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Accidents

 "What to do at a bike accident scene"
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1) Get to victim, reassure, establish communication, first evaluation of victim
 
After a person has gone down, they will be in a confused and scared state. They probably don't know what happened when they went down. They may be confused, frantic, etc., and often the only thing on their mind will be their bike. It is important to reassure them and to make sure they will not try to move or get to their bike. You can tell them the following:
“You've been in a motorcycle accident. It is important that you do not try to move. My name is Jason (whatever your name is).”
Tell them the ambulance is coming (assuming someone has been sent to get one!) If your name is something like “Chainsaw” or “Mega-death”, tell them your name is John.
 
Be careful what you say around the victim, even if they are unconscious. Hearing works in the unconscious state and if you say something like, “Boy, is this dude messed up bad! Maybe we shouldn't call an ambulance after all!”, it's going to register at some level with the person and can do nothing but harm. How you say things will be important as what you say; keep (or at least sound) calm and it will reduce the panic of everyone else present.
 
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2) Safety factors
 
An accident scene can be a hectic place with a lot of things going on at once. It is important to keep safety in mind; if you are helping someone lying in the middle of the road and a semi comes barrelling down on both of you, you aren't going to do that person much good.
 
a) Traffic If people are available, get someone uproad and downroad to wave down traffic. This is especially important in tight twisties where they may not have time to stop after seeing the accident site.
 
b) Hazardous material spills (petrol, oil, brake fluid) People and vehicles will slip on this stuff. If ambulance personnel slip on oil while carrying the victim, it is bad. Either clean it off the road or indicate to everyone where it is.
 
c) Power lines If power lines are down around or near the victim, ambulance crews may not be able to get near the person until they are shut off. It is important to call the local utility company to get these live wires turned off at the same time an ambulance is called. If the ambulance arrives and
they are still live, they will have to call the utility company and wait for them to come out, wasting a lot of precious time in the Golden Hour.
 
d) Fire People who smoke tend to light up under stress. Ask these people to either extinguish their smokes or move away from the flammable materials and/or bikes. It is easy to forget something obvious like this in a stressful situation like an accident scene.
 
e) Safety circle Establish a few people around the immediate accident scene to help direct traffic, to point out fluid spills, and to warn people who may want to light up (see (d)).
 
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3) Best-trained individual (medically-wise) attends to victim (U-ABCC)
 
The person with the most training (first aid, CPR, etc.) attends directly to the victim. Assuming the victim is lying on the ground, this person should sit behind their head and should stabilize his or her head to avoid unnecessary movement (i.e. hold their head still). Assume the person has a back/neck injury and any unnecessary movement could risk paralysis.
 
This person should be doing ``U-ABCC'' at the arrival on the scene and every 5 minutes thereafter:
 
U [Unresponsiveness] (?) Ask the victim three questions and document their responses;
 
Who are you? Where are you? What time of day is it? (Or asking what day of week it is would be fine also. Many people do not know what time of day it is without a watch even in a normal state.)
 
A [Airway] Is there something to impede their airway? Gravel in the helmet, something down the throat? This needs to be cleared immediately, without helmet removal if at all possible.
 
B [Breathing] Is the person breathing? Determined by listening, watching their chest, feeling for breath, etc.
 
C [Circulation] Check the pulse on the throat initially and subsequently on their wrist. This is the carotid artery, right next to the wind pipe/adam's apple on either side. If pulse is not present, remove helmet if necessary and begin CPR immediately. When checking pulse on their wrist, do not check with thumb; use the two fingers next to the thumb.
 
C [Cervical] Spine Immobilization Support the victim's head and make sure
they don't move it. CONSIDER EVERY MOTORCYCLE ACCIDENT A HEAD INJURY; CONSIDER EVERY MOTORCYCLE ACCIDENT A CERVICAL/BACK INJURY! 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 Jason. Answer me without moving your head. We don't know if you have a neck injury or not. An ambulance is on the way.''
 
Again, make sure that the victim does not move at all, their head or any other part.
 
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4) 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.
 
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4a) helmet removal procedure if airway blocked or no respiratory action.
 
This is the method recommended by Orthopedic Surgeons. It requires two people.
 
Remove glasses and unbuckle the chinstrap. One person should be to the side of the head of the victim and the other person should be directly behind the head of the victim, stabilizing the head to avoid excess movement (as seen in (3)).
 
