Bike First Aid

This book is about first aid for bikers. Specifically, what are the dos and don'ts of the '''First Biker On Scene (FBOS)''' - because sooner or later it will be you. Comments to the pages in this book are welcome, and their content will be merged into the relevant chapters where appropriate.

STOP, then HHH

If you are FBOS, two things to remember : * '''STOP''', and * '''Life over Limb''' STOP means ... '''S:''' ''Stop'' ... don't rush into action mode you could cause MORE damage if you react without cool, calm and sensible behaviour. '''T:''' ''Think'' ... think about what to do next. HHH is the best approach. '''O:''' ''Observe'' ... what is going on, who is present, what are the dangers, exactly what is the patient's situation? '''P:''' ''Panic'' .... but do so '''''slowly''''' and with controlled behaviour. and HHH means '''H''' - ''Hazards'' - is there anything that will endanger ME? Next is there anything that will endanger the patient? If so sort that out first! Never forget Hepatitis and HIV - protect yourself with gloves and any other "barrier" device if there is blood or other body fluid present. '''H''' - ''Hello'' - is the patient responsive and conscious? If not - '''H''' - ''HELP!!!'' Get help! 082911 or 10177 for medical assistance - these are call centres so don't forget to tell them where you are! '''Life over Limb''' means that if a person is in danger of dying because they are not breathing, then broken bones and bleeding are of secondary importance - Help First then act as a Heart Lung Machine - provide CPR. If they are not in danger of dying ... stabilise the patient ... Spinal Stabilisation and immobilise broken (fractured) limbs. What's CPR, What's Spinal Stabilisation, How do you Immobilise fractures ... look for the next Tip of the Day - Andy, Brendan - your turn to chip in. We'll eventually combine these tips into a manual for members.

Legal Aspects of being a good Samaritan

OK the legal aspects, and I'm not going to continue a debate on this thread, we can start another if it is of interest, Bear in mind this is South Africa not USA - very unlikely that you'll end up on court for providing assistance. The following is an excerpt from our training manual ... The main question asked in a South African court would be “What would a reasonable person with the same qualifications and the same equipment have done under similar circumstances. A qualified first aider is not legally bound to provide treatment for casualties, considering that a court may find him/her guilty of negligence if he/she ''does not'' provide treatment. If you do provide treatment, you have to do so without adversely affecting the patient, causing the deterioration of the patient’s condition, or by breach of confidentiality. You are guilty of negligence if: * You provide outdated care * You cause the death of a patient (culpable homicide) * You provide treatment that you are not qualified for, except when: ** The patient gives his consent (orally, or by implicitly accepting treatment without any complaint). Only the patient himself can give this consent. Parents have to consent to treatment on behalf of their children. First aid on minors if the parents are not at the scene or first aid on an unconscious patient is given with ‘implied consent’. **It is a true emergency when a patient is in mortal danger or when his condition may deteriorate if you do not do something. This justifies treatment without consent. Even then, you are in no position to provide treatment if the patient expressly refuses it, unless you are convinced that the patient is confused, possibly because of severe shock. Emergency Medical Care: Level 1 – 3: First Aiders – Not HPCSA registered Level 5: Basic Life Support (BLS)/Basic Ambulance Assistant (BAA)/Basic Paramedics * HPCSA registered * Supervised Practice Level 6: Intermediate Life Support (ILS)/Ambulance Emergency Assistants (AEA)/ Intermediate Paramedics * HPCSA registered * Independent Practice Level 7/8/9: Advanced Life Support (ALS)/Critical Care Assistants (CCA’s)/National Diploma EMT’s (N.Dip) * HPCSA registered * Independent Practice On any medical scene, it is a requirement by law to abide by the instructions of the level above you as they are higher qualified (this includes doctors, nurses etc). HOWEVER, in many cases Doctors (GP’s/Pharmaceutical etc), Nurses or hospital staff may defer to you to perform CPR or other emergency procedures because they are not always trained in that area nor are they experienced. ''The world needs dreamers that DO!''

