1. What should I do? A Rider’s Been Injured In an Accident…
Don Arthur, MD
Emergency Medicine Physician
Rider

2. Keeping Things in Perspective
No, you are not Superman.
You will not miraculously fix injuries and be included in the next edition of the Bible.
But…
You can save a life or a limb!
You can lessen suffering.
You can bring calm to a stressful situation

3. Good Samaritan Laws
Laws protect the general public when assisting a victim during a medical emergency.
Assume no medically trained person is available to assist the victim.
Protect a layperson if (s)he has good intentions to aid the victim.
Some laws protect medically trained responders
who follow normal procedures.
Victim may sue if a responder acts with malice
or recklessness.
Some states have penalties for those
who do NOT assist.

4. Good Samaritan Laws Four key elements:
Care rendered is performed as the result of the emergency
The initial emergency was not caused by the person
invoking the law
The emergency care is not delivered in a grossly
negligent or reckless manner
Aid is given with permission whenever
possible to obtain it
State laws vary widely… check them out at:

5. Mechanisms of Injury Blunt force trauma Penetrating injuries Abrasions
Head and neck injuries
Chest and abdominal injuries
Musculo-skeletal injuries
Penetrating injuries
Impacted objects
Road debris
Rider possessions
Abrasions

6. THE FASTER YOU GO, THE BIGGER THE MESS
Speed and Energy
Kinetic Energy = ½ MV2
At 80 MPH
FORCE OF IMPACT
At 40 MPH
SPEED 10 20 30 40 50 60 70 80 90
100
THE FASTER YOU GO, THE BIGGER THE MESS

7. Scene Management Remain calm and others will join you!
Assess the scene for continuing hazards – traffic, fire risk
Safety Circle – protect yourself and others at the scene.
Control traffic and bystanders.
Best trained responder should attend to victim.
Approach victim and introduce yourself:
Offer assistance to victim(s) and get a response.
Don’t argue with the victim.
Don’t move the victim.
Be careful what you say…
“You’ve been in a motorcycle accident and it’s important that you don’t move. An ambulance is on its way. My name is Don and I’d like to help you.”

8. ABCC-911 CAUTION ONLY IF UNCONSCIOUS! AIRWAY
Are there any obstructions to breathing?
Do not change head position unless
necessary.
BREATHING
Is the victim spontaneously breathing?
Are breaths regular and unlabored?
CIRCULATION
Check for pulse on the side of the victim’s neck or at the wrist.
Assess pulse quality (use your own as a reference).
Count the number of pulses/minute.
Don’t use your thumb.
IF RIDER IS INJURED
DO NOT
REMOVE HELMET
CAUTION

9. Airway Must have an open and unobstructed airway
Open the victim’s mouth without moving head
Clear the airway of any foreign material
Move jaw forward to move tongue forward

10. ABCC-911 Tell the operator: CERVICAL (NECK) SPINE
Assume there is a neck injury.
Anything you do can and will make it worse!
And the Good Samaritan Law may not apply if you do.
HELMET REMOVAL
Only if necessary to establish an airway
Should only be performed by two trained people
Requires constant head support and immobilization
Tell the operator:
Motorcycle accident with injuries
Number of injured
Severity of injuries
Location (use your GPS)
You hang up last
I see a
trauma center
in your future…

11. Gather Essential Information
IF VICTIM IS CONSCIOUS
Get as much pertinent information as possible
and write it down to give to ambulance crew
Name, address, phone number, age
Emergency information card?
Medical problems, medications, and allergies
Who should be contacted?
Vehicle insurance and towing preference
Helps emergency personnel
Victim may not be able to respond if
medical condition worsens
Establishes rapport with the victim

12. Accident Scene Facts
Ask victim what (s)he remembers about the accident
Speed, weather, road conditions
Minutes leading up to accident
Traffic patterns as accident evolved
Position of other vehicles and objects
Draw the scene
Note vehicle positions and directions of travel
Photograph scene
Don’t photograph victim without permission
This will assist medical personnel in assessing mechanisms of injuries and possible extent of unseen injuries
Victim may not later remember details essential for insurance claims

