None of us want to be put in a situation where we are the only person who can help an injured motorcyclist after an accident, but it may well be that your assistance will or can save a life. As a former EMT and Fire Chief, I was often dispatched along with the closest Paramedic Unit and Paramedic Ambulance to situations where a motorcyclist had been involved in a serious accident.
First, a caveat. This information is compiled from a variety of sources. The information is intended to assist those who do not have formal emergency medical training. If you have training, follow the specific training you were provided. This in no way replaces formal emergency medical training. It is meant as an adjunct for those who find themselves in an emergency situation and need to assist. To not assist will often be much more harmful than knowing you did everything you were capable of doing.
Second, if you don’t have a small medical kit on your bike, get one. It may well save a life, and that life could be yours. Make sure it is a Motorcycle Accident or Trauma medical kit. This will have the necessary components to deal with a serious bleed injury. Some order of operations charts roll up with instructions as to what to do and in what order. Having one in the kit will help keep you focused. Often when one confronts a serious motorcycle accident, it is not uncommon for people to blank out about what needs to be done due to shock caused by the incident. A chart or notes will help a lot.
MoreBikes, a UK publication produced an excellent four part series of articles that dealt specifically with First Responder First Aid to a motorcycle accident from December, 2023 through to March 2024. Please have a look at their full articles and consider subscribing. They are doing all of us a great service by addressing this issue.
As someone who has attended nearly 150 motorcycle accidents over my 43 years of emergency responses, I can’t emphasize enough how crucial the first four minutes are after a serious incident. The actions of the first responder may mean the difference between life and death.
The care you provide as the first person on the scene is critical in the event of serious spinal or head injury in particular, as is trauma that creates a major bleed to the motorcyclist. But before you rush in to help, it is essential to have situational awareness, and thereby ensure that you don’t contribute to the problem by becoming a victim yourself.
Secure the scene first, to ensure you and the victim are not struck by any other vehicles.
The following are a series of steps you need to take in order of importance. They are not all-inclusive. If a paramedic, doctor, or nurse arrives on the scene, the person with the most medical knowledge and training should take the lead until the arrival of emergency personnel on the scene.
First, immediately call 911 or have the first arriving additional person do so if you are too busy stabilizing the patient. Don’t assume that someone else has made a call. There are a variety of acronyms used depending on your location or country that will assist in providing an accurate report to the 911 or emergency operator.
One such acronym is ISBAR. It stands for the following information to be provided to the call taker.
I – Introduce yourself.
S – What is the situation?
B – What’s the background? Preceding events or known medical problems.
A – Your current assessment of the situation.
R – Response. What response do you require?
If you have more than one victim, ensure you assess or triage the victims quickly and deal with the most severe and life threatening injuries first.
Again, ensure that the scene has been secured. Ensure that vehicle traffic is stopped and use bystanders or other vehicles to block the road so that vehicles will not drive through the accident scene. Have someone put out flares, cones, or strobes if you have them about a hundred yards ahead of the site to warn drivers to stop. Of course, you need to do this in both directions and flag down vehicles if at night, ahead of the incident location.
Patient Assessment
Assessment has to be quick, but thorough. Look for these five critical factors.
- Bleeding: Where and how much?
- Unconscious: Is the person unconscious or very drowsy?
- Respiratory Distress: Is the person breathing, or having difficulty breathing?
- Pain or numbness: Where is the person experiencing pain or altered sensations (numbness or total lack of feeling).
- Skin changes: What is the color of the person’s skin, and if there are injuries to extremities, what is the color of the limb below the actual injury site? (Red, White, Blue)
Upon the initial assessment, determine whether the patient is responsive or not. If he is responsive and not having difficulty breathing, leave the helmet on. Without knowing whether the person has suffered a critical cerebrospinal injury, one should not remove the helmet, unless first aid mandates it, such as having to perform CPR. Leave the helmet removal for an arriving medical professional to remove it.
If a bleed is found, it must be dealt with quickly. The acronym R.E.D. stands for Rest: place the patient on their back (as long as they are comfortable doing so. Remember that the potential for a serious spinal, neck, or cranial injury exists. If the patient is responsive and complains upon the advent of movement, stop and pad the person in the position they were found. If not, Elevate the injury (extremity) and apply Direct Pressure to a bleed. If the bleed does not respond to direct pressure, a tourniquet is required. Apply the tourniquet as close to the injury site as possible. Mark down the time with a pen and write the time on the patient’s forehead with the letter T. If transport to a medical facility is going to take more than an hour, relieve the pressure on the tourniquet for up to ten minutes, monitoring blood loss.
If the person is having difficulty breathing, sit him up and prop him or her in this position. It will aid in relieving pressure on the lungs. If the person is not breathing, begin CPR immediately. Have one person perform compression, while the second person breathes the patient. If you are alone, do one person CPR. Below is a short video on CPR, if you are not trained. Any compressions and breaths will help, so don’t be afraid, it still has to be done. Performing CPR may make a difference in the patient’s survival. If you haven’t taken a course, I recommend you do so.
Leave the helmet removal for an arriving medical professional to remove if possible. However, if it must be removed, it requires two people to remove the helmet safely. One person needs to provide head, spinal, and neck support by placing his hands on either side of the patient’s head and holding it stable. If the person needs to be placed on his back, try to employ a third person to assist as and person will align the head with the movement of the body, while one person synchronizes the torso, and a third person rotates the hips and lower extremities in unison.
The following diagram illustrates the proper removal of the helmet. Again, this should only be considered if it is essential. Otherwise, leave the helmet removal to a professional medical person trained in its removal.
After stabilizing the scene your assessment should immediately include the ABCs, otherwise known as Airway, Breathing, and Circulation, followed by a head-to-toe check for bleeding. Always protect the person’s spine, head, and neck alignment while checking for bleeding. D is for Disability. Ensure spinal protection. If bleeding is found, E is next, which is to Expose the injury site. Once exposed, apply direct pressure to the bleed, and if the injury is to an extremity, raising it will assist in controlling the bleed.
If you can determine the mechanism of injury as this will help first responders. If there are witnesses, have them write down what they saw. Then after your primary assessment and treatment, if the patient is conscious, determine vital signs, (responsiveness, heart rate, skin, respiration, temperature, pupils). Write them down and monitor them every five minutes for changes. Ask the patient if he has any medical condition that may make his situation worse, such as allergies, medications, history, etc.
Provide all these details and information to the police and/or EMTs upon arrival. Try to stay calm, not just for your sake, but to assist the patient. If an injury is serious, shock is a real consideration. You being calm may well help the injured party to stay stable. Reassure the patient and if you have a blanket, cover the patient and keep his temperature stabilized.
Don’t be afraid to help. Any help is better than none, and as a good samaritan, if performing medical aid to the limit of your ability, you are protected from liability, so just help.
Ciao…
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