As
everyone knows, an accident scene can be very frightening and
overwhelming, especially if you have no medical training. For most
people fear and lack of knowledge prevent them from helping out. But
even if you have had no formal training in cardiopulmonary resuscitation
(CPR) you can manage an accident scene and help those who know what they
are doing. This article is not intended to teach CPR or first aid. If
ever you have a chance to take a course through your local Red
Cross...please do so. It is so valuable to be able to have the knowledge
of CPR. This article is merely a guideline for those who have no idea
what to do at the scene of an accident.
I know there are those
who say that CPR classes are useless unless you already have formal
training, that there is to much information expected to be learned in a
very short period of time. But through my own personal experiences, I've
seen 10 year olds able to perform CPR they learned by just watching it
done on TV...and I do have more faith in the human mind than those who
can not believe this to be possible. I have faith in you all, so if you
have a chance, try taking the course! Take is as often as you
can...practice makes perfect, and it can do you no harm, only good can
come from it. I have seen and heard of many bystander CPR who were
responsible for saving a life at a seen while waiting for the professional
medics to arrive. Unfortunately those situations usually pertain to
specific events such as heart attacks, stroke, drowning or
electrocution. A person who is killed instantly -no breath- has a
very poor chance of survival no matter how good the CPR is. This
is because that person has a fatal injury.
Although there are an infinite
number of accidents scenarios and resulting injuries, each can be
handled in a step-by-step manner following some general accepted
guidelines.
FIRST OF ALL REMAIN
CALM!
First of all one thing
you must try to remember is that to panic is a very normal reaction.
There is not a single soul who at one time or another felt a bit of a
panic when they are faced with some form of trauma. Unfortunately when
you panic, it limits your ability to think. So try to recognize that you
might be in somewhat of a shock, but tell yourself to remain calm.
If you are to be of any help, if there is to be some form of control at
the scene, you might be the one to be able to keep the scene under
control by just remaining calm. People/bystanders tend to take
instruction much easier from a calm person who seems to know what they
are doing rather than one who is panicking. Next, know your limitations,
your capabilities and make sure to stay within them. If you never
have had the chance to take that CPR course then do not attempt to
perform CPR on anyone. Make sure to ask someone to call 911 first
thing...then Ask the bystanders, Does anyone know CPR? If someone
does, allow them to perform the CPR. What can you do? If you know
some basic first aid, you can be very useful to someone with minor
injuries who may be going into shock or bleeding from an open
wound. Even with no first aid training at all, you can still help
manage the accident scene.
PROTECTING THE SCENE,
THEREFORE PREVENTING FURTHER INJURIES!
First of all try to
evaluate the scene, identify the victim(s) is anyone lying in harm's
way. I once came across a downed rider who was in the middle of PCH
Pacific Coast Highway, a very busy highway on the California Coast. The
rider was smack dab in the middle of the 4 lanes. The first thing
I did was incorporate some help by passing motorist and lucky enough we
had a few flares we used to lay down to direct oncoming cars around the
victim. Please be very very careful if this is the scene you come
upon. We certainly don't want you to place yourself in danger and them
we would need more medical personal to take care of more victims. Direct
people to stand some distance away in all directions where vehicles can
approach and have them stop or divert traffic through hand
signals. If you are alone with an injured person and in a
dangerous spot, you have no choice but to move the victim to a safer
location. Okay now here is a though most would not think of at the scene
of a downed rider, when people/bystanders come across an accident, they
tend to become very stressed, and while waiting for instructions or not
knowing what to do, they tend to light-up, smoke, you know...to calm the
nerves...unfortunate according to the Hurt Report, fuel system leaks and
spills were present in 62% pf the motorcycle accidents in the post crash
phase...not a good place to be when lighting up don't ya think. If a
bystander does attempt to smoke, kindly ask them to step on it, and
explain we don't want a fire on top of everything else right now. It's
for their protection as well.
AGAIN
CALL FOR HELP!
In today's world cell
phones have made is almost a guarantee help can arrive soon...almost
everybody has one. Chances are if you don't have one a bystander or
passing motorists will. Before calling for 911, make sure to know your
location, how many injured persons you have, and how serious you can
assume their injuries are. When ever in question as to how serious,
remember, all victims are serious until this can be ruled out by a
qualified emergency medical professional. In most situations, one
emergency vehicle can only handle one victim at a time, so if there are multiple
victims, make sure to relay this to the dispatcher you speak to. Tell
the dispatcher that this is a motorcycle accident...I can promise you
they will immediately think of the worst scenario preparing for head,
neck and spinal injuries. This is a given to all medical personal, and
it is a good idea for you to also assume this as well. Now sometimes
when speaking to the emergency dispatcher we have had a moment to catch
our breath and thoughts, and suddenly realize what we are doing
here...you can start to feel a panic again...just take deep breaths, and
remember, the dispatcher is relying on you to provide as much
information as possible to help the victim. Never hang up with the
dispatcher until they indicate for you to go ahead and do so. They
might have more questions for you as you are waiting for the emergency
paramedics to arrive.
|
|
Learning a
different form of A-B-C's...