13. Don’s Simple Categories
First, Do No Harm!
Injuries you can’t do anything about (but can always make worse)
Head injury
Neck injury
Internal chest and abdominal injuries
Open fractures (bone has broken through the skin)
Penetrating injuries
Injuries you can do something about… and should
Open chest wound
External bleeding
Eye injury
Closed fractures
Injuries you can do something about…
but probably shouldn’t
Positioning for comfort
Abrasions

14. Injuries You Can’t Do Anything About But Could Make a Whole Lot Worse
Head injury – usually caused by striking a fixed object
Neck injury – can result in paralysis and death
Internal chest and abdominal injuries
Open fractures (bone has broken through the skin)
Penetrating injuries
FIXED OBJECT
COUP INJURY
CONTRA-COUP
INJURY

15. Injuries You Can Do Something About
And Should
Open chest wound
Air entering chest cavity will collapse lung
Apply occlusive dressing over wound
Tape in place only on three sides
External bleeding
Apply direct pressure at the site of bleeding
If severe, apply pressure at pulse point
No pressure to skull if fracture is suspected
Eye injury
Protect the eye from further injury
Closed fractures
Splint in place to avoid further injury

16. Injuries You Can Do Something About But Probably Shouldn’t
Positioning for comfort
Victim may ask you to move him to ease pain from injuries
Movement may make the injury worse and do nothing for the pain
You may not be covered by Good Samaritan Law for non-emergency or unnecessary treatment
Let the professionals perform all victim movement
Abrasions
Field treatment won’t improve eventual healing
May further contaminate the wound
Protect from further contamination
Do not put anything directly onto the
wounds except to stop significant
bleeding

17. Most Common Injuries ATGATT Bone Fractures – Open or Closed
Legs and feet
Arms and shoulders
Hands
Pelvis and hips
Back and neck
Road Rash
Head Injury
Internal Abdominal Injuries
Internal Chest Injuries
Bleeding from Injuries
Nerve Damage

18. ATGATT Because walking away in disgust
beats riding away in an ambulance.

19. 5½ hour First Aid/CPR/AED classroom course
How Can You Prepare?
5½ hour First Aid/CPR/AED classroom course
23.4mB Smart Phone App
Contains videos and instructions
Carry it with you in your Smart Phone!

20. You don’t need a lot… just the basics.
First Aid Kit
Suggested Contents
Triple antibiotic ointment packet
Antiseptic cleansing wipes
Plastic adhesive bandages (Band Aids)
Instant cold compress
Triangular sling/bandage
Gauze dressing pads
First aid tape
Gauze roll bandage
Latex-free exam-quality vinyl gloves
Hand sanitizer
Scissors
Plastic tweezers
You don’t need a lot… just the basics.

21. Common Medical Problems Nothing gets better during a ride!
General thoughts
Dehydration
Cardiovascular conditions
Deep vein thrombosis (DVT)
Respiratory conditions
Urinary conditions
Skin conditions
Other riding effects
Surgeon General’s warning…
Nothing gets better during a ride!

22. “Dad went on a little ride this morning… to Ohio.”
Warning
THE SURGEON GENERAL HAS DETERMINED THAT MOTORCYCLE RIDING IS HABIT-FORMING!
Courtesy: Donna Fousek, 2004
“Dad went on a little ride this morning… to Ohio.”

