned
At 7:10 p.m. on the Islamabad Highway, you are the first person to reach a crash. A motorcycle has collided with a car. The rider lies on his side, helmet still on, eyes open but confused; he keeps asking where he is and does not answer when you ask his name. Blood is running steadily from a deep cut on his right forearm. His left leg is pinned under the motorcycle, and fuel is dripping from the tank onto the road. The car driver is shouting and walking around. Traffic is passing at about 70 km/h, and the light is fading. You have a first-aid kit and a mobile phone; there is no fire, but you can smell petrol. You are alone with two bystanders.
1. What are your first three actions, in order?
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First, protect the scene. Park your motorcycle off the carriageway, switch on hazard lights if you have them, and put on a high-visibility item if available. Ask the two bystanders to warn traffic from a safe distance; do not let them stand in the live lane. Do not smoke or use a naked flame near the leaking fuel.
Second, call Rescue 1122 and the police. Give the location, the number of casualties, the fuel leak, the trapped leg and the rider’s confusion. Stay on the line and follow the dispatcher’s instructions.
Third, assess the rider from a safe distance and only approach when traffic is being warned. If the motorcycle’s ignition is reachable without moving the rider or crossing traffic, switch it off. Do not move the rider unless there is an immediate threat such as fire. Confusion after a crash can indicate head injury, so keep him still and monitor his breathing while waiting for help.
2. How should you manage the helmet, the bleeding and the trapped leg?
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Do not remove the helmet. It is keeping the neck aligned, and removing it can worsen a spinal injury. Remove it only if the airway is blocked, the rider is vomiting, or you must start CPR, and only if you have been trained and have help. Otherwise, kneel at the rider’s head and hold the helmet steady in line with the body.
For the forearm bleeding, apply firm direct pressure with a clean dressing from the kit. Do not remove a soaked dressing; add another on top and keep pressing. If bleeding is severe and a tourniquet is available and you are trained, use it according to training.
For the trapped leg, do not pull the rider free. Moving him can worsen fractures and spinal injury. Keep him still, reassure him, and let the rescue team lift the motorcycle. Do not give food or drink.
3. What should you say and not do while waiting for the ambulance?
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Identify yourself and speak calmly. Tell the rider that help is coming and that he has been in a crash. Ask simple questions and note whether his replies become more drowsy or confused. Keep him warm with a blanket or jacket, but do not cover the face or restrict breathing.
Do not:
- let bystanders crowd him or move his helmet;
- argue with the car driver or try to establish blame at the scene;
- give him water, food or cigarettes;
- promise that he will be fine;
- leave him alone without someone monitoring his breathing.
Record the time of the crash and any changes in consciousness if you can. When the ambulance arrives, report what you saw, what you did and the fuel leak. Your role is to protect, call, reassure and hand over, not to act beyond your training.