Again this is
not an attempt to teach you the basics of CPR, but their are some general
guidelines you can take with you just in case...No matter how crazy the
situation appears to be, it's a fact...you can only help one victim at a
time, and you can only do one thing at a time for that victims. The
A-B-C's I was writing about above stand for the
ABC's
of Lifesaving...
A -
AIRWAY
B - BREATHING
C - CIRCULATION
You need to
asses the victim in this exact order. I hate to be graphic, but it would
be senseless to apply pressure to a bleeding wound if the patient in not
breathing. Without oxygen, the bleeding will stop on its own in about four
minutes when the victim dies. The heart will no longer pump the blood
through the body. You have to go through the A-B-C's first.
A-
AIRWAY
The victim is
not responsive but you can hear them moaning or mumbling, this is a good
indication they are breathing, if they have a full face helmet on, and the
window is fogging, this is also an indication they are breathing, but not
an absolute. You need to establish whether or not the victim is able
to breath. One indication is when a person is completely silent, you
cannot hear any breath sounds, or by placing your ear to their mouth and
you cannot feel their breath, nor do you see their chest rising. Now let's
take at look at the obvious, if a 500lb bike is lying atop a victims
chest, it is highly likely the victim will have either constrictive or no
ability to breath. Immediately yet carefully remove the bike off the
victim, anything that is physically preventing the victim from the ability
to breath, you find them face down in show, water, heavy grass...you must
find a way to allow air to get to the victim by removing the
problem. Now in other situations, an unconscious victim who may be
laying flat on their back with nothing blocking their airway, or at least
it can appear to be that way, may indeed have a blocked airway from their
own tongue. They are in a complete state of unconsciousness,
therefore their tongue relaxes and lays back against the opening of their
throat. If they have any nasal blockage, they are not getting any
air. This is the most common form of airway blockage in an
unconscious victim, and the easiest to remedy. But before you do anything
you must determine if anything needs fixing. So in a nut shell, if there
are no obvious signs the victim is not breathing, you will have to make
sure and determine this for yourself. As mentioned earlier, watch their
chest for it to rise and fall, if they are wearing clothing that prevents
you from being able to determine this, simply unzip or unbutton their
jacket/sweater, or gently lift their garment just enough to have a clear
view of their chest is moving. If you don't see any movement, do not
assume they are not breathing just yet. Their breaths may just be very
shallow. Place you hand near the victims nose and mouth and feel for
breath. If it has been determined they are not breathing, the first
step is to make sure that victim has an open airway. The hard candy he was
sucking on to keep his mouth moist on the run could be stuck/lodged in
this throat, or that lazy tongue could be blocking his airway. Once again,
if you are not trained in opening a persons airway through a CPR training
course, asked bystanders if anybody there has CPR training?
Removing or clearing block airways need to be done with extreme caution
for the victim might have head, neck or spinal injuries. You can always
say something to the effect, "this person doesn't appear to be
breathing, does anybody here know CPR or how to clear an
airway?" Sometimes those who have had CPR training and are
standing by might be in somewhat of a state of shock, but usually when you
make the universal request for CPR assistance, this is all it takes for
them to snap out of it and step forward. As stated before, even well
trained people panic at these times. The most important thing to remember
during this situation is to remain calm and nothing else can be done until
you can establish and airway for the victim. If you have no one around
that knows how to check for blockage...you are going to have to make the
decision as to whether you want to risk doing this yourself. All I
can tell you is this, if you place your middle 3 finger gently under the
victims chin...just like your mommy use to do when she wanted your full attention
and asked you to "look at here" okay...with one hand you gently
place under the victims head and the other hand with your 3 fingers under
the victims chin, gently tilt the head back, as if to point their chin
just a little more in direction to the sky/above. Now gently drop
open the victims jaw, look inside their throat to see if you can see any
blockage, if so...then gently take your index finger and do a sweep of the
throat to lift out the blockage/candy/gum...etc. Again only do this if you
have no other resource and the victim is not breathing. Now If the victim
is lying on his stomach and you have determined he is not breathing, this
is not the time to be concerned about moving him because of possible
injuries to the spine/neck...this victim needs to get oxygen first and
foremost. So you have no choice but to move him. If possible, enlist the
help of bystanders and roll him over onto his back. This is called a log
roll, and it is just as it sounds. You want to roll the victim all
at once as if he were a big log of lumber. his shoulder, stomach,
hips, legs, feet...and at the same time. Once he is rolled over, determine
once again if he is breathing. If not, then find out why? Once you know
there isn't something blocking it, yet still no breathing, now is the time
to move onto B-Breathing
B-BREATHING
Now that the
victim has an open airway, move to B is the patient breathing? Can
you hear it, see it or feel it? If not, call for help again. If artificial
respiration will be needed and the patient has a full face helmet on, you
will have no choice but to remove it. The recommended method of the
American College of Orthopedic Surgeons requires two people. There
website is http://www.aaos.org/word-html
paper/position/mhelmet.htm
1.