23. Preparing for the Ride Carefully consider potential riding impact
Chronic illnesses
Predisposing conditions
Family history
Carry a card with emergency information
Name, address, phone numbers
Next of kin and how to contact
Significant health history
Medications and allergies
Health insurance information
Vehicle insurance and towing information
Make an ICE entry in your cell phone contacts
Put a sticker on the back of your driver’s license
Take extra medication (in safe and dry place)
Prevention is better than treatment
When in doubt, talk with your primary care provider

24. Dehydration Water loss from heat exposure – primarily sweating
Normal vapor loss from lungs
Normal ‘insensible’ water loss from skin
Increased water loss during heat exposure
Keep skin covered
Use cooling methods
Significantly affects mental and physical functions
Can accelerate development of fatigue
Accentuates fatigue effects
Many symptoms mimic fatigue
Dry mouth, headache  nausea, muscle weakness
Increases risk for heart and circulation problems
Especially when taking some medications

25. Rehydration Stay ahead… DRINK before you need to
Water AND electrolyte (salt) solution
Sweating causes loss of water and electrolytes
Need to replenish BOTH
Low salt levels can be harmful
Read the labels
Amounts of electrolytes vary
May contain carbohydrates (sugar)
Avoid caffeine or alcohol for hydration
Both cause water loss by increasing urination
And this can accelerate dehydration

26. For Diabetics
Carbohydrate (sugar) in solutions can be dangerous for diabetics
Can raise blood sugar level acutely
May result in rebound decreased blood sugar
May increase water output through urine
Most athlete supplements contain sugar
+ Sugar
No Sugar
Contains necessary electrolytes
No carbohydrates/sugars
Add to your water bottle

27. Cardiovascular History of heart disease Deep vein thrombosis
Medications
Physician consultation
Deep vein thrombosis
‘Sludging’ effect
Pain
Swelling
Redness
Numbness in feet
Pulmonary embolism
Anticoagulants (‘thinners’)
Treatment:
Leg exercises
Support socks

28. Deep Vein Clots EMBOLUS TO LUNGS NORMAL BLOOD FLOW DEEP VEIN
THROMBOSIS
DEEP LEG VEINS

29. Respiratory System Allergies – especially seasonal
Upper respiratory infections
Effects of smoking
Nicotine effects on blood vessels
Nicotine effects on night vision
Nicotine withdrawal effects
Physical conditioning
Medication effects
Increased fatigue & sleepiness
Dryness of mucous membranes

30. Urinary System Kidney disorders can hasten dehydration
Kidney stones can be caused by dehydration
Bladder infections and prevention
Risks associated with ‘endurance extenders’
Bladder infection
External skin irritation and infection
Loss of friends

31. Skin Conditions Heat rashes and “Monkey butt” Infections
Worsening of chronic conditions
Eczema
Psoriasis
Foot care
Sunburn
Preventive strategies
Clothing fit
Clothing changes (especially socks)
Skull cap
Shaving
Lotions and lip balms
Powders
Treatments

32. Vibration and Overuse Causes and effects Prevention
NERVE
COMPRESSION
SWOLLEN
TENDONS
Causes and effects
Excessive handlebar vibration
Causes increased fatigue
Causes swelling around
nerves in wrist and elbow
Prevention
Use grips with increased padding
Gel inserts for handlebars
Gel inserts in gloves
Relax your grip
Skier’s Thumb

33. Other Hazards Stings and bites Eye protection External ear infections
Be careful where you rest!
Examine your boots and helmet
Eye protection
Flying objects
Ultraviolet effects
Dryness
External ear infections
Extended ear plug use
Swimmer’s ear solution

34. Environmental Protection
Helmet – proper fit, full face, liner
Windshield – laminar flow
Eye protection
UV filtering sunglasses
Prescription lenses/bifocal inserts
Hearing protection
Skin and lip protection
Powder to prevent chaffing
Sun
Wind
Dryness
Moisture
Temperature
Vibration
Noise
ENVIRONMENATL
EFFECTS
Courtesy: Paige Ortiz

35. Be On The Lookout… Distracted drivers …are out to kill you!
You’re four times
It’s hard to
more likely to have
concentrate on
a road accident
two things
when you’re on
at the same time.
a mobile phone.

36. Be alert for subtle hazards…
Road Hazards
Be alert for subtle hazards…

37. THE END
Enjoy the Road!