Emergency Assistance for Injured Riders: What You Need to Know

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

2. 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. 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. 4 Good Samaritan Laws Four key elements: 1. Care rendered is performed as the result of the emergency 2. The initial emergency was not caused by the person invoking the law 3. The emergency care is not delivered in a grossly negligent or reckless manner 4. Aid is given with permission whenever possible to obtain it State laws vary widely check them out at: http://www.heartsafeam.com/pages/faq_good_samaritan

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

6. 6 THE FASTER YOU GO, THE BIGGER THE MESS Speed and Energy FORCE OF IMPACT 0 10 20 30 40 50 60 70 80 90 100 Kinetic Energy = MV 2 At 40 MPH At 80 MPH SPEED

7. 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 . Dont argue with the victim. Dont move the victim. Be careful what you say Youve been in a motorcycle accident and its important that you dont move. An ambulance is on its way. My name is Don and Id like to help you.

8. 8 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 victims neck or at the wrist. Assess pulse quality (use your own as a reference). Count the number of pulses/minute. Dont use your thumb. ABC C-911 IF RIDER IS INJURED DO NOT REMOVE HELMET IF RIDER IS INJURED DO NOT REMOVE HELMET CAUTION ONLY IF UNCONSCIOUS!

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

10. 10 ABC C-911 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 I see a trauma center in your future

11. 11 Gather Essential Information 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 IF VICTIM IS CONSCIOUS

12. 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 objec ts Draw the scene Note vehicle positions and directions of travel Photograph scene Dont 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. 13 Injuries you cant 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 shouldnt Positioning for comfort Abrasions Dons Simple Categories First, Do No Harm!

14. 14 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 Injuries You Cant Do Anything About But Could Make a Whole Lot Worse FIXED OBJECT COUP INJURY CONTRA-COUP INJURY

15. 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. 16 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 wont 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 Injuries You Can Do Something About But Probably Shouldnt

17. 17 Most Common Injuries 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 ATGATT

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

19. 19 23.4mB Smart Phone App Contains videos and instructions Carry it with you in your Smart Phone! How Can You Prepare? 5 hour First Aid/CPR/AED classroom course

20. 20 First Aid Kit 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 Suggested Contents You dont need a lot just the basics.

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

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

23. 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 drivers license Take extra medication (in safe and dry place) Prevention is better than treatment When in doubt, talk with your primary care provider

24. 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. 25 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) Rehydration Avoid caffeine or alcohol for hydration Both cause water loss by increasing urination And this can accelerate dehydration

26. 26 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 For Diabetics + Sugar No Sugar Contains necessary electrolytes No carbohydrates/sugars Add to your water bottle Contains necessary electrolytes No carbohydrates/sugars Add to your water bottle

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

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

29. 29 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 Respiratory System

30. 30 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 Urinary System

31. 31 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 Skin Conditions

32. 32 NERVE COMPRESSION SWOLLEN TENDONS Vibration and Overuse 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 Skiers Thumb

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

34. 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 Courtesy: Paige Ortiz Sun Wind Dryness Moisture Temperature Vibration Noise ENVIRONMENATL EFFECTS

35. 35 Youre four times Its hard to more likely to have concentrate on a road accident two things when youre on at the same time. a mobile phone. Distracted drivers are out to kill you! Be On The Lookout

36. 36 Be alert for subtle hazards Road Hazards

37. 37 Enjoy the Road! THE END donald.arthur@comcast.net