Ready Hands · Seoyeon Kim
Chapter 9: Road Accidents: Making the Scene Safe
What Can Happen
A care worker is driving a woman she supports home from a day centre. A little ahead, she sees a car on its side at the edge of the road and a motorcycle lying further along. Other cars are slowing down, and nobody has got out yet. The care worker's first thought is to stop and run to help. Her second thought, the one her training gave her, is to make sure that she and the woman in her car do not become part of the accident.
A road accident is one of the most dangerous places to give first aid, because the traffic does not stop for you. This chapter explains, step by step, how to arrive at a road accident safely and how to call for help and check the people involved without putting yourself or them in more danger. It explains what to do when the person you support is with you, why it matters to stay until help arrives, and what to tell the emergency services. The first aid itself is covered in other chapters: checking a person who has collapsed in Chapter 3, CPR in Chapter 4 and bleeding in Chapter 10.
Step by Step: Arriving at a Road Accident
Step 1. Stop only where it is safe. Do not brake suddenly in the traffic or stop on a bend where other drivers cannot see you. Slow down, look for a safe place at a sensible distance from the accident, off the road or at its edge, where you will not block the way for emergency vehicles, and stop there. If you cannot stop safely, drive on and call the emergency number as soon as you have stopped somewhere safe.
Step 2. Turn on your hazard lights to warn other drivers, and apply the parking brake. At night or in poor light, leave your headlights on if they help others to see the scene, as long as they do not dazzle drivers coming the other way.
Step 3. Put on a high-visibility vest before you get out, if you have one, so that other drivers can see you. Look carefully before you open the door, and get out on the side away from the traffic. If the person you support is with you, tell them what is happening and ask them to stay where they are for now; a later section of this chapter explains what to do next.
Step 4. Warn the traffic that is coming towards the scene. If you have a warning triangle, place it on the road at a good distance behind the accident, as the law where you live requires, but only if you can walk there safely; on a fast road it may be safer not to. Never run across the road or into moving traffic. If other people have stopped, one of them can stand off the road, well back from the scene, and signal to drivers to slow down.
Step 5. Look for dangers before you go near. Look and smell for fire, smoke and leaking fuel. Look for broken glass, sharp metal, fallen cables and vehicles that could still move or roll, and notice the traffic that is still passing. At night, use a torch to look, and point it at the ground so that you do not dazzle drivers. If there is fire or a strong smell of fuel, keep back and tell the emergency services. Your own life matters too.
Step 6. Make the vehicles involved as safe as you can, but only if you can do so without danger. If a vehicle's engine is still running and you can reach it safely, switch the engine off. Do not smoke, and ask others not to smoke or use anything that makes a flame near the scene. Never try to turn a vehicle upright or push it.
Step 7. Protect yourself before you touch anyone. Put on disposable gloves from your first aid kit if you have them, and keep your phone with you. If the scene still feels unsafe, stay back, call the emergency number and tell the operator why. Giving clear information from a safe place is real help.
Step by Step: Calling and Checking the People
Step 1. Count the people involved. Look in and around every vehicle, and look further away as well. A person may have been thrown from a vehicle, a motorcycle rider may be lying some distance away, and a person walking or cycling may have been hit. Look for children, and for people on the floor of a vehicle or behind the seats. Knowing how many people are hurt helps the emergency services send enough help.
Step 2. Call the emergency number, or ask a bystander to call while you check the people. Put the phone on speaker. Tell the operator where you are, using the road, the direction of travel and any landmarks or junctions, as Chapter 2 explains. Say how many vehicles and people are involved, whether anyone is trapped, and whether there is fire, fuel or another danger. Stay on the line and follow the operator's instructions.
Step 3. Do not move an injured person unless there is danger, such as fire, a strong smell of fuel or traffic that cannot be stopped. Moving a person who is hurt can make an injury worse, especially an injury to the neck or back. If a person is lying in the road, ask others to warn and slow the traffic from a safe place off the road, and tell the operator, so that the person can stay still where possible. A person sitting in a vehicle is usually best left in the seat until the emergency services arrive, unless the person is in danger there.
Step 4. Talk to each person and keep them still. Speak calmly, say who you are and tell the person that help is on the way. Ask the person not to move the head or neck. Stand or kneel where the person can see you without turning, so that the person does not twist to look at you. Ask where it hurts, and listen.
Step 5. Check each person who does not respond. Speak loudly and tap the shoulders gently, as Chapter 3 explains, and check breathing for no more than 10 seconds. If the person is breathing normally, keep the airway open and watch the breathing until help arrives, moving the head and neck as little as possible in the way courses teach; if the person vomits or you must leave to get help, the recovery position protects the airway. If the person is not breathing normally, tell the operator and start CPR as Chapter 4 explains; the person may need to be moved carefully onto the back on a firm surface for this.
Step 6. Leave a motorcycle rider's helmet on. Taking off a helmet can harm the neck. The helmet comes off only if it must come off to keep the airway open or to give CPR, and then only in the way taught in courses, ideally by two people, one of whom supports the head and neck. If the visor can be lifted, you can talk to the rider and watch the breathing through the opening.
