Accident Scene Management

Accident Scene Management

The first hour of trauma is termed the ``Golden Hour'' by the Emergency Medical Services (EMS). The idea is that trauma victims have the best survival chance if they are in surgery within one hour after the accident. 
Qualified medical personnel are really the people who should be handling everything, but until they arrive there are things that we, untrained members of the CPF, can do to help the medical professionals before they arrive.
These guidelines are obviously applicable only to those members who are not trained paramedics. Accident scene management can consist of two components:
1.) Safeguarding and rendering assistance to the injured and paramedics on the actual scene and
2.) Traffic control.

  The Golden Rules of On-scene Accident Management are:

• Your own safety comes first;
• Treat the scene as if it is someone near and dear to you lying on the scene:
• Call the Emergency Services. ( Either ask someone on the radio to do so or call them via your cell phone by dialing 112 or 147);
• Safeguard the scene as soon as possible and obtain assistance from standby members to do so;
• Cordon off the area. Do not allow bystanders to come within at least 3 metres from the body, ideally even further. (Chevron barrier tape will always come in handy);
• Cover the body. Should the person still be alive, and you are either unable or unqualified to provide first aid, take care not to restrict breathing, introduce infection in open wounds, or create further injury by moving the patient around whilst covering the body. A so-called “space blanket” is ideal for this purpose;
• Avoid any rowdiness or laughter at the scene as it may well be construed as being highly insensitive and unprofessional by the next of kin or friends of the patient/deceased;
• Taking photos of the injured/deceased is also highly insensitive and unprofessional. Although photo evidence may well assist in the later investigation of the case, this may only be done under instruction of the person/authority in charge of the scene.
• Under no circumstances should you allow any unauthorized access to the body.

  Fire hazards:-
• Evaluate the possibility of any fire hazard as soon as practically possible. This includes leaking fuel lines, perforated fuel tanks, electrical shorts, and possible burning cigarettes inside the vehicle. Inform responding members that fire extinguishers are required at the scene;
• Ideally members should provide for at least one or two serviceable fire extinguishers being available at every accident scene;
• Provide assistance if and when required by paramedics, or any other authority arriving at the scene without hampering their duties;
• Avoid walking around on the scene;

  Conduct towards injured persons:
STAY CALM AND TALK TO THE PATIENT/S.
 • Identify yourself. (Rather use your own name instead of your call sign);
 • Inform them that medical assistance is on their way;
• Request them to remain still and not move around;
 • NEVER EVER discuss the severity of the patient’s injuries within hearing distance of patient him/herself;
• Do not move the body of an injured person unless it is absolutely necessary. (The safety of the person and chances of further injury through, for instance, secondary collisions or fire should however be considered);
• Avoid the removal of a helmet from seriously injured motorcycle driver. If breathing is restricted then only loosen the chin belt without moving the head around. Conduct towards third parties (other road users):
• Be polite when communicating;
• Explain to them that there has been a serious accident ahead with injuries but avoid giving out further details;
• Do not argue with family members and/or friends who are in shock or aggressive due to shock. Be firm but polite with them. Understand that their erratic behavior is due to shock and not because they are naturally rude or aggressive.

  Traffic Control & Safety:
We wish to sound a word of warning and highlight the following: Accident scene management is a voluntary and auxiliary service in as far as CPF-members are concerned. Although we deal in more detail with traffic control underneath we wish to start off by dealing with safety first.

The following rules are applicable as far as regulating traffic is concerned:
• Members are not obliged to render assistance if they feel that it is too dangerous to do so. When they do so, they do so at their own risk;
• Doing duty/ regulating traffic on an accident scene is a very dangerous exercise and members must only choose to embark on this when it is absolutely necessary for the safety of injured persons and/or paramedics and there is no other authority who can adequately do so;
• Be alert at all times and always expect road users to act erratic and dangerously. Always be on the lookout for danger;
• Withdraw immediately from the scene once the police or traffic department arrive and they can take over the management of the scene;
• Never expose yourself or other members to danger;
• Do not block the road or access to the scene of any potential emergency vehicle with your own vehicle.

  Emergency Scene Equipment
We wish to reiterate that Accident Scene Management is a voluntary and auxiliary service that we may render and what is stated here regarding emergency equipment is done more in an endeavour to advise members of what can be used by volunteers who really want to go out of their way to assist rather than to require that this equipment be acquired by members.

Having said that, the following equipment may be of use at an accident scene:-

 Traffic Control:
• Road cones;
• Flashing hazard lights;
• Reflective jackets or at least reflective bibs;
• Flash lights, especially those with a strobe function.

Medical:
• Full First Aid Kit;
• Six bottles of drinking water (can also be used for cleaning);
• List of primary communication numbers with Emergency Services;

 On-Scene Equipment: 
• Fire Extinguisher;
• Mini generator;
• Floodlight on extension pole;
• Danger tape/ chevron tape;
• Bolt cutters to disconnect batteries;
• Flashlights;
• Bag of sawdust;
• Static flares (Used for helicopter landing and lighting)

 Remember:
Your own safety always comes first.

 We shall deal in more detail with Traffic control later