First aid on the road

The first aid on the road indicate the gestures of first aid adapted to the context of the public highway, and in particular of the traffic accidents.

This article relates to the action to be taken by a witness alone and without material; the techniques equips some with specific material are treated in the article Prompt road help.

The action of a witness of an traffic accident is the same one as for any accident:

to protect;
to alert or make alert the helps;
to help.

However, the specific risks and the configuration imposes certain adaptations.

To protect

First of all, as a good first-aid worker, it is necessary to analyze the situation; it is useless to precipitate with the risk to put its life in danger.

First danger: circulation

The principal risk of suraccident is that a vehicle strikes a person (victim, witnesses, intervening) or a vehicle (broken vehicle, vehicle of a witness, conveys intervention) - one will remember the drama of Loriol. The risks are most important on the primary distributers (Autoroute S or expressways), like night or by bad weather.

On a fast road with separate roadways of type Highway, as a witness, it is necessary to distinguish two cases:

the accident takes place on your roadway:

to put its hazard warning lights (warning) ;
if a person already dealt with the beaconing upstream, one will be satisfied to go to prevent the helps while stopping with the limits emergency call following;
if not, to stop if possible after the accident (see hereafter) and on the Hard shoulder; to put a clothing seeing (clear clothing the night, of bright color the day, waistcoat with High-visibility if you have one of them); in 2005 in France, 20 pedestrians died on highway, and in 75% of the cases the night, which shows the importance of the visibility;
to put its close relations and witnesses at the shelter behind the rembarde of safety;
to announce the accident to 150-200 m at least downstream by a triangle of indication and/or a person making of the signs (the night, to think of using a white linen or better, with a flashlight); the person carrying out the beaconing will walk if possible behind the safety fence, the hard shoulder being able to be borrowed by vehicles (motorists exceeded by relentissement, first-aid organizations, accidental variation of a vehicle);
if a person is ejected out of her vehicle on one of the lanes, it should be drawn on the hard shoulder (emergency Dégagement) by paying attention not to be done oneself to reverse;

the accident takes place on the roadway on other side of separation: to stop with the limit emergency call following, by putting its hazard warning lights and while stationing on the hard shoulder, and to pass alarm by specifying well that the accident takes place on the other roadway; to take again the road once last alarm (one can nothing make moreover, and to remain on the spot is dangerous); to make calls of headlight during a few moments to announce the accident to the vehicle on the other roadway.

On a road with not-separate roadways, it is necessary in the same way to stop on the side by putting the hazard warning lights; it is necessary to ensure a beaconing of both side, in priority on the constrained lane. If there is a close curve (less 100 m), to think of positioning indication before the curve. The night, one will be able to position a vehicle in order to clarify the accident with the headlights (while waiting for the helps).

Downtown, it is enough to put witnesses to deviate circulation and to avoid the conduits at the risk of the drivers irritated by the obstruction.

If a witness conveys some stops and goes down to carry help, it is recommended that it keeps with him his ignition key to avoid the flight of his vehicle.

Pourquoi is it necessary to stop after the accident?

the other drivers are distracted by the accident, the risk is thus upstream;
certain vehicles of help will have to pull over in front of the vehicle, it thus should not be obstructed;

Why the beaconing is it with 150-200 m?

With 130 km/h, one needs approximately 150 for 200 m to stop; if a driver sees the beaconing only at the last time, there remains to him thus time to carry out an emergency braking. With 90 km/h, it is enough to a hundred meters to stop, one could thus make a closer beaconing on a “normal” road, but it is advisable to keep simple figures at the head and not to multiply the particular cases with the risk all to forget.

Second danger: the fire

The second risk is the fire hazard. If you have a Extincteur, leave it and put it near the broken vehicle. If one can open the door of the broken vehicle, the contact should be cut. It is necessary to prohibit to smoke near the accident.

What to make in the event of beginning of fire?

If you have an extinguisher, to test the extinguisher in a sure zone, then to tackle the base of the flames. If smoke leaves lower part the cap, to sprinkle initially by one of the deformations of the cap without raising it (in order not to bring air), then raise the cap without you to burn (using a glove of handling or a rag) and to finish to sprinkle by protecting you from the cap. If the cap does not present deformation, one can start the opening (the lever is in general close to the wheel), which will have for effect of slightly raising it or sprinkling through the grill and the intake air side windshield; however, in the general case, the engine takes fire if it is touched (gasoline escape), there will be thus always a deformation of the cap.

If you do not have an extinguisher or that the extinction is ineffective, it is necessary to extract the victims from the vehicle (emergency release).

Note that the contact must be crossed to prevent the appearance of fire; if fire starts before you had time to cut the contact, it is then useless to do it, that delays even unnecessarily - and thus dangereusement - others gestures (extinction, emergency release).

---- Note : when one approaches the broken vehicle to open the door, it is recommended to approach it by the front one, thus, the victims will see arriving the rescuer and will not be surprised at the time of the opening of the door (in the event of surprise, they are likely to turn the head and thus to worsen a possible traumatism with the cervical Vertèbre S). ----

Third danger: movements of the broken vehicle

The third risk is the movement of the broken vehicles: to tighten the hand brake and to engage a speed (the contact being crossed).

