Presentation on theme: "What should I do? A Rider’s Been Injured In an Accident…"— Presentation transcript:
1What should I do? A Rider’s Been Injured In an Accident… Don Arthur, MDEmergency Medicine PhysicianRider
2Keeping 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
3Good Samaritan LawsLaws 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 responderswho follow normal procedures.Victim may sue if a responder acts with maliceor recklessness.Some states have penalties for thosewho do NOT assist.
4Good Samaritan Laws Four key elements: Care rendered is performed as the result of the emergencyThe initial emergency was not caused by the personinvoking the lawThe emergency care is not delivered in a grosslynegligent or reckless mannerAid is given with permission wheneverpossible to obtain itState laws vary widely… check them out at:
5Mechanisms of Injury Blunt force trauma Penetrating injuries Abrasions Head and neck injuriesChest and abdominal injuriesMusculo-skeletal injuriesPenetrating injuriesImpacted objectsRoad debrisRider possessionsAbrasions
6THE FASTER YOU GO, THE BIGGER THE MESS Speed and EnergyKinetic Energy = ½ MV2At 80 MPHFORCE OF IMPACTAt 40 MPHSPEED102030405060708090100THE FASTER YOU GO, THE BIGGER THE MESS
7Scene Management Remain calm and others will join you! Assess the scene for continuing hazards – traffic, fire riskSafety 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.”
8ABCC-911 CAUTION ONLY IF UNCONSCIOUS! AIRWAY Are there any obstructions to breathing?Do not change head position unlessnecessary.BREATHINGIs the victim spontaneously breathing?Are breaths regular and unlabored?CIRCULATIONCheck 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 INJUREDDO NOTREMOVE HELMETCAUTION
9Airway Must have an open and unobstructed airway Open the victim’s mouth without moving headClear the airway of any foreign materialMove jaw forward to move tongue forward
10ABCC-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 REMOVALOnly if necessary to establish an airwayShould only be performed by two trained peopleRequires constant head support and immobilizationTell the operator:Motorcycle accident with injuriesNumber of injuredSeverity of injuriesLocation (use your GPS)You hang up lastI see atrauma centerin your future…
11Gather Essential Information IF VICTIM IS CONSCIOUSGet as much pertinent information as possibleand write it down to give to ambulance crewName, address, phone number, ageEmergency information card?Medical problems, medications, and allergiesWho should be contacted?Vehicle insurance and towing preferenceHelps emergency personnelVictim may not be able to respond ifmedical condition worsensEstablishes rapport with the victim
12Accident Scene FactsAsk victim what (s)he remembers about the accidentSpeed, weather, road conditionsMinutes leading up to accidentTraffic patterns as accident evolvedPosition of other vehicles and objectsDraw the sceneNote vehicle positions and directions of travelPhotograph sceneDon’t photograph victim without permissionThis will assist medical personnel in assessing mechanisms of injuries and possible extent of unseen injuriesVictim may not later remember details essential for insurance claims
13Don’s Simple Categories First, Do No Harm!Injuries you can’t do anything about (but can always make worse)Head injuryNeck injuryInternal chest and abdominal injuriesOpen fractures (bone has broken through the skin)Penetrating injuriesInjuries you can do something about… and shouldOpen chest woundExternal bleedingEye injuryClosed fracturesInjuries you can do something about…but probably shouldn’tPositioning for comfortAbrasions
14Injuries You Can’t Do Anything About But Could Make a Whole Lot Worse Head injury – usually caused by striking a fixed objectNeck injury – can result in paralysis and deathInternal chest and abdominal injuriesOpen fractures (bone has broken through the skin)Penetrating injuriesFIXED OBJECTCOUP INJURYCONTRA-COUPINJURY
15Injuries You Can Do Something About And ShouldOpen chest woundAir entering chest cavity will collapse lungApply occlusive dressing over woundTape in place only on three sidesExternal bleedingApply direct pressure at the site of bleedingIf severe, apply pressure at pulse pointNo pressure to skull if fracture is suspectedEye injuryProtect the eye from further injuryClosed fracturesSplint in place to avoid further injury
16Injuries You Can Do Something About But Probably Shouldn’t Positioning for comfortVictim may ask you to move him to ease pain from injuriesMovement may make the injury worse and do nothing for the painYou may not be covered by Good Samaritan Law for non-emergency or unnecessary treatmentLet the professionals perform all victim movementAbrasionsField treatment won’t improve eventual healingMay further contaminate the woundProtect from further contaminationDo not put anything directly onto thewounds except to stop significantbleeding
17Most Common Injuries ATGATT Bone Fractures – Open or Closed Legs and feetArms and shouldersHandsPelvis and hipsBack and neckRoad RashHead InjuryInternal Abdominal InjuriesInternal Chest InjuriesBleeding from InjuriesNerve Damage
18ATGATT Because walking away in disgust beats riding away in an ambulance.
195½ hour First Aid/CPR/AED classroom course How Can You Prepare?5½ hour First Aid/CPR/AED classroom course23.4mB Smart Phone AppContains videos and instructionsCarry it with you in your Smart Phone!
