How to react to a fallen biker

DOHC1

DOHC1

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It's a situation no one wants to be put it - biker wipes out and is on the ground. How do you react?

I'm trained in CPR/First aid, so I know rule #1 is to not move him/her. However, I have seen videos where the people around the fallen biker check for feeling in the injured person's legs, feet, fingers etc. Any tips on how to react to a situation like this? Do you ask them to slightly wiggle their toes/fingers to ensure there's no spinal injury? What else can one do in this situation as everyone waits for the paramedics to arrive other than talk to them, calm them down, and ensure they are breathing?
 
1st thing they teach you in first aid class is survey the scene. I'd block off traffic immediately, call for help any bystander to call 911 than check to see if rider is breathing and if there's any major blood lose. I'm really bad with people bleeding profusely as I'd just put my hand on the wound to stop the bleeding but to protect yourself you should use a glove or a clean piece of clothing. If they stop breathing perform CPR if you're trained for it. If you're not CPR trained the best you can do is comfort the rider.

Coincidentally today around 1am I saw a motorcyclists pulled off to the side of the road and did 3 quick lane changes to see if he needed any help. Luckily he didn't cauz I was wasted from some dude buying 2 round of shots for everyone at the bar lol.
 
I generally find running around yelling wtf! With my arms flailing around calms the scene down and is the appropriate first step
 
So seriously. St johns is good to have, however I find a lot of it doesn't make sense all the time. So, I'll bring you guys through the actually important first steps. Trauma is basically my profession.

We use an algorithm MARCHE.

M major bleeds. Once you get to the patient first thing you do is check for major bleeds as that will kill him before anything else... You'll notice a major bleed basically by how much your anus puckers. You'll know it when you see it. Stop it any way you can, kneel in their groin to stop a leg bleed, jam your fingers in there do anything to keep that blood in... Including moving the patient if it's severe.

A airway. Now you check the airway, obstructions and proper positioning. You may have to put them in recovery position to let gravity open the throat if they are really out. Also allows gravity to drain any vomit which is likely to occur.

R respirations. Now you check that they are breathing and is the time to start rescue breathing for them. Everyone should carry one of those little CPR mask deals in their cage.

C circulation. Do a pulse check at the carotid and see if there is a radial pulse. If you get a radial then they have a decent BP. Check for any other bleeds.

H head to toe look for other injuries, broken bones, ribs, and see if the pelvis is stable. A broken pelvis can make them bleed out internally enough they can die. If found, hold the pelvis in a stable position to prevent it from creating more damage.

H hypothermia. Even in 40 degrees over seas we watch and prevent hypothermia. The more blood someone looses the colder they get. The colder they get the less ability they have to clot. So keep them warm.

E is everything else, so all the little things. This is the very basics and there are a million things between all of these steps that are all scenario dependent. You can not move to the next step until the one you are on is fixed. Studies show that only about 1.5% of paralysis is caused by people moving the patient after the incident, but spinal control is important however, if they are dying right then and there, then you f the c-spine and save them.
 
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Sorry it's a big blob guys damn iPhone. I will structure it properly tonight when I get to my comp tonight.
 
The big blob is good reading. Thank you.
 
Very good explanation rmemedic, I definitely picked up on a few things there.
 
thanks for the info, much more in depth than the AMFR course I took at St. John. =)
 
rmemedic, great post.

I used to be a first aid and cpr instructor and examiner and when we taught advanced classes what you posted was along the lines of what you said. Different acronym but the meaning was the same.

The only thing I would add is no matter how bad the situation is, do as psycho44 says and survey the scene. No point stopping major bleeding if you are both in the left hand lane of the 401 and about to get creamed by a car. Use your bike/car to block or do something to protect you and the fallen rider.
 
Rmemedic:

I was told that at a motorcycle accident it's important to leave the helmet on the fallen rider and let the paramedics/doctors remove it. Obviously if you need to start CPR you aren't going to be able to do so with someone in a full-face helmet. What would be the procedure there?
 
Basicly if you need to do rescue breathing then you need to remove the helmet. They say not to move the patient to prevent further injury(paralysis), however if they need CPR that means their brain is not getting oxygen. If no CPR is performed then the patient will DIE or be brain damaged. Both of which are further injury.

