30 July 2018

National Road Victim Month: How to treat an Unresponsive Casualty

National Road Victim Month

National Road Victim Month. National Road Victim Month is held annually in August to remember people who have been killed or injured on our roads. As well as honoring people that have been lost and injured, it is also a great opportunity to raise awareness to make our roads safer.

The likelihood of having been in a car accident or knowing someone who has is highly likely, but would you know how to behave if you came across the scene of a serious car crash? 

The following is a step by step approach as guidance should you be the first on scene at an accident:

  • When approaching an accident scene it is really important to ensure your own safety. Make sure that all traffic has stopped and it is flagged up that there has been an accident otherwise there may be additional casualties. 
  • If other people are around; get them to phone the emergency services – if you are on your own, assess the situation and treat any life threatening conditions first.
  • Quickly establish how many vehicles have been involved and assess the occupants of all the vehicles to ensure no one has life threatening injuries
  • Quickly check if quiet casualties are responsive: – if there is no response check if they are breathing. If they are unresponsive and breathing ensure they are in a position where they are leaning forward or to one side in a position where the airway will remain open. Move them the minimum necessary and avoid twisting them. Keep talking to the casualty calmly as they can hear you even if they are unconscious. Keep them warm.
  • Support the head and neck to avoid them twisting – do not cover their ears, keeping talking to them calmly and keep checking that they are still breathing
  • If the person is not breathing you will need to resuscitate – if you are on your own and have not called an ambulance – do this now and ask their advice as to the best way to resuscitate, as this is not easy to do in a car.
  • Only remove an unconscious person from a vehicle if there is an immediate danger to their life from fire, flood, and explosion….ask the emergency services over the phone for their advice as to what you should do. It is very difficult to remove an unconscious person from a vehicle and there is a major danger that you could worsen their injuries and injure yourself in the process.
  • Conscious casualties should be entrusted to the care of bystanders and removed from the wreckage to a safe area. Be aware of confused and dazed casualties who may wander into danger. Brief the bystanders to keep the casualties warm and calm and help them to contact next of kin. Look for any major bleeding and life threatening injuries and treat these first.
  • Note the nature of the wreckage and be aware of possible injuries as a result: bodies are softer than metalwork, so if there is major damage to the vehicle it is possible that there could be internal injuries to the casualty – ensure the bystanders notify you if there is any change in the casualty’s condition.
  • People thrown from horses, motorbikes or bicycles are at particular risk of damaging their pelvis. If you know how to stabilise someone’s pelvis then do this and keep monitoring them for signs of shock as a fractured pelvis can lead to internal bleeding.
  • Anyone trapped in a vehicle should be monitored carefully and the emergency services notified immediately. If someone is crushed, note the exact time when the accident happened as this is important in deciding on how and when to release the casualty). If there are additional people around, show them how to support the person’s neck to avoid them twisting as there is the possibility of a spinal injury.
  • If there is severe bleeding this will need to be controlled – wear gloves and apply dressings.
  • If a motorcyclist is involved only remove their helmet if they are unconscious and there is no other way to assess their breathing or their airway is in danger. There is usually a way of lifting the visor, it may be sensible to loosen their chin strap.
  • If a casualty has been hit by a car and they are lying on their back unconscious and breathing – they should be carefully rolled into the recovery position to keep their spine in line. This should ideally be done with the support of others to avoid twisting the spine.
  • (If you have received advanced training on MILS and recognition of early airway obstruction and are confident that you are able to react quickly if their airway is in danger – then maintain MILS and continuous airway monitoring and roll them into the recovery position immediately should they begin to obstruct).
  • If a casualty has been hit by a vehicle or thrown from one and they are conscious in the road, they should be encouraged to keep still. Ensure that someone is directing traffic and maintaining safety. Support their head and neck, keep them warm and dry and wait for the emergency services.


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Advice from First Aid for Life