Unresponsive Driver, Bleeding Passenger, Petrol Smell, Live Traffic
At 23:00 you are the first to arrive at a single-vehicle crash on a lit urban dual carriageway in Abu Dhabi. A car has hit the central barrier and stopped in the second of three lanes, facing the wrong way. Its engine is still running and there is a strong smell of petrol. The driver, a man in his thirties, is slumped over the wheel; he is breathing but does not respond. A passenger is sitting on the road beside the car holding a forearm that is bleeding heavily, and shouting. Traffic is still passing at about 80 km/h. Your phone battery is at 20 percent.
1. Set out your actions in order, from arrival to handover.
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Protect, call, then treat.
- Scene first. Stop 30-50 m before the wreck, hazard lights on, and angle your car to shield the lane if you can do so without stopping in a live lane. Do not walk between the two vehicles; keep your own body out of lane three.
- Call the emergency services with road, direction, lane, number of casualties, that one is unresponsive and that there is a fuel leak.
- Kill the ignition if the key or button is reachable without stepping into traffic, and keep everyone away from smoking and flame.
- Do not move or extract the slumped driver. Steady the head, check response, open the airway if needed and confirm normal breathing, then keep monitoring.
- Control the arm bleeding with firm direct pressure through a clean cloth or clothing; do not lift it to look; keep the arm raised if no fracture is suspected.
- Keep both casualties warm, keep the shouting passenger sitting down, and stay until handover, reporting exactly what you found and did.
The order is not negotiable: an unprotected scene turns one casualty into three, and a 20 percent battery is enough for one clear call.
2. Both casualties need you. Who do you treat first, and why is the noisy one not necessarily the priority?
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The quiet one is usually the sicker one. The passenger is shouting, which proves a patent airway and a working circulation. The driver is unresponsive and cannot protect his own airway; an unresponsive breathing casualty can stop breathing while you are distracted elsewhere.
The single exception is catastrophic external bleeding - spurting, soaking clothing, or pooling on the road. That kills in minutes, so a look at the arm in the first seconds is warranted; if it is that severe, 15 seconds of direct pressure comes first, then the airway.
In this scene the practical answer is: pressure on the arm while you are already crouched beside it, then the driver's airway - both inside the first minute, because the petrol smell makes speed matter. Reassess the driver continuously; if breathing becomes noisy, gasping or absent, that takes absolute priority.
3. What does the petrol smell change about the plan?
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A strong petrol smell with the engine running means fire can start from a source you cannot see, and neither casualty can evacuate themselves.
It changes three things:
- Kill the ignition if reachable, and keep bystanders, their engines and any cigarettes well away and upwind.
- Accept that the driver may have to be moved - spinal precautions abandoned - if fire actually starts. A suspected spinal injury is a serious risk; a burning car is a certain one.
- Prepare the evacuation route: know where you and the walking passenger would go, at least 100 m upwind, and warn approaching traffic.
Until there is smoke or flame, the clinical priorities stay airway and bleeding. The smell raises readiness, not panic.