You remove the helmet while someone else supports the head, Its a two person job, then you procede with CPR. Being paralyzed but alive is medically better than dead.

For CPR if you arent sure what to do or its really gruesome bleeding then just do chest compressions. You should put your hands betweent he nipples and compress about 1 - 2 inches. Chest compressions are more important than breaths as the lungs should still have oxygen in them but arent able to move the oxygen without compressions.
 
Dead on gnatwest. Chest compressions are the most important portion of CPR. I did forget to say scene survey your safety is #1.I carry a little trauma kit with basic airways gloves, lots of packing, bandages, occlusive dressings and a couple tourniquets. Usually I have my trauma bag in my truck too when it's not needed at work just in case I come across something.
 
It's refreshing to see a useful GTAM topic for a change. Well done.
 
rmemedic said:
I generally find running around yelling wtf! With my arms flailing around calms the scene down and is the appropriate first step
Click to expand...

99% that is what happens .. or people all stand around and just look at the downed rider.

If you dont have the minimum first aid training, call 911 and ensure the scene is safe for YOURSELF and the downed rider.

Dont take the helmet off unless you have the skill set for it, and your basic first aid course does not provide that. If the person has no vitals, chest compressions are key.
Again dont perform AR to a person unless you KNOW them and feel safe doing so.
 
Very informative post rmemedic. Thanks.

A good thing to remember when calling 911 (especially when talking to the Ambulance) is to calm down, stop talking, and listen to their questions.

They have numerous questions to ask and the caller needs to be calm, and they need to listen. Help is started almost immediatley after you place the call, and none of these questions will slow anyone down.

I think another good thing to remember is, if you don't have any special skills to provide assistance, and there are a lot of people there already....move along. You always see when a rider has an off, everyone and their dog stops and hangs around.
 
psycho44 said:
1st thing they teach you in first aid class is survey the scene. I'd block off traffic immediately, call for help any bystander to call 911 than check to see if rider is breathing and if there's any major blood lose. I'm really bad with people bleeding profusely as I'd just put my hand on the wound to stop the bleeding but to protect yourself you should use a glove or a clean piece of clothing. If they stop breathing perform CPR if you're trained for it. If you're not CPR trained the best you can do is comfort the rider.
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If you are not trained in CPR and the rider is not breathing, do your best! Any medic will tell you that bad CPR is better than no CPR.
 
mjavor said:
If you are not trained in CPR and the rider is not breathing, do your best! Any medic will tell you that bad CPR is better than no CPR.
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Agreed. Even if you don't have training.... Try. You are protected under good samaritan laws as long as you aren't doing anything crazy.
 
rmemedic said:
Dead on gnatwest. Chest compressions are the most important portion of CPR. I did forget to say scene survey your safety is #1.I carry a little trauma kit with basic airways gloves, lots of packing, bandages, occlusive dressings and a couple tourniquets. Usually I have my trauma bag in my truck too when it's not needed at work just in case I come across something.
Click to expand...

I have been volunteering with ST John since I was 10 started as a Cadet and provide First response for a verity of events from charity BBQ's to motor cycle and ATV races. Lots of fun unlike RM medic Trauma is a Hobby for me and im a junky.

Medics advice was great but I think its important to point out that if you really want to know how to help any injured person asking on an internet is not the best way to do it. Go get some training at least CPR level its important to have an studies have show the more people have it in a society they more likely someone is to survive a critical injury. When you stop breathing you only have 3 mins till brain death (Approx). If you have Kids elderly parents and are around people who are high risk a little knowledge can go along way. Bad CPR is better than No CRP.

That said I will answer this question as if you have no medical training. I have lots of toys to play with in my Trauma bag as I’m sure medic does that you won’t have access to so I will keep it simple and short. I will also assume you are the only person who stopped and point out. One quick note this is not a How to nor am I speaking on behalf of my training or organization this is from my own mind and experience and this is not a replacement for medical training.

Important note..You don’t have to stop you are not required unless you have medical training legally. But if you stop plan to stay and play you cant walk away until a medic or doctor takes over.

Approach the incident. – Don’t get to close – A good rule of thumb is try to stay 2 fire trucks away from and back. This will let the Pro’s get in with their equipment and keep you back should anything blow. Put your hazards on. If its two dangerous from fire downed electrical wires don’t attempt rescue. You might just be making more casualties for pros to pickup.