For these operations (to cut the contact, to tighten the hand brake and to engage a speed), it is necessary to pay attention to engage only the arm in the vehicle because of the risk of inopportune release of the inflatable cushions to explosive ( Airbag S ). In addition, it is necessary to attempt to avoid making too much move the suspensions, in order not to make move the victims and worsen a possible traumatism.

To alert

detailed Article: First aid: alarm

On the road except agglomeration, to indicate

the number of the road (for example “RN 11”, “RD 95”),
an estimate of the position (for example “between the exit of Beaulieu and the exit of Dompierre”); to think of using the signposts as well as the kilometric points which mark out certain roads;
the way on which the accident occurred, especially for the separate roads with roadway of type Autoroute (for example “in the direction the Small rock-Niort”).

Because of the difficulties of localization, it is preferable to use the terminals of emergency call on the highways and expressways, or the fixed telephones so available (public cabin, trade, dwelling). So even if one sees a person calling of his portable on the roadside, it is necessary all the same to stop on the following terminal of call; the helps will thus have a call on the spot making it possible to have a good estimate of gravity, and a call of a terminal making it possible to have a good localization.

To help

If one is trained with the gestures of first aid, they should be adapted to the configuration.

It is important to act even if one is not the first on the spot. Indeed, because of sideration (surprise, fascination, fear), it is probable that the people present did not have the presence of mind or courage to protect and to alert. As regards the acts of help to anybody, it is advisable to remain very careful because of the extreme risks, by respecting the elementary precautions, to go in particular on other side of the safety fence by supervising circulation permanently. It is also important to conform to the indications of the first-aid organizations, given at the time of the call or when they are presented.

Victim lengthened on the roadway

The case of a victim lengthened on the roadway or the side (pedestrian, two wheels, nobody ejected) is rather close to the situations of accident in the home.

The wounds are often multiple, it is thus necessary, while waiting for the helps, to treat in priority the vital distresses: Hemorrhage, unconsciousness, stop of breathing. One will always suspect a traumatic attack of the back, one will thus prohibit to move the victim and one will systematically maintain the head in the position in which one found the person, except if this one unconscious (setting in PLS) or is subjected to an imminent danger (emergency Dégagement). The other attacks (wounds, burns) are secondary and will be dealt with by the helps.

The difficulty of the helmet arises however:

the withdrawal of the helmet is a delicate operation which is likely to worsen a possible traumatism of the nape of the neck; the helmet thus should be left places from there on a conscious person, to be satisfied to open the visor by maintaining the helmet in the position of origin;
if the person is unconscious but breathes, it should be turned the person in side Position of safety; there exists the best technique of withdrawal of helmet allowing dealt with, if it is not known, one is satisfied to turn the person with her helmet;
if the person does not breathe, it will be necessary in any case to withdraw the helmet to him to make him the artificial Ventilation, it does not matter the manner.

Victim upright

A victim can sometimes rise itself. If that is a good predicts (it is conscious), it can be seriously wounded all the same and its state can be degraded. In particular, it can suffer very well from a fracture of the rachis which would not have moved yet but could be mobilized thereafter, of a cranial traumatism, of a hemorrhage…

The main issue will be to calm the victim and to make it have patience until the arrival of the helps. The problem of the Position of waiting is delicate here: if the position best adapted is the reclining position, the change of position will cause a mobilization of the rachis and thus can make move an unstable traumatism and cause irrevocable damage (paralysis even death). There is no simple answer to this problem.

That is to be modulated according to the mechanism and of the kinematics of the accident.

Victim in a vehicle

In the case of a person in a vehicle poses the problem:

of the access: if the doors do not open (for example because of the deformation of sheet), it can be necessary to break a pane (for example with the crank of a jack) by paying attention not to be wounded and not to wound the occupants;
explosive inflatable cushions (Airbag® type), if they did not start, present a risk; one should not in particular interpose between the instrument panel and the occupants;
the victims sat, it is necessary to avoid thus mobilizing them to leave them in the cockpit (except need for a emergency Dégagement); the gestures must thus be adapted to the sitted situation:

Release of the air routes: an unconscious victim and which breathes must be left sitted, but it is necessary to rectify it against the file and to maintain head in careful rocker;
Stop of a hemorrhage: in addition to the direct manual supports and plugs relay, only the points of compression to the upper limbs and the neck are possible; it is not possible to review compression to the lower extremities, therefore if the direct manual support is impossible or ineffective, a garrot should directly be made.

It is necessary well to think of questioning the people implied to know how much people were in the vehicle; indeed, of the people can be ejected out of sight. To also think of questioning the witnesses on this subject.

Collective accident

In the case of a collective accident (for example an accident of because), one will stick in priority to deal with the valid people in order to gather them in a security zone while waiting for the helps, and this more especially as being shocked psychologically, implied do not have their capacity of reflection and can saunter on the roadway; it is to better avoid new victims rather than to focus itself on only one distress.

Formations

In France: Certificate of additional training to first aid on the road (AFCPSSR): to only act and without material vis-a-vis an traffic accident; to adapt the gestures of first aid to the road accidents; specific protection (beaconing, risk set fire to), to practice the gestures on the victim sitting in the vehicle (maintenance of the head, stop of a hemorrhage…), withdrawal of helmet of an unconscious motorcylcist… It is necessary to be titular AFPS, but the formation can be done at the same time. It lasts 8 with 12 h.

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