The person on the side puts one hand behind the victim's head supporting at the base of the skull (not on helmet). They put their other hand on the jaw bone/chin (again, not on helmet). They will be supporting the head, so it is important to get a good solid grip. Keep some tension in the arms so that if the person pulling the helmet slips the victim's head won't drop.
 
The person sitting behind the head will then slowly pull the helmet directly back and off of the head. Watch out for catching the nose on the chin-guard on full-face helmets, as well as ears and earrings.
 
After the helmet is off, put a leather jacket or something under the head of the victim! If the person supporting their head lets go, their head will drop a good 4 inches or so. This would not be good. If possible, it would be best to have a third person ready with something to place under the victim's head once the helmet is off.
 
After the helmet is off, the person behind the head should again hold the victim's head to promote cervical immobilization.
 
AGAIN, THIS IS ONLY TO BE USED IN SITUATIONS WHERE THERE IS NO OTHER OPTION! Leave the helmet on until the ambulance personnel arrive if at all possible!
 
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5) After initial evaluation of seriousness of injuries, call for ambulance
 
After there has been a quick evaluation of the number of injured people and just the most preliminary guess of seriousness, someone has to be sent to get an ambulance. Remember that an ambulance can only support one truly injured person.
 
It is important to remember that a lot of the injuries that don't look serious to us could very well be life-threatening and injuries that look fatal are relatively minor. Don't get fancy with the initial seriousness evaluation. If you can't tell, assume it's Urgent!
 
Send one or two bikes to the nearest house.
 
When you go to the door, REMAIN CALM... THINK! Take a second and a couple of deep breaths. It will not help to have this biker person in a very excited state on the doorstep of some person's home. The people will be far more receptive to someone who looks like they have a grip on themselves.
 
Do not ask directly for entry into their house; something like ``There has been an accident. Please call 000.'' There is no need to specify that it was a motorcycle accident to them (it is important to let the Emergency Medical Services dispatcher know that it was a motorcycle accident, however). It is less threatening to ask to call 000 than it is to ask to come in and use their phone.
 
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5a) Things to tell Emergency Medical Services dispatcher
 
General tips/things to cover when talking to the EMS dispatcher:
 
a) there has been a motorcycle accident
 
b) need an ambulance
 
c) the # of injured people (and how badly injured they are). A severely traumatized person will require an entire ambulance to themselves, so it is important to give the EMS dispatcher some idea of the scope of the accident. If they only send one ambulance and there are two people who need one immediately, it will be a problem.
 
d) location of accident (get help from the people whose phone you're using, they should know how to describe their location best)
 
e) You (the caller) hangs up last! The EMS dispatchers are well-trained and will get all the information they need from you before hanging up. Stay on the line until they do.
 
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5b) Things that may be necessary for victim
 
It is helpful if you know some special equipment is going to be necessary to tell the dispatcher;
 
a) Helicopter: Most rural areas cannot handle severe trauma and they may need to get the victim to a trauma center via helicopter. If they know there may be a need, they can get the helicopter ready to leave for the rural hospital when a doctor establishes the extent of the injuries.
 
b) fire: Should the fire department be called in?
 
c) Jaws of life
 
d) Utilities See (2-C) about downed power lines above.
 
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6) Document personal information if possible (victim may pass out)
 
Before the ambulance arrives, if possible, document information about the victim. They may become unconscious and it will be helpful to have information like:
Full name Next of kin (plus phone number) Age, date of birth Doctor
 
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6b) AMPLE documentation
 
Remember that ``There is AMPLE time to document this before the ambulance arrives.'' Again, this will be very helpful to the paramedics if the victim passes out.
 
A Are you allergic to anything?
M Are you on any medications? Street drugs?
P What's your past medical history?
L Last meal - when did you eat last? (will help anesthesiologist if one is necessary)
E What were the events leading up to the injury? Document the mechanisms of injury. If the doctors and paramedics have some idea how accident occurred, it will give them better ideas on what kind of injuries to look for. Did the person low-side and slide for a while on one of their sides? Did they go over the bars? Did they head-butt a solid object, such as a car? If they went over the bars, is there any obvious damage to the tank/handlbars which might indicate they hit the lower abdomen/groin area? This kind of stuff could help the doctors/paramedics.
 
  7) Wallets, purses, rings
 
Do not go rooting through personal effects of the person. There should be no need to go through their wallet or purse for insurance information; the hospital personnel will deal with all of that. If there is some important reason that you need something from their wallet or purse, make sure you have at the very least a witness! Preferably a law enforcement officer if possible. If the person is conscious, ask first and if they say ``no'' then don't push it.
 