Dial it in Give a location and what you witnessed. Nature of injuries will not be know but the mechanism will. Auto accidents – Broken bones / Bleeds/ Concussions etc. Ask for Ambulance, Fire (May have to cut people out of cars) and police. You can call back with any specific medial information if you need too later however by the time you can even know whats going on you will probably have police, EMS and hoze jockeys coming out your wazoo.

When you get out going to the rider Heads up keep checking for hazards make sure traffic isn’t trying to sneak by or is still moving.

Upon arriving – Rider standing or moving

- If they are up and around and talking (May have removed helmet) Make them sit they could still have a serious spinal or internal injury and if they pass out while standing can add more injures or make it worse.
- Check them for major bleeds I would consider anything with a blood stain uder the cloths larger than you palm major. Apply pressure. If you dress be aware that medics might need to cut it avoid using anything like cotton that might leave bits in the wound(also clean if not sterile) but use what you can.
- Monitor them and cover with a blanked. If they pass out monitor breathing and pulse and be ready with chest compressions if you think you can handle it. gnatwest instructions on this was a pretty simple and affective if you have no training. For CPR if you arent sure what to do or its really gruesome bleeding then just do chest compressions. You should put your hands between he nipples and compress about 1 - 2 inches. Do this to a 1 and 2 rhythm. Its important to know if you get it wrong and you do this over a beating heart. You wont do much harm but try not to. Expect to Breack ribs and if you are also breathing into them expect vomit. Ensure all the vomit is out of their mouth and repositions the head and recheck pulse and breath and continue.

Upon arriving – Rider down.
- Assess their LOC (Level of consciousness). I like to do this in the following stages
o Hello can you hear me – Open your eye if you can hear me
o I’m want to help you is that okay (If they say no keep talking to them don’t touch them keep asking them its not okay to help someone with out their permission unconscious or if they go unconscious its implied consent help away)
o Lay still for me
- At this point my training will diverge a bit from what Medic said. ***** the breathing before major bleeds. I’m guessing the difference is he’s a combat medic and has different mechanism of injury and transport logistics to deal with than a general first responder. But either way it makes little difference is this situation as if you are not breathing and no pulse blood is useless and if you are breathing with no blood.. well same thing.
- On a full or half face mask loosen the straps but don’t remove the helmet (Cut if you can) Check The breathing and pulse. Perform CPR and needed if the helmet needs to come of you will have to have a second person. From the back of the Helmet(top of head) reach into the foam and pull it outwards like you are trying to tear the helmet in half from the bottom and Pull and slowly, Gently and purposely see saw the helmet off (don’t get caught of the nose). This will let you adjust the air way. (For s suspected spinal don’t tilt the head use a modified jaw thrust (google it))
- That being said that a pretty advanced skill set if you don’t have the training stick to chest compressions as said by a number of people (It was asked so I thought I would answer).
- If they are breathing but unconscious treat bleeds in needed or cover with a blanket be ready to talk to them and keep them still if they awaken. Check their pulse and breathing every 2 or three minuets and be ready to perform compressions.
- If they are conscious keep them talking and ask them questions like were they are their name what time it is to see if they have any concussion of decreased level of awareness. Not much you can do but you can tell the paramedics it will help them out. Keep them from moving
- Treat bleeds and steady and support broken limbs. Cover with a blanked if needed.
- If you think someone has a broken leg or arm and you can Cut their clothes off around the injury with their permission do so. Always protect their modesty and try and have a witness to avoid any logal issues Also don’t look for their wallet just leave it were it is and inform the police if they need it.


That’s pretty much it of the top of my head. I’m sure medic can expand/ Correct anything I have missed.

Just a few points

- Don’t put your self in danger to perform a rescue
- Don’t act beyond your training or what your comfortable with
- Get some training if you travel dong distances with people
- Have a cell phone

And if you try to help someone and you are unsuccessful (IE they die) don’t suffer guilt get counseling immediately. Your local st john ambulance will be able to provide or point you to people who are trained to help you deal with your feelings.

Trying to perform CPR on someone and be later told that they passed away if tough but it isn’t your fault If you have to do CPR they are in the worse state of health possible (Essentially dead) don’t feel bad get someone to talk to who is trained.
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