20You don’t need a lot… just the basics. First Aid KitSuggested ContentsTriple antibiotic ointment packetAntiseptic cleansing wipesPlastic adhesive bandages (Band Aids)Instant cold compressTriangular sling/bandageGauze dressing padsFirst aid tapeGauze roll bandageLatex-free exam-quality vinyl glovesHand sanitizerScissorsPlastic tweezersYou don’t need a lot… just the basics.
21Common Medical Problems Nothing gets better during a ride! General thoughtsDehydrationCardiovascular conditionsDeep vein thrombosis (DVT)Respiratory conditionsUrinary conditionsSkin conditionsOther riding effectsSurgeon General’s warning…Nothing gets better during a ride!
22“Dad went on a little ride this morning… to Ohio.” WarningTHE SURGEON GENERAL HAS DETERMINED THAT MOTORCYCLE RIDING IS HABIT-FORMING!Courtesy: Donna Fousek, 2004“Dad went on a little ride this morning… to Ohio.”
23Preparing for the Ride Carefully consider potential riding impact Chronic illnessesPredisposing conditionsFamily historyCarry a card with emergency informationName, address, phone numbersNext of kin and how to contactSignificant health historyMedications and allergiesHealth insurance informationVehicle insurance and towing informationMake an ICE entry in your cell phone contactsPut a sticker on the back of your driver’s licenseTake extra medication (in safe and dry place)Prevention is better than treatmentWhen in doubt, talk with your primary care provider
24Dehydration Water loss from heat exposure – primarily sweating Normal vapor loss from lungsNormal ‘insensible’ water loss from skinIncreased water loss during heat exposureKeep skin coveredUse cooling methodsSignificantly affects mental and physical functionsCan accelerate development of fatigueAccentuates fatigue effectsMany symptoms mimic fatigueDry mouth, headache nausea, muscle weaknessIncreases risk for heart and circulation problemsEspecially when taking some medications
25Rehydration Stay ahead… DRINK before you need to Water AND electrolyte (salt) solutionSweating causes loss of water and electrolytesNeed to replenish BOTHLow salt levels can be harmfulRead the labelsAmounts of electrolytes varyMay contain carbohydrates (sugar)Avoid caffeine or alcohol for hydrationBoth cause water loss by increasing urinationAnd this can accelerate dehydration
26For DiabeticsCarbohydrate (sugar) in solutions can be dangerous for diabeticsCan raise blood sugar level acutelyMay result in rebound decreased blood sugarMay increase water output through urineMost athlete supplements contain sugar+ SugarNo SugarContains necessary electrolytesNo carbohydrates/sugarsAdd to your water bottle
27Cardiovascular History of heart disease Deep vein thrombosis MedicationsPhysician consultationDeep vein thrombosis‘Sludging’ effectPainSwellingRednessNumbness in feetPulmonary embolismAnticoagulants (‘thinners’)Treatment:Leg exercisesSupport socks
28Deep Vein Clots EMBOLUS TO LUNGS NORMAL BLOOD FLOW DEEP VEIN THROMBOSISDEEP LEG VEINS
29Respiratory System Allergies – especially seasonal Upper respiratory infectionsEffects of smokingNicotine effects on blood vesselsNicotine effects on night visionNicotine withdrawal effectsPhysical conditioningMedication effectsIncreased fatigue & sleepinessDryness of mucous membranes
30Urinary System Kidney disorders can hasten dehydration Kidney stones can be caused by dehydrationBladder infections and preventionRisks associated with ‘endurance extenders’Bladder infectionExternal skin irritation and infectionLoss of friends
31Skin Conditions Heat rashes and “Monkey butt” Infections Worsening of chronic conditionsEczemaPsoriasisFoot careSunburnPreventive strategiesClothing fitClothing changes (especially socks)Skull capShavingLotions and lip balmsPowdersTreatments
32Vibration and Overuse Causes and effects Prevention NERVECOMPRESSIONSWOLLENTENDONSCauses and effectsExcessive handlebar vibrationCauses increased fatigueCauses swelling aroundnerves in wrist and elbowPreventionUse grips with increased paddingGel inserts for handlebarsGel inserts in glovesRelax your gripSkier’s Thumb
33Other Hazards Stings and bites Eye protection External ear infections Be careful where you rest!Examine your boots and helmetEye protectionFlying objectsUltraviolet effectsDrynessExternal ear infectionsExtended ear plug useSwimmer’s ear solution
34Environmental Protection Helmet – proper fit, full face, linerWindshield – laminar flowEye protectionUV filtering sunglassesPrescription lenses/bifocal insertsHearing protectionSkin and lip protectionPowder to prevent chaffingSunWindDrynessMoistureTemperatureVibrationNoiseENVIRONMENATLEFFECTSCourtesy: Paige Ortiz
35Be On The Lookout… Distracted drivers …are out to kill you! You’re four timesIt’s hard tomore likely to haveconcentrate ona road accidenttwo thingswhen you’re onat the same time.a mobile phone.
36Be alert for subtle hazards… Road HazardsBe alert for subtle hazards…