You are driving along and come across an accident with injuries that has just happened. Perhaps, you are the first, and maybe the only one, on the scene. The actions you take immediately can often mean the difference between life and death. The sooner a victim is treated, the greater the chance for survival. Emergency medical service professionals say the first "Golden Hour" is critical in preventing serious injuries from turning into fatalities. Here are some simple life saving steps recommended by the National Highway Traffic Safety Administration (NHTSA) as part of its National Standard Curriculum for Bystander Care as well as by EM providers. Not as comprehensive as a formal first aid course, these basic life-saving skills are simple enough to be learned quickly and then applied by just about anyone coming upon an accident. Recognize the Emergency. Accidents are sometimes not immediately obvious. If you did not actually see or hear the crash happen, suspect one if you observe vehicles parked at unusual angles, skid marks, glass on the road, broken guard rails or fences, a smoking vehicle, etc.
Decide to Help. Stop even if others are already assisting. "A helper always needs a helper." Do not fear legal problems if you do some thing wrong. Good Samaritan Laws in most states protect people from litigation should they stop and help as long as they act in good faith.
Call for Help. While calling for help is important, assisting the seriously injured is more critical. If you alone, provide life-saving procedures first, and call for help when all victim are breathing and major bleeding has been stopped. If more than one person is available, the more capable should provide medical attention while other summons help. Make sure whoever calls for help can tell the 911 dispatcher the exact location of the accident, the number of victims and their condition, and what help is being given. Make sure they stay on the line to answer all the dispatcher's questions and then follow instructions given.
Assess the Victims. Check for consciousness. Is the victim able answer the you? Check for breathing. Gently tilt the person's head to its normal, eyes-front position and check for breathing. Hold your hand in front of the person's mouth and nose to see if you can feel breathing. Look for victims with head injuries (a cracked windshield is an obvious sign) or are paralyzed. If a person is talking or screaming, he or she is breathing. Move on to others who are not breathing. Look for victims thrown clear of the crashed vehicle or under the dashboard. Indications include an empty driver's seat, open doors, missing windshields or an unoccupied infant seat.
Provide Life-Sustaining Care, If Needed. Victims who are not breathing need your help first. Maintain an open airway. Remove items that might be blocking the airway such as food or gum. If not breathing, start breathing. If available, cover the person's mouth with a CPR protective shield. Pinch the person's nose, if not covered by the shield. Blow air into the person's mouth-- one breath every five seconds. If the chest does not rise, gently tilt the person's head back a little more. Continue rescue breathing until the victim can breathe without your help or professional assistance arrives and can take over for you. Once the victim is breathing, check for bleeding. Put on protective gloves, if available. Control bleeding by applying direct pressure to the wound using a gauze bandage or cloth. Wear protective gloves or use a towel or article of heavy clothing. If the person is able, instruct him or her to continue to apply pressure to the wound so you can tend to other victims or seek help. Stay with the victim until he/she is breathing and excessive bleeding is controlled.
Consider Your Safety and Other Responders. Look for downed electrical wires, smoke and fire, the smell of gasoline, trees that might fall or signs of hazardous materials. If too dangerous to stop, drive on to get help or get to a phone and call for help. Do not move victims. Never transport a victim in your vehicle. Put up warnings or have others warn other drivers of the accident without putting themselves in peril. Park your vehicles a safe distance from the crash site and away from moving traffic with hazard blinker lights on. If first on the scene, raise hood to signify a problem.
A "Bystander Kit" should be carried in your vehicle. This can be a very complete kit, a basic kit or anything in between. The simpler kit costs considerably less to assemble and could easily fit into a glove compartment while still providing most of the essential needed for bystander care.
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