Collisions on the Road - Safety Advice

[RescueRanger]

Hello,

Continuing on from my theme of posts on first aid, today I will be focusing on what immediate actions you can take when you encounter an accident on the road, be it as a victim or a passer-by. So why is it important to consider road safety? Every day in Pakistan thousands of people get injured on roads, according to International Journal of Medicine Trauma RTC's(Road Traffic Collisions) are the leading cause of death for adults under 44 years age.

So lets start off with the basics: Road Safety

Roads are busy with cars, buses, taxis, bikes and pedestrians. According to available data for 2009 to 2020, a total of 104,105 accidents are reported in Pakistan including 44,959 fatal and 59,146 non-fatal accidents. Due to these accidents, 55,141 people have died while 126,144 were found injured. [1] According to available information from Rescue 1122 for the period between 2013 and 2020 the largest contributor to trauma injuries in Pakistan have been road traffic collisions with over 83% involving motorcycle users within the peak earning age of 21-30 years old and the majority of victims earn below 15,000 PKR.

[Image source Rescue 1122 - Used with Permission]

Pedestrians and Child Safety​

Children struggle to judge speed and distance until they are at least eight.

• Show young children you’re serious about them holding your hand near the road. Toddlers may try to fight it but it’s a good time to stay firm. Especially with unpredictable traffic and distractions.
• You can start to teach the Green Cross Code: (stop, look, listen, think and cross) from around five years. If you’ve forgotten your ‘stop, look, listen and think’, you can easily find the rules online.
• Many people, especially teenagers, get distracted by their phones when they are out. As a result, they are less aware of dangers in their surroundings such as other people or traffic. If your teenager insists on wearing their headphones, encourage them to opt for the ear bud types and ideally only use one side.
• Children learn by copying what you do. Now more than ever, it’s helpful to set a good example before you step off the pavement.

Cyclists & Motorcycle riders​

Cyclists and Motorcycle riders are particularly vulnerable road users. It is vital that all riders know what to do (and what not to do) if there is an accident. If you are cycling with children and teenagers, reinforce the importance of not overtaking lorries, buses and other large vehicles on the inside lane. Explain about their blind spots.

The simplest way to protect children (and yourself) is to wear a helmet every time Even if it’s a quick cycle around the block or down to the park.

[Whilst ingenious, this will not protect the head of the user in this photo should he meet with an unfortunate accident].

All road users should have basic first aid supplies with them, even if it is just a couple a triangular bandage.

Drivers​

It’s mind boggling the difference speed makes to a child’s chances of survival if hit by a car. 20 mph means most children will survive, just more than 20 mph and nearly all will die, or at the least experience serious life-changing injuries.

• It is incredibly important to slow down in built-up areas or where you seeing children playing. It only takes a moment to take a life.
• Avoid the temptation to look at your phone when driving. If you get into the habit of keeping it out of reach, it makes that easier.
• No matter how short your journey, remember to use the right child car seat or booster seat for your child’s weight and height.

What to do in the event of a road accident​

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

First steps:​

• When approaching an accident scene it is really important to ensure your own safety. Make sure that all traffic has stopped. Ensure everyone is aware that there has been an accident otherwise there may be additional casualties.
• Be aware of oncoming traffic to ensure that it is not posing an additional danger. Note if there is any fuel spillage or potential fire risk – turn off car ignitions if possible. Put on vehicle hazard lights and use a warning triangle if there is one available.
• 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. Assess the occupants of all the vehicles to ensure no one has life threatening injuries.

Remember that a road traffic collision may have more than one casualty and you may be the only person trained or skilled to respond. This response requires some thought.

You can only do so much, so do the BEST you can.

STOP

THINK

and then ACT!
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Call emergency services early you can use the following numbers 15, 1122, 911. Remember when you call an emergency number use the following mnemonic:
L: Location [exactly where you are, landmarks, road names, buildings, street signs, fixtures, are there any barriers/hazards etc]
I: Incident [What has happened, be exact]
N: Number [ Give your telephone number in-case the control need to call you back]
E: Exact number of people injured and the exact level of their injuries or other risks/hazards you can spot/see safely.

Check the quiet ones first:​

• People screaming, crying and making a noise have to be breathing – your initial priority is therefore to check anyone quiet and not moving.
• 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.

[people can often suffer with soft-tissue or musculoskeletal damage to the c-spine (the section of the spine that runs from the base of the skull down the neck) -

It is important that YOU DO NOT MOVE ANYONE WITH A SUSPECTED C-SPINE INJURY - Approach them from the front maintain eye contact with them and tell them to keep looking in front and to not move their neck- then keeping them seated in the position they were stabilise their neck as shown in this video. [IMPORTANT: This video is aimed at Emergency Medical Technicians - as a first aider you will only need to follow steps from 0:00-0:32 of this video and keep the persons neck secure until ambulance arrive]. ONLY MOVE THE CASUALTY IF THEY STOP BREATHING, ARE BLEEDING EXCESSIVELY OR THERE ARE HAZARDS SUCH AS RISK OF FIRE.

Important checkpoints:​

• 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 in 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 the 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.
• You should monitor anyone trapped in a vehicle carefully and notify the emergency services immediately, this includes the exact time of the accident. 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.
• Wear gloves and apply dressings if trying to control severe bleeding.

Be careful how and when you move them:​

• Only remove a motorcyclist’s 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. This video shows the safe technique for single person emergency helmet removal:

• 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 include the support of others to avoid twisting the spine.
• If a casualty has been hit by a vehicle or thrown from one and they are conscious in the road, they should try 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.

I hope you have enjoyed reading this post and will learn something from it. I will continue to post on topics of safety from time to time to keep us all safe, healthy and able to look after ourselves, our families and community.

[1] Memhood A (2021). Alarming Figures of traffic accidents need attention. The News Pakistan. Nov 2021. Available online: https://www.thenews.com.pk/print/910436-alarming-figures-of-traffic-accidents-need-attention