Step 7. Help a person who is trapped by staying close. If a person cannot get out of a vehicle, do not try to pull the person out unless there is danger such as fire. Tell the operator that someone is trapped, because the emergency services have the equipment to free people safely. If you can reach the person without danger, talk to the person through the door or window, and ask the person to keep the head still. If the person is awake and you can reach safely, you can support the head gently in the position you found it, as courses teach. Reassure the person and keep watching the breathing.
Step 8. Give first aid for what you find, and stay. Press firmly on heavy bleeding, as Chapter 10 explains. Keep the person warm with a coat or blanket in cold weather. On a hot day, make shade for the person, because lying on a hot road can quickly add heat illness to an injury. Give the person nothing to eat or drink. Stay with the person and keep talking until the emergency services take over.
When the Person You Support Is With You
When you come across an accident while you are with a person you support, your first responsibility is to that person. The person may be frail, unable to move quickly or easily frightened, and may not understand what is happening. Before you think about anyone else, decide where the person you support will be safest, and make sure the person is there. Only then can you decide how much you can safely do for others.
If your vehicle is parked safely off the road and out of the way of traffic, the person you support may be safest inside, with the seat belt on and the doors closed. On a hot day, keep the vehicle cool with the air conditioning running, and never leave the person alone inside a hot, closed vehicle, as Chapter 8 explains. If the vehicle is at risk of being hit, help the person out on the side away from the traffic and to a place well away from the road, such as behind a barrier or on the grass beside the road, if this can be done safely.
Explain to the person in simple words what is happening and what you will do: that there has been an accident, that you are going to call for help and that you will stay close. A calm voice helps a person who is frightened or confused. If the person becomes upset and needs you, stay with them. You can still help the people in the accident by calling the emergency number and giving clear information, which is often the most useful thing anyone can do.
Do not go so far away that you cannot see the person you support or reach them quickly. If other people have already stopped and are helping, it may be best for you to make the call and then stay with the person you support. When you can, call your workplace as its procedures say, so that your colleagues know where you are and that you may be late. If the person you support was shaken by what happened, tell your workplace and the family, and watch later in the day for signs that the person is upset or unwell.
If your own vehicle is involved in a collision while the person you support is with you, the same order applies. Stop safely, turn on the hazard lights and check whether the person you support is hurt. Ask the person whether anything hurts, and look for signs of injury, especially if the person is frail or cannot tell you. If the person is hurt, or if you are not sure, call the emergency number and keep the person still in the seat unless there is danger. Afterwards, follow your workplace's procedures: tell your supervisor and the family, and write a report even if nobody seems hurt, because some injuries in older people only show later.
Staying Until Help Arrives
Once you have called and given first aid, stay at the scene until the emergency services arrive, unless it becomes unsafe. A person who is hurt is calmer when someone stays and talks to them, and the emergency services may have questions that only you can answer. If the scene becomes more dangerous, for example if a fire starts, move back to a safe place and tell the operator.
Use the waiting time well. Keep watching the breathing of anyone who is badly hurt. If others have stopped, give them simple tasks: one person can warn the traffic from a safe place off the road, another can look out for the ambulance, and another can bring blankets or water for the helpers. Clear tasks keep people calm and stop bystanders from crowding around the people who are hurt.
When the emergency services arrive, let them take over and tell them what you know. Say how many people are hurt, what you saw of each person, what first aid you gave and when, and any changes you noticed. If you saw the accident happen, tell the police what you saw, in your own words and without guessing. Give your name and contact details if they ask, so that they can reach you later. If you have to leave before help arrives, because the scene becomes unsafe or the person you support needs you, tell the operator first.
Respect the dignity of everyone involved. Do not take photographs or videos of people who are hurt, and ask others not to. Do not share details of the accident or the people involved online. People who are hurt on the road have the same right to privacy as the people you support.
An accident can stay with you afterwards, even when you did everything well. It is common to feel shaky, to keep replaying what you saw or to sleep badly for a few nights. Write down what happened for your workplace's report while you remember it clearly, and talk to a colleague or a supervisor. Chapter 15 explains more about looking after yourself after an emergency.
Things to Check
Check that your vehicle carries a high-visibility vest within reach of the driver's seat, a warning triangle as the law where you live requires, a first aid kit with disposable gloves, and a blanket.
Check that you can find the hazard light switch at once in every vehicle you drive for work, without searching for it.
Check that your phone is charged before every drive and that you know how to find your location on it, so that you can tell the operator exactly where you are. Check also that the emergency number of the country where you work, and of any country you travel to, learned from official information, is saved in it.
Check that you know your workplace's procedure for an accident on the road, including what to do with the person you support and whom to call.
Check before every drive how quickly the person you support could get out of the vehicle, and whether you would need help to move the person safely.
Check whether your first aid course covers road accidents and helmets. Practising these steps with others makes them easier to follow when traffic is passing and you feel nervous.
Check the first aid kit in each work vehicle regularly. Replace anything that has been used, make sure there are enough disposable gloves, and check that the torch works.