If the person has rings on, the fingers may swell up and it is important to get them off. Consent is paramount if the person is conscious. Make sure there is at least one witness when removing them.
 
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8) Have person check pulse every 5 minutes & document it
 
Every 5 minutes the pulse should be checked at the wrist. If the pulse goes away at the wrist, check at the throat. This is a late sign of shock (see 9).
 
Write down the number of beats per minute and the time you took the measurement.
 
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8a) Have person check breathing every 5 minutes & document it
 
Just like the pulse, check number of breaths per minute, the most reliable method being by placing your hand on the person's chest. Obviously if the victim is female it would be best to have another lady do this if at all possible.
 
Try to check their breathing rate without their knowing it. If they know you are counting their respirations, they may unconsciously alter their breathing rate.
 
Record this number along with the pulse every 5 minutes. Also note the type of breathing; fast, shallow, yodelling, gurgling, labored, easy, whatever. Even in layman's terms it may be useful to the paramedics.
 
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9) Watch for signs of person going into shock
 
Signs of shock:
a) Inability to answer the 3 questions coherently (Who are you, etc.)
b) Pale, cool, clammy skin
c) Delayed capillary refill press your fingernail so that it turns white. It should turn back to pink in less than 2 seconds. If it takes longer, that is not a good sign.
d) Radial pulse (pulse at the wrist) goes away but there is still a pulse on the neck
 
There isn't much we can do once someone starts going into shock, but a few minor things that may help:
 
a) Assure adequate breathing. This really comes with the AB of U-ABCC.
b) Loosen restrictive clothing.
c) Reassure victim.
d) Keep the person warm (not too hot though).
e) Elevate the feet ~6 in. This is actually a judgement call since you shouldn't really do that with suspected spinal injuries.
f) Control bleeding. This is probably obvious but if you don't realize the victim is bleeding and they are rapidly going into shock, this should tell you something.
g) Immobilize fractures. This helps relieve pain and control bleeding.
 
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10) Stop bleeding, using sterile bandages/dressings if available
 
Two important things here are to
(a) stop any bleeding as soon as possible and
(b) keep the wounds sanitary as much as possible. Peripheral limbs are commonly lost to infection, but given the choice between stopping bleeding and using a non sanitary cover, using the non sanitary wrapping is preferred. Blood loss is bad.
 
If sterile dressings are not immediately available, women in the group may be carrying sanitary tampons, or Kotex napkins. Either can be used as a sterile dressing, although obviously the sanitary napkins would be superior.
 
EXCEPTION: If there are cuts anywhere on the head, do NOT apply pressure. If there is a bone chip it is possible to push it into the brain. It is also possible that stopping the flow of blood or cerebral spinal fluid can lead to a buildup of pressure on the brain which is not good. You should still bandage the cuts loosely.
 
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11) In case of femur injuries (extremely common in moto accidents), check
for blood loss
 
80% of motorcycle accidents involve someone going over the top of their motorcycle. Femur (the ``thigh bone'') injuries are very frequent. There are huge arteries that run along the inner thigh; if these are compromised the person can bleed to death in a very short amount of time. It is important to minimize bleeding in this region! Use a pressure point above the cut to control blood flow out of the femur artery.
 
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12) When ambulance arrives
 
Before the ambulance arrives, send people to the intersections in all directions to watch for/direct the ambulance.
 
When the ambulance arrives, it is important to stay out of their way as much as possible. Meet them and identify yourself as being ``in charge'' and to be the person to contact if they need anything (bikes moved, people moved, whatever). Make sure you
 
a) Provide accessable parking for ambulance
b) Let EMT's know who's in charge
c) Give factual account of accident (``And then the car comes along at 154 feet per second and hits our buddy here!'' is probably not going to help anything). At 40 MPH, there are 60,000 units of kenetic energy. At 50MPH, there are 120,000. It is IMPORTANT for medical personnel to have an
HONEST estimate of the speed and circumstances at the time of the accident.
d) Give them all of the information that has been written down (periodic vital signs and the three questions from U-ABCC at 5 minute intervals, personal information about the victim, etc.)
e) Give EMT's an honest evaluation of patient's drug/alcohol consumption
f) Stay back or leave if told
g) give EMT's time to work
 
It is important to give the ambulance people the most accurate information possible! If the person just had 10 beers in the past hour, tell them! They are not the law enforcement officials and their only immediate concern is the safety of the patient. By underestimating, trying to cover up, or not telling the whole truth, you are only keeping important information away from them which may be necessary for the safety of the patient.
 