Remove glasses and unbuckle
the chinstrap. One person should be to the side of the victims head and
the other person should be directly above the victims head.
2.
The person on the side puts
one hand behind the victim's head at the base of the skull (not the
helmet) and the other hand on the chin (again, not on helmet).
|
|
This
person is the one supporting the head so it is important to get a good
solid grip and keep tension in the arms so that if the person pulling the
helmet slips the victim's head won't drop.
3.
The person sitting behind
the head them slowly pulls the helmet directly back and off the head.
watch out for catching the nose on the chin-guard on full face helmets, as
well as ears and earrings.
4.
After the helmet is off,
put a leather jacket or something under the head of the victim. If the
person supporting their head lets go, the victim's head will drop about
four inches. If Possible have a third person ready with something to place
under the victim's head once the helmet is off.
5.
After the helmet is off,
the person behind the head should hold it immobile while artificial
respiration are being given.
PLEASE
REMEMBER...THIS IS ONLY TO BE DONE WHEN THERE IS NO OTHER POSSIBLE
OPTIONS! Never
remove a victims helmet unless it is to provide life-saving artificial
respirations to someone who isn't breathing. Otherwise leave the helmet on
until the paramedics/ambulance personnel arrive.
C -
CIRCULATION
Now
that the victim has an open airway
(A)
and someone is breathing
for him (B),
now is the time to move
onto (C) Circulation.
A person who is breathing on his own definitely has a beating heart, even
though it may be an irregular heart rate and could change at any time. As
long as he is breathing on his own, he should need no assistance from
bystanders. Checking for a heartbeat is best done by placing your fingers
on one of the victim's carotid arteries. The carotid arties are on both sides
of the windpipe. You can practice finding this on yourself. Place
you index & middle fingers on your windpipe, then slide them about an
inch to the right or left. If you're over the carotid artery, you'll
feel it pulsate with the beat of your heart. If the victim has no
pulse, you'll need to find someone who can begin artificial compressions.
Prior training is necessary to do compressions, but anyone can determine
if compressions are needed and enlist the help of a trained bystander.
also, below is a basic CPR instruction...if you have a printer, copy and
print this instruction...fold it up and keep it with you at all
times. You just never know when it might come in handy. Obviously
actual training with The American Heart Association or The American Red
Cross is your best bet, but heck...if that is not possible, at least you
will have the basic guide.
TIME FOR
FIRST AID
Only after
having established that the victim has an open airway, is breathing, and
has a beating heart, can you move onto basic first aid. you may even have
to perform a little first aid for a person who is receiving bystander CPR.
Suppose you notice that with each manual compression administered to the
victim, blood is squirting out of the victims chest. You can't keep
pumping the person blood out onto the ground. In this situation, you'd
want to apply direct pressure over the opening to stop the bleeding.
There are
many times when the victim of an accident is injured but awake. If the
person is awake and moving, he is taking in air and has a beating heart-at
least for now. A person with even minor injuries will most likely be
confused immediately following the accident and will probably not remember
what happened. A rush of adrenaline can mask pain and the victim may not
believe he is injured. In a motorcycle crash, you should always assume the
victim has a head, neck, or spinal injury.
Reassurance
and reorient an awake victim by saying something like, "my name is
Cathy, You've been in a motorcycle accident. An ambulance is on the way.
It's best if you do not move." There is always the possibility that
an awake victim may loss consciousness or become incoherent so it's a good
idea to get some basic information from him as quickly as possible. As a
minimum get his full name, and the name and phone # of a relative or
friend. Also if the victim has a head injury, they can become combative,
angry, and uncooperative. In this case try to assure the victim he is
going to be alright and help is on the way. Never, ever put yourself at
risk of injury or harm. If you notice a person bleeding, apply
direct pressure. Never use a tourniquet unless trained to do so...you
could do more damage than good. Watch for signs of shock...it's a good
indication that the person is losing blood, possibly from a location you
cannot see, generally an internal injury. The best thing to do when
a person is exhibiting signs of shock is to keep him warm and attempt to
control bleeding.
SIGNS OF
SHOCK
|