Safety First

===STEP 1 : SAFETY=== Recognizing the dangerous situations and safety of the scene, depends on good scene assessment and management. The 4 S’s of Safety * Safety of yourself * Safety of the scene * Safety of any vehicles / equipment / machinery * Safety of the patient At the scene of any emergency, there could be any number of potential dangers / hazards present: * Body Fluids * Traffic * Fire / smoke * Trapped patients * Dangling power lines * Petrol / oil spillage on the road * Bystanders smoking * Gasses / poisonous fumes * Bombs * Building / structural collapses * Vehicles lying on their sides or roofs * Vehicles balancing on the edge of a cliff / motorway * Hazardous chemical spillage (liquid / powder) General Rules of Safety * Wear protection. Keep rubber gloves handy in your vehicle. * Do not allow bystanders to smoke where there is petrol / oil spillage on the road. * Do not roll vehicles lying on their roof or side onto their wheels again. * Do not touch vehicles that make contact with dangling power lines. * Do not enter a scene where there are gasses / poisonous fumes without the necessary protective equipment. * Do not enter a scene where there are hazardous chemicals (liquid / powder) spilt. * Stay upwind from the scene, protect the bystanders, do not smoke, and do not walk through the chemicals. * Use bystanders to assist with controlling traffic and crowds. * Switch off the ignition and withdraw the key to reduce the likelihood of sparks. * Inform the relevant authority: besides the ambulance services, the fire and rescue services will also need to be notified. * Do not move the casualty from a damaged vehicle if he / she is safe and stable where he / she is. * Only move a casualty from a vehicle if it can be done safely or if his / her life is at risk.

ABC of first aid

Always remember your ABC's after hazards,hello,help (get help ASAP) start your ABC * '''A-airway''' (check for patent airway and obstructions)if obstruction found, first rectify with removing obstruction * '''B-breathing''' -is your patient breathing?, listen carefully for breath sounds for 20 counts if none detected use your hand to carefully move the head back to open airway (head tilt chin lift) with c- spine considerations and give 2 rescue breaths before progressing to next step * '''C-circulation''' is the patient's heart still beating if not start chest compressions with 30 compressions to 2 rescue breaths till your help arrives

Putting it into practice

You are riding on a sunday morning when you round the corner and come across a bike in the ditch and a dazed rider lying on the verge of the road. You've checked that: '''H''' you and your patient are safe ie no Hazards '''H''' your patient is talking coherently but in pain '''H''' you've asked someone to call 082911 for help and report back to you '''A''' Airway is ok ... he's talking to you so '''B'''reathing and '''C'''irculation are ok too. CPR is therefore not necessary (people who are awake get very irritable if you try to do CPR on them!) Remember CPR is a last resort for someone who is dying. What now? '''LIFE OVER LIMB''' Are there any other life threatening injuries? If so, treat them - bleeding from an artery will cause death within minutes so stop the bleeding using pressure. Pack bandaging (rip up a t-shirt) over the wound and wrap tightly to stop the bleeding. Don't remove an soaked bandage ... just add more. Tourniquets are not a good idea except in extreme situations because they totally block off circulation, leading to the eventual need for amputation of the limb. Pressure bandages are preferable. '''SPINAL MANAGEMENT''' After ascertaining that the patient is in a bad way but in no danger of dying immediately, stabilise him/her. 1. Don't remove the helmet - leave that for the paramedics. 2. Hold the head in the position that is in. Try your best not to move it. The paramedics will strap the head using head blocks and a neck brace, when they arrive. Until then, hold the head and don't move away until they take over and tell you to. Keep talking to the patient - he/she will be in shock and need continual reassurance. 3. Keep monitoring vital signs. If the patient starts slipping into unconsciousness, remember life over limb. If the need for CPR arises that is more important than the spine. Maintain as good an airway position as is possible without moving the head - obviously if the head position is blocking the airway it will have to be moved as carefully as possible and then stabilised. The picture below shows the procedure for moving the patient onto a stretcher/backboard. I have found it to be more comfortable and easier to maintain a stable position by lying flat on the ground with my hands holding the shoulders and holding the head with the inside of my forearms. This is personal preference and will depend on your physical build. Stabilising the spine: The female responder might want to lie down for better comfort and stabilityStabilising the spine: The female responder might want to lie down for better comfort and stability Log Roll : Rolling the patient to place a backboard under them: There should be more helpers to roll the patient.  Rolling is done on the command "One Two THREE" by the person holding the headLog Roll : Rolling the patient to place a backboard under them: There should be more helpers to roll the patient. Rolling is done on the command "One Two THREE" by the person holding the head ''The world needs dreamers that DO!''