If the helmet was removed, send it along in the ambulance. The doctors may use the visible damage to the helmet to assist them in what to look for in terms of injuries.
 
If there were leaking fluids, let the medical personnel know. The fluids may have gotten on the patient and they need to know if there was oil, fuel, brake fluid or something like that on an open wound.
 
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13) At the hospital
 
Only have one or two people in the Emergency Room at a time. If the doctors have questions and neither of the people in the ER know the answer, send one of them out to the other people to find out the answer. Crowding everyone into the ER will only make it more stressful and difficult for the ER staff to do their jobs.
 
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14) Dealing with law enforcement
 
As with the ambulance, when law enforcement arrives identify yourself as being “in charge”. Let them know that if there is anything they need, such as bikes moved or people moved, you are the person to talk to.
 
For them, walking on to a scene of bikers who are all in a very excited state is intimidating and this will help calm them and give them some easy way to control the bike people.
 
It is obviously important to do whatever the law enforcement officials ask.
 
Before the officers do arrive, try to not move motorcycle parts any more than necessary! They may need to take accident scene notes and by moving things around you may confuse the situation for them. Parts will need to be moved off the road to avoid further accidents, but move them directly to
the side so the law enforcement officials can determine roughly where it stopped if necessary. Try not to disturb the bike any more than necessary. (Petrol valve should be shut off, electrics turned off, bike propped up vertically, etc.)
 
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15) Thank yous
 
Officers often get little or no recognition for helping out on the scene. It will cheer all of them up to no end to receive some kind of thanks for their help; any of the following are appropriate
1: cards 2: in newspaper 3: in person
 
It will improve our image as bikers and rewards all those people who take time out of their own lives to help others. It is important!
 
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16) Couple of miscellaneous notes
 
Leathers will have to be cut off by medical personnel. Be mentally prepared for it. If they do not cut off your clothes, they will not be able to do a proper assessment of the wounds and you are not being treated properly! If you are conscious and insist that they do not cut your leathers, they cannot by law. If you are unconscious, it is implied consent and they will remove them if in doubt.
 
Over 50% of fatalities are alcohol related. I know it's a ‘cliche' but don't let friends drink and ride unless you're prepared to lose that friend.
 
Like I said earlier, in 80% of the accidents involve going over the handlebars. If your bladder is full, the extreme pressure can easily cause it to break. Make a pitstop by the bathroom before you leave.
 
In an emergency situation, psychological management is important. If a central person takes charge and is remaining calm, this will transfer to all of the other people on the scene and will help the victim far more than if everyone is overly excited and pumped with adrenaline. Take two deep
breaths when you feel yourself losing it.
 
Take basic first aid and CPR courses!  Go with some riding buddies or get your club to have a class!
 
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17) Four most important points from this:
 
The four most important things were
 
a) Stay calm
b) U-ABCC
c) AMPLE
d) Who are you/Where are you/What time of day is it?
 
IMPORTANT POINTS:
·          
1. To address the question about applying pressure to a head wound.
NO. Don't do this. You can hold a dressing over the wound to slow the bleeding but don't press down like you would for a LAC on the leg. There are exceptions, but for basic skills, good rule of thumb.
2. If you have a rider down and not moving, but he is breathing or is alert and oriented but doesn’t want to move. Like stated here, DON’T remove the helmet. However, if the helmet is to remain on the rider and you are maintaining C-spine. You MUST elevate the shoulders. The helmet will raise the head and can obstruct the airway due to positioning or even cause further damage to the C-spine by causing misalignment. The jacket you were going to use to stop the riders head from smacking the ground when you "let go" is a good source and when folded over a few times is just the right thickness to accommodate the thickness of the helmet.
3. When advising emergency services of the location of the accident mention any landmarks and nearby points that may assist them finding the location. It may be possible to provide a GPS location from someone attending with a GPS unit.


