Crash scene 101
WHAT TO DO IF YOU’RE FIRST AT A ROAD ACCIDENT
Paramedic Wendy Adams watched as a man physically tore pieces off a buckled car to reach two young boys trapped in the back.
She was travelling home from Auckland when she happened upon the crash in which a car had been struck by a truck from behind.
‘‘I could see the kids in the back and one was critical and needed to get out straight away but they were really stuck in there,’’ she recalls.
‘‘I remember saying to this guy – we need to get this kid out.’’
The brawny man from a concrete laying firm began ripping pieces off the hatchback to reach the boys.
‘‘He did this amazing job of hauling the boot and pieces of the car away, pushed and pulled so we could reach this child. This guy was amazing.’’
It was a heroic effort but not one everyone could replicate at the scene of a crash.
Driving along the highways this summer break no one is immune to the prospect they end up seriously injured, or worse dead.
In 2018 alone, 376 people were killed on our roads and far more seriously injured.
What would you do if you arrived first on the scene of a crash?
Assess the scene
Adams, St John Waikato region’s acting territory manager, has attended hundreds of crashes in her almost 20 years as an intensive care paramedic.
When arriving at a crash scene, the first thing she recommends is to assess the scene and note any potential hazards.
Broken glass, fuel leaking, fires and downed powerlines can all be harmful.
‘‘Approach the cars with a bit of caution. If there are powerlines down don’t go anywhere near it – even if there is someone in the car – as they can easily arc and possibly electrocute you.
‘‘A lot of the time people think a car maybe on fire but it can be the airbags releasing powder, people think that’s smoke, just be aware of that.’’
Patients should not be moved unless it was absolutely safe and necessary to do so.
But Adams says if victims appear to have minor injuries and are happy to get out of the car, help them do so.
‘‘Don’t stop them, let them get out and help them to a safe part of the road. If they look injured and they’re not speaking leave them there.’’
Make the crash area safe
The first thing someone can do is make the area safe to prevent any further crashes, Waikato road policing Senior Sergeant Pete van de Wetering says.
‘‘There is going to be traffic arriving at that scene and if it’s in a place that’s not easily visible, it’s straight away a hazard itself.’’
Motorists should park their car in a position down from the scene, or before a bend, with hazard lights on.
If they’re capable, or if there’s more than one person, start diverting traffic, he says.
‘‘You want to stop traffic coming through the scene to prevent another tragedy. Make yourself visible and safe.’’
Call 111
Call 111 as soon as you can.
‘‘It doesn’t matter if we receive more than one call – it’s better than no calls. Get on the phone quickly,’’ van de Wetering says.
Give the location first. Then assess the scene, count the number of vehicles and patients, look at how serious they are and then relay that information.
‘‘We do need some idea of how many people are involved so we can get the right vehicles, and number, responding quickly. If there’s seven people involved we’ll get a number of ambulances on the way immediately.’’
Call takers are trained to ask questions. Although some may seem superfluous, van de Wetering says every question matters.
‘‘Before the call has ended, call takers are already dispatching units to it. Try to keep a level head as best you can.’’
Detail the crash’s location with north or southbound lanes.
A helpful tip for attending crashes on places such as the Waikato Expressway is to provide a north or southbound lane location.
‘‘There are median barriers all the way down those highways and sometimes we have to travel a long way before we can turn around and come back,’’ Adams says.
It can also help determine where the closest ambulance can be dispatched from.
‘‘Make the scene safe, call emergency services then go and see if you can provide medical help,’’ van de Wetering says.
Who to attend to first?
There’s no straightforward answer but, as a general rule, Adams recommends attending to the quietest person first.
‘‘If there’s someone clearly unconscious or with an obstructed airway, if they can take a look at them and open their airway if possible that goes a long way in saving their life.’’
For example, if someone is slumped forward over the wheel and don’t appear to be breathing, tilt the person back in their seat, she says. Pull the jaw down while supporting the person’s head and neck.
‘‘People will worry about doing that, or causing a spinal injury but if you have a blocked airway you are going to die.’’
Then tend to any bleeding victims. Stemming the flow with your hands or fashioning a piece of clothing or material as a tourniquet is an option, Adams says.
‘‘If someone is in a car and you can see a whole lot of blood spurting, put pressure on the limb and try to elevate it. You really have to squeeze tight and hold the limb up.’’
Victims complaining of pain or a sore neck should not be moved until an ambulance has arrived.
If someone is going into
‘‘shock’’ and is distressed, remove them from the vehicle, comfort them by speaking to them and take them away from the scene.
‘‘I wouldn’t advise anyone being given anything to eat or drink until they have been seen.’’
What if a car’s on fire?
First, assess your own ability. If you feel it’s safe and you can, try to make the car safe, Van de Wetering says.
‘‘If there’s spilled fuel then straight away there’s a huge risk – you have fumes and fires can ignite from the slightest spark.’’
Turn off the ignitions of crashed vehicles but avoid airbags. If a crashed car is at substantial risk of catching fire, try to get the person out.
‘‘But this has to be done with minimal movement to the victim as there could be neck or spinal injuries.’’
Reassure victims
Sometimes the best thing a bystander can do is to reassure crash victims. Keep talking to them if you can’t move them. Offer blankets or clothing if they’re cold, or to call family or friends.
‘‘Common sense kicks in for most people. Sometimes it takes one person to get things moving,’’ Van de Wetering says.
Tips:
Park your car in a safe spot, away from the crash area. Switch on hazard lights. Post other people or warning triangles on all approaches to the crash site. If people are injured, call an ambulance. Don’t get between any undeployed airbag and injured or trapped person. Undeployed airbags can deploy with force some minutes after a crash and could injure both the rescuer and injured/trapped person. If it is safe, turn off the ignition. Check breathing and blood loss. If any vehicle has dangerous goods, follow the instructions for dangerous goods.