A question for the professional first responders out there. What would you want me (us) to do (or not do) if we are first on the scene of a major highway accident, or see smoke and flames coming from a neighbor’s house, or even, perhaps, witness an assault or shooting? Other than immediately calling 9-1-1. (Probably a whole other conversation about how to make a 911 call. From my time listening to scanners, FR’s can spend a lot time looking in the wrong places based on lousy information given to 911 call takers.)

Response time in cities can be and usually is in minutes. But in rural and even suburban areas wait times for ambulances can be a lot longer. I live in a small town in SE PA with its own fire and ambulance service but once had to wait 30 minutes for an ambulance after a traumatic, self-inflicted injury (my FBI finger print card has only 9 of 10 spaces filled in).

So, if I roll up on a multi-car/truck pileup on a rain slicked section of I-95 what should I do? I carry a decent FAK in the car including trauma bandages and Celox. I have a fire extinguisher, a blanket and blue tarp. I carry a couple of strobe lights. So I’ve got gear. But what can and should I do that won’t compromise the patient’s condition, won’t complicate the EMT’s job and hopefully won’t get me sued?

The related question is what kind of training can a civilian get that makes one an asset rather than a liability in that kind of situation?

Now, in more than 40 years and a half million miles of driving I have never (knock on the wood trimmed center console) actually had this happen. But this forum is about being prepared, right?

I am not a professional first responder by any means, I'll be interested to hear what they may have to say. On the two traffic accidents I witnessed and was first on scene, I suggest: Go slow. First on scene can be first clipped by a fast Audi second on scene. Be safe. Stop well away from the accident, well away from the traffic flow. Blinkers on, put on a hi-res vest, put on eye shield, gloves, and leather gloves as you get out of your car. Walk back up the road well off the actual road, taking care of any traffic. Report in (call 911) - stay on the line until they say to hang up, even if you could be assisting. Be prepared - that means training in basic first aid and keeping a FAK with you in your car. Stay within your limits. Tell victims you have basic first aid training, you've called 911, help is on the way, can you help them. If they say no, don't help. Don't attempt the roadside thoracotomy no matter how bad it looks. The best you can do is apply pressure to bleeding, hold wounds stable, and calm victims, until the pros arrive. It could be gross - a woman I supported her neck for 45 minutes until she was evaluated and collared had a fair amount of scalp pulled away. Expect to stay for the duration - the firefighters didn't want me to let go her neck until they were ready, and it took a long time. Then there are accident / witness reports, and then maybe handshakes and a thank you for your help. Another woman on a moped had a grisly compound fracture of her leg and was in shock (I didn't travel with so much as a blanket then, never again). Don't move anyone unless there's physical danger to them. Tell everyone to stay in their cars until help arrives. Look for fire and other threats, but don't be afraid of it. If you have a fire extinguisher, its okay to take it with you as you assess the scene.

Know your limitations. Most of us aren't used to accident scenes, I get a bit of the shakes re-living these ones now. You won't remember to do everything, you have to be careful - you have to err on the side of caution, stay within your training, and do no harm. Help will be there as quick as they can.

I have been a first responder. In general I agree with the comments I've read so far, especially " Know your limitations. You won't remember to do everything, you have to be careful - you have to err on the side of caution, stay within your training, and do no harm. Help will be there as quick as they can."

Do what you are trained to do. Be supportive but do no harm as some people will try to make a lawsuit out of it. Also be careful about exposure to someone else's blood. It's a very high risk problem these days.

Some scenes are not stable, as in violent crime. The police have had to clear scenes before we were able to go in and help. One of my partners looked into a window and down the barrel of a 45. One patient, "slightly out of control" missed my forearm and literally bit off 3 inches of stretcher matress.

Be careful of your personal physical risk. I flagged a fireman to chase down a bystander puffing on a pipe as we had gasoline all over the place.

Keep in mind that training is training. Training does not make up for lack of experience. I have seen green medics absolutely flake out after a bad situation, especially when someone didn't make it.

Every situation always presents its unique set of problems and the training program doesn't plant a plan in your head for everything that happens. Training teaches you the basics and the ability to think and build confidence that you can handle a situation...hopefully, correctly to the best of your ability.

And I want to personally thank everyone who has ever tried to help in an emergency. Bless you! I remember a number of times when people hindered our efforts to do our job.

As everyone else has said , know your limits and don’t try to go beyond them.

Also sometimes the best course of action is nothing at all, and by that I mean that sometimes just someone who can talk to the victim, hold their hand if that’s what they need will do worlds of good for the moral, let them know that they are not alone and help is on the way.



“Be careful of your personal physical risk. I flagged a fireman to chase down a bystander puffing on a pipe as we had gasoline all over the place“

A couple of years ago we had something like this happen to us on a roll over, except it was the local LEO that popes a flair and tossed in near a puddle of gas next to the truck we were trying to cut the guy out of .