I C E- IN CASE OF EMERGENCY Apparently this is a standard procedure all paramedics follow at the scene of an accident when they come across your cell phone. ICE - 'In Case of Emergency' We all carry our mobile phones with names & numbers stored in its memory but nobody, other than ourselves, knows which of these numbers belong to our closest family or friends. If we were to be involved in an accident or were taken ill, the people attending us would have our mobile phone but wouldn't know who to call. Yes, there are hundreds of numbers stored but which one is the contact person in case of an emergency? Hence this 'ICE' (In Case of Emergency) Campaign The concept of 'ICE' is catching on quickly. It is a method of contact during emergency situations. As cell(mobile) phones are carried by the majority of the population, all you need to do is store the number of a contact person or persons who should be contacted during emergency under the name 'ICE' ( In Case Of Emergency). The idea was thought up by a paramedic who found that when he went to the scenes of accidents, there were always mobile phones with patients, but they didn't know which number to call. He therefore thought that it would be a good idea if there was a nationally recognized name for this purpose. In an emergency situation, Emergency Service personnel and hospital Staff would be able to quickly contact the right person by simply dialing the number you have stored as 'ICE.' For more than one contact name simply enter ICE1, ICE2 and ICE3 etc. A great idea that will make a difference! Let's spread the concept of ICE by storing an ICE number in our Mobile phones today! It really could save your life, or put a loved one's mind at rest . ICE will speak for you when you are not able to.


WRBA PC & Jo’burg PC Announcement: 
Yes, there are arguments for and against the dangers of riding a bike. So will there be for riding a car, walking, making use of public transport, etc. When it is your time: it is your time – irrespective of what your ride or where you are! However, we still believe that many deaths and accidents could have been prevented. Many lives were ended prematurely because we have hastened to our own end. We don’t need to be Christians in order to believe the following: “What you sow, you will reap.” Live by the sword, die by the sword. Many a biker has died an untimely death…     
 
We are not trying to take the fun out of biking or putting a damper on a great jol.  What we are saying is that there are consequences to everything we do.  
·         Alcohol and biking do not mix well.   If you know you still have to ride home, check your consumption.  
·         Speeding excessively on unknown roads or in suburban areas, especially at night, does not mix well.  
·         Riding when using medication or being sick does not mix well.   
·         Being in a negative state of mind or being totally the moer-in distracts your concentration. 
·        Don’t be a show off, ride according to your own ability and skill level.  We are not all Rossi’s. You can develop rider skills under controlled circumstances and proper environment.   
·         Wear the proper gear or you’ll have fun with a steel scrubbing brush later. (ATGATT – All The Gear, All The Time)  
There is a responsibility on each one of us when we swing our leg over the seat of the bike and turn the ignition. That responsibility is to our family, club members, friends and other road users. We have to accept that responsibility and be accountable every time we ride. If we can not accept this, we should not ride.   
All clubs have Presidents and most have Road Captains, and being one of these title bearers carries a huge responsibility. You are not there to win a popularity contest, you are there to protect your members – do not let your riders ride if they are not in a state to do so! Rather loose a member that resigns due to strict rules than standing at a grave site seeing the casket being lowered…  
Signed: WRBA PC & The Jo’burg PC.

  Have a look at this Web site:  www.ridetodie.com UK & USA.  
Hopefully it'll change the way you dress! ATGATT = All the Gear All The Time! - The way you decide to ride that road! 
If this has saved just one life then it's been worth it. 
In SA we have lost too many brothers and sisters, family, friends and even strangers - Let's get off our bleddy ar$e$ and do something about it instead of bitching and moaning about 'other' cagers! What are YOU doing for YOURSELF!
Also go to
www.motorcyclistonline.com - 50 ways to Save Your Life.

This might be a good time to remind everybody of 2 no, no's when riding motorcycles.

1. Do not ride without a license for when you are then involved in an MBA Medical insurance will not pay as you are illegally on the road. 

2. when riding, see to it that you have some sort of medical cover eg: hospital plan, accident insurance, medical aid.

Diederick sez:

WITH MY FIRST ACCIDENT AS WELL AS MY CURRENT ONE my wife had to fax my drivers licence to the medical aid the first working day. My first accident they didn't know for over a week if I was going to live or die (i believe in a gov hos i might have died), my medical bills are just over 1 mil, my back op alone was R 350 000, If i didn't have medical aid i would be paralyzed.

The bills of my current accident are currently sitting at close to R 400 000. REMEMBER ICU can cost up to R 11 000 or more per day 
Nobody wants to crash, but it is a real possibility when riding bikes so please hav your medical insurance in order, it is part of being ATGATT (All The Gear All The Time)


 
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