Transcript Accident Scene Management

Accident Scene Management
Tony Dix
RoADAR (Dip)
Accident Scene Management
First on the scene … … ?
Do you know what to do … … ?
Do you know what not to do … … ?
The police do not routinely record or attend all collisions because
often it is sufficient for drivers to speak directly to their insurance
company.
Think DANGER !
Protect yourself, is it safe to stop where you have ? If not, move! Consider
hazardous materials (chemicals, gas, oil, brake fluid etc) – keep safe!
Protect the scene as best you can, position vehicle, lights on and hazard
lights illuminated. Send people along the road ( both sides of incident ) to
warn approaching traffic. No smoking at scene!
Protect any casualties.
If there are casualties in the road do not move them – close the road !
Initial Action … …
Inform the Emergency Services – ensure 999 or 112 is dialled and have
confirmation! Too many calls are better than none … aiding locations in
rural spots and information. Agencies should exchange information.
What information you should give :
•Location ( Marker Post, road designation – A40, nearby village, landmarks
etc)
•Number of people injured and severity
•Number of vehicles involved
•What’s happened to your knowledge
Don’t terminate the call until you are told to or the Operator does so.
Initial Action … … cont’d.
Assess casualties – if walking around – sit them down. Give them
something to do – if they have a arm injury they can hold it !
Look for others … is there an unattended car or bike ?
If there is more than one casualty – beware of the quiet one!
Trauma … what to do
Actions can be remembered by:
Dr A B C
Danger
Response
Airway (Cervical spine awareness)
Breathing
Circulation
Aims of First Aid / action at scene
•Preserve life
•Prevent condition becoming worse
•Promote recovery
Dr
ABC
Think RESPONSE !
Does the casualty respond to : A V P U
Shake & shout!
Alert
awake & responsive
Verbal
responds to verbal stimuli
Pain
responds to pain i.e. finger nail bed test etc
Unresponsive
no response
Dr
ABC
Think AIRWAY !
& C - Spine
Has the casualty got a patent airway ? Have they got a blockage i.e. dentures,
debris or blood in the mouth, causing an obstruction ?
The airway will have to be cleared and then maintained – helmet removal
ONLY if necessary (and after training) being aware of c-spine movement.
Head tilt, chin lift or method of obtaining patent airway
Without a patent airway no amount of effort and excellent team work will
save the casualty from death.
Modified Jaw Thrust
Chin Lift
Jaw Lift
Triple Jaw Thrust Manoeuvre
Dr
ABC
Think BREATHING !
Is the casualty breathing ? If not … why not ?
We check to see if they are breathing for no longer than 10 seconds by :
looking at their chest for movement i.e. rising & falling
listening for sounds of breathing i.e. gurgling, rasping or snoring sounds
feeling for breath on side of face or hand
The casualty may have a chest injury or may be prevented from breathing
normally by a weight on their chest or by constriction.
Dr
ABC
Think CIRCULATION !
Assess for signs of circulation for no longer than 10 seconds :
Look for normal breathing - coughing or other movement such as:
eyelid tremors
facial ticks
or
clues of no circulation i.e. cyanosis (blueness)
A pulse check is no longer carried out by non – health care personnel
due to time & in over 50% of cases an inaccurate conclusion, either
present or absent of a pulse.
Protocol
If breathing :
recovery position
Check responsiveness
Shake & shout
Open Airway
Head tilt / chin lift
Check breathing
Look, listen & feel
No breathing
Start Chest compressions
CPR 100 per minute
30 : 2 ratio
Continue Until Help Arrives
or Patient Responds
Get help
Check for major blood loss – you need your blood to transfer oxygen
around the body.
RECOVERY POSITION
IS USED TO TURN A CASUALTY INTO A SAFE
POSITION THAT WILL NOT ENDANGER HIS PRESENT
CONDITION OR OBSTRUCT THE AIRWAY
OBJECT
MAINTAIN CLEAR AIRWAY.
REDUCE RISK OF CHOKING ON VOMIT OR BLOOD.
PREVENT CASUALTY FROM ROLLING
AND CAUSING FURTHER INJURY.
PLACE CASUALTY IN A POSITION WHERE
IT IS EASIER TO BREATHE.
The Recovery Position
Points to remember … …
CONSIDER EVERY MOTORCYCLE ACCIDENT A HEAD
INJURY.
CONSIDER EVERY MOTORCYCLE ACCIDENT A
CERVICAL/BACK INJURY!
Support the victim's head and make sure they don't move it.
This is important even if they feel they can move their head normally!.
When you talk to the victim initially, add on a short bit to reassure them;
‘You've been in a motorcycle accident. It is important that you don't
move. My name is *****. Answer me without moving your head. We
don't know if you have a neck injury or not. An ambulance is on the
way.’
Points to remember … … cont’d.
Cervical Spine Immobilisation
Again, make sure that the victim does not move at all,
their head or any other part.
Ask the victim three questions and document their responses:
Who are you?
Where are you?
What day is it?
If breathing is taking place normally, LEAVE HELMET ON!
It is very dangerous to remove someone's helmet if they have some
type of cervical/back injury. The only time it should be removed is
if the airway is blocked and cannot be cleared with the helmet on or
if it is necessary to perform CPR.
Points to remember … … cont’d.
If you witnessed the collision make a mental note of what happened.
The ambulance crew and hospital staff NEED to know:
•an ‘honest’ estimate of speeds (greater speeds – greater injuries !!)
•how rider/pillion ‘fell’ off
•did they ‘slide’ along the road
•what did they hit as they slid/rolled along the road ( part of body
involved ?)
•did they land on their head ?
•which part of the body landed first ?
All this information is of great importance and can reduce the risk of some
injuries being ‘missed’. It will assist in treating ‘hidden’ potentially serious
injuries.
Information for the Insurance company :
You should send the following details to your insurance company as it will
help them process your claim.
•Date of collision
•Time of collision
•Location of collision
•Road condition
•Name of officer attending scene
•Make of vehicle
•Registration number
•Driver's name
•Driver's address
•Insurance
•Damage to vehicle
•Any witnesses
Police responsibilities at a scene of a collision
•Protect the scene from any further collisions.
•Ensure any injured people are looked after and treated by the appropriate
emergency service.
•Direct the traffic through and around the scene safely.
•Examine the collision scene, determine how the collision happened and
decide if any offences have been committed.
•Record all collision details where injuries occur or drivers make allegations
about or against others.
•Identify witnesses who will help determine the cause of the collision.
•Help in the recovery of the vehicles away from the scene.
•Investigate where necessary.