A couple of years ago we had something like this happen to us on a roll over, except it was the local LEO that popes a flair and tossed in near a puddle of gas next to the truck we were trying to cut the guy out of .


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Doesn't it just boggle your mind, when professionals make such profound mistakes??!!

I remember being told by CHP if you are going to help to always park 'downstream' of the wreck so that your car doesn't become a second accident. They park upstream because they have lights and use the car to protect the accident scene. Someone might want to confirm this but i also remember that if you are out at about 2-3am and come across someone on the right shoulder, park and don't use the emergency blinkers. Evidently, this is because the drunks out at that time will aim for anything with light on to 'follow home'.

depending on the situation, first responders do try to put there cars/trucks in such a way, so they will act like crash barriers, when tehy respond to a car crash. Handbrake on and steering wheel full to the left or right, so if it does get hit, it will roll to the side of the road, instead of making the pile larger. Equipment is replacible, people aren't.

For normal people, always make sure you are safe. We don't need another victim. Keep you action, down to what you know and have been trained to do.

Parking depends on the situation. For example, I used to be an EMT. If we were first on, we'd park upstream, to act as a traffic barrier. The trick was parking so that we could get out once we had our patient. If we weren't first on, we'd park downstream so we could leave without passing the scene.

Limitations! Know them.

Don't get tunnel vision; make sure you tell 911 an accurate description.

DO NOT BECOME A VICTIM! If it's in the middle of I-95 at 7pm on rain-slicked roads, you're just setting yourself up to be killed by traffic.

If you want to help, be ready to leave when told. Some folks are great to help, others are complete a$$holes that endanger folks. Get in the way, you may be arrested. Most EMS/Fire folks have no qualms getting PD involved.

If you don't know how to triage, learn. It's all well and good to try and do CPR on someone, but if you've got 3 folks in the next car and they bleed out and die, you've killed 3 (and still probably not saved the first). You NEED to manage time and resources when you're the only one there.

Honestly, as EMS, random folks being first on are kind of scary. Too much "wannabe" attitude (even saw a guy with a Crown Vic and amber light bar, trying to be like a cop, even with dark blue clothes). A police dept. I used to work with actually confiscated a guy's FAK, vest, and helmet. Why? It had the Star of Life on it, which is a trademark. He wasn't an EMT, medic, or associated with EMS in anyway. We ended up taking half his stuff and throwing it on our ambulance - his equipment was top-notch, but he was a hazard to others.

Lastly, again, don't become a victim. Gloves at the least, eye protection and a mask if there's squirting fluids. Traffic hazards, environmental hazards (are you going to freeze on the side of I-95 in january once you give your coat to someone in shock?), legal ramifications (though Good Sam. laws usually are pretty good), etc. Don't feel like you NEED to help. Only do it if it can be done safely and help others.

I really cannot add more then what has been already posted. Training and on-going practice are key to any skill mastery and would suggest ARC First Aid training (basic, community, advanced or whatever is available in your area) as a start. CERT training and if it moves you join the local Volunteer Fire Department and obtaining First Responder training would be great addition.

Pete

Some sound advice already posted here. There are some points I would like to emphasize:

First, DON’T put yourself in a situation where you could become another victim and make the situation more complicated. This should be common sense but you would be surprised how many people allow “tunnel vision” or “the candle moth syndrome” to affect their decision making process and put themselves and others into life threatening situations because they want to help. I have seen just as many trained rescuers without experience do this as laypersons. The best advice I can give anyone is STAY OUT OF TRAFFIC! Time after time I see bystanders trying to direct traffic or standing in moving traffic lanes as cars wiz by at highway speeds. Don’t forget that even HUGE fire apparatus lite up like Time Square parked on roadways get hit regularly. You safety is your priority… not the victims already involved in the incident.

Second, as anyone who has taken CPR knows, early activation of the 911 system is the key step in any emergency to assure the proper response gets dispatched and on the way quickly. No matter what tools or training you have, even if you are an on duty fire fighter/EMS worker/PD officer notifying the call center that there is an emergency is your first priority. Before you call 911, take a deep breath and calm down. A frantic 911 with (frequently wrong) spotty information can cause more confusion. By calming down and observing what is going on you can give the 911 operator a clear view of what is going on allowing them to make the right dispatch decisions. If you keep driving while you call 911, report where the accident happened not where you are 5 minutes later when the operator ask you (seriously, this happens ALL the time).

Lastly, sometimes your best action is to do nothing but make the 911 call. As someone else noted, know your limitation. What level of training do you have, what tools do you have with you, are you trained to use those tools you have? I know that is not in the ethos of the member’s of this forum, but sometimes you are going to be ill equipped and ill prepared to do anything but make a situation worse. The hard part is to know when to do something and when to just make the call. Taking that deep breath and staying calm can help you make that decision based off of facts not emotions.