I would like to hear from the professionals on this one.

What do you feel the order of help should be when coming upon an accident and you are alone?

1- Extinguish any fire if possible if there is a threat to life.
2- Flare pattern to warn oncoming traffic
3- Examine people for injuries.
4- Notify the authorities, 911, etc.
5- Treat, within your capabilities, any life threatening injury.

I know every accident is different, but I think there is a process that should be followed.
Lots of people pick up their cell phones and call 911 just to say there is an accident. I feel there is a lot that should be done prior to that call.

I am very interested in your comments.

I was always taught to call 911 first if it looks as though people are injured, the faster they are notified the faster they can get there and help, usually it is better to send someone to call 911 why you do the rescue aspect. From there I would throw flares out since it can be done fast and improves my saftey and the saftey of the injured, after all I am no help if I get hit myself. From there I would extinguish whatever flames I could and then check the people out and triage them on the severity of the injurys and what I could do for them.

That is what I would do, however being im no professional, I don't know if that is proper procedure. I'm just using what I learned as a Boy Scout and from my CPR/Defib training.

1. Call for help first.
2. Is there any danger to self in attempting to help the other person? It would not help the paramedics much if you add to their casualty risk....
3. Remove casualty from the danger area - if not, reduce the risk of further injury to the casualty - if there is a fire and you can safely put it out, do so. If you can remove him safely out of harm's way do so. If not, mark out the danger areas to warn oncoming road users to reduce the risk of further injury - flares , lights, etc.
4. Treat the casualty within the means available to you in terms of training / equipment.

1) call 911
Unless you arrived in an ambulance with a trained partner and are yourself trained then call 911 or equivalent first. The reason for this is that once you become involved in providing aid you will lose your time perspective and precious minutes will pass delaying the arrival of needed help. If it turns out that the EMS / Fire personel are not needed then they can be called and canceled later.

2) Make the scene as safe as possible.
If you arrive on a traffic incident you may put your car between the accident and traffic, put your flashers on and your emergency brakes. Then, if you have flares put them behind your car at 10', 20', 50'. If there is a sharp bend in the road then run back and place one on the other side of the bend so folks don't come whizzing around the bend only to discover that they cannot stop in time to avoid becoming part of the problem.

3) Don't become a casualty!
If there is a fire stand back and get some marshmallows - seriously! Go looking for anyone who may have been ejected from the vehicle and assist them. Don't become involved in extinguishing a fire. That is orders of magnitude beyond the training and gear you are likely to be carrying in your vehicle unless you happen to be a firefighter with one of the response vehicles. Unless you have turn-out gear and a mask don't approach a vehicle fire.
If you have latex gloves put them on. Just because they had a vehiclular accident doesn't mean that they don't have HIV, tuburculosis, or any other communicable desease and their blood will be all over the place just trying to infect you.

4) Don't harm the victims!
If they can stand up and walk about and are already doing it get them to sit down or better lay down away from traffic and accident. They may have spinal injuries that are not obvious to you or themselves. With a neck injury (very common in vehicular accidents) they may feel fine until they turn their head the wrong way then they will stop talking, breathing and standing as they sever their spinal cord in the neck and fall to the ground a quadruplegic unable to breath (think Chris Reeves) If they are in the vehicle and it isn't burning then keep them there until the ambulance arrives with the proper spinal imobilization devices - collar, board, etc...

5) If there is severe bleeding that you can reach apply direct pressure and bandage.

Without EMT or better training stop here and wait for ambulance.

As a trained individual there are other items to attempt and examine.

triage - apply MCI triage if there are more patients than there are trained aid providers. If you are alone then this means you will only be treating one patient and it had better be the one that has a chance. Those who can walk get no attention and those who aren't going to make it get no attention. Life is tuff.

ABC
Check all victims for breathing and if absent check their airway while maintaining spinal immobilization. (Many EMT's, myself included, carry cervical collars in their private vehicles) the airway needs to be checked and cleared / stabilized prior to applying a collar.

Check rate and quality of breathing and assist if necessary.

Check rate and quality of circulation - this involves checking for major bleeding, checking rate and strength of pulse and blood pressure.

When the Ambulance arrives have the MCI triage results ready and the ABC assessment of the individual you are working.

First rule of anyone pulling to the accident is: Scene safety.

You have to look when you are coming upon the accident and make notes about nature of the accident, mechanism of injury, what sort of accident is it (tractor trailer with load of petrol or just two passenger cars), look at surroundings (downed power lines/spills/etc etc), try counting number of victims... and call 911. All that stuff I just mentioned is done from the distance. If there is a spill, contaminated area, possible explosives or maybe it’s a crime scene (sniper shooting) with perpetrator still present it is in your best interest when something goes off to be pretty far away. If there is a truck involved look for the hazmat tags (blue/yellow, white and red) and try to note all the markings so you can tell it to the operator.

When you get in touch with an operator you are going to tell them all that info you just observed so they can notify right units. And wait for the proper authorities. Above will determine if fired dept needs to be sent to contain gas spill, if people are pinned, if there are injuries or maybe hazmat team needs to suit up. I personally love when people who call 911 give me all the above info and most important proper location of the accident.

BUT

I understand that you are not talking about major disasters but regular accidents that happen every day. Above will still apply. It’s just that most likely you will already be on top of the accident scene either because traffic brought you there or because you are the first one who came upon the scene.

Under no circumstances you should attempt to remove a person out of the car unless you know proper methods of extrication (and it takes two at least to do anyway plus equipment is needed). In extreme cases proper extrication methods are ditched in order to get somebody out ASAP but everything humanly possible is done to keep the spine in line. If you want to keep the scene safe block it with your car at least 50 -100 feet away and lay down the flares (your initial observation will tell you if it’s safe example: no flares on overturned propane tanker scene). If there are fumes or potential Hazmat situation you try to be upwind at least 250 feet – 500 feet away (farther the better). Don’t hurt yourself, people involved in the accident would give EMS enough work without you getting hurt.

As far as the care goes. Advice people even those who feel all right to stay in their cars. No need for anyone to wonder around and collapse or get hit by incoming traffic. I usually ask them to remain in their cars until ambulance comes so people can get evaluated, and EMT will hear with his own ears that patient stated: “I’m fine I don’t need help” and get Refusal of Medical Attention form signed. It makes no difference for me that I’m an EMT. I’m not the unit assigned to this job and even if I’m there to help I will not interfere unless I see life threatening conditions. Also remember that if somebody has a collapsed airway and you start cpr you have to stay there until you are cleared. No matter what else you see you can’t stop unless of course you are in danger. With car accidents injuries may not be that visible. Seat belts, airbags will prevent a lot of external injuries but they may cause or not protect from internal ones and what you don’t see is very dangerous.

Don’t take statements, don’t try to reason with one driver or another, just be sympathetic but don’t throw any judgment. If by any chance you are qualified to provide care (and started one) you have to wait for EMS units to arrive in order to transfer care otherwise you are negligent and it can cost you your license. In order to get a proper count don’t only look in the cars some people can be ejected from the vehicle. When police arrives make your statement and tell them everything. Tell EMTs what you’ve seen. Maybe drives was unconscious when you got there but now he is out of the car and walking. Any info will be appreciated.

BUT

America(ns) wouldn’t be today what we are if it wasn’t for heroes. If it wasn’t for people who ignored all sense of danger and were brave enough to do thing that saved countless lives. I lost track of the amount of times I acted like a cowboy in order to get to the patient faster or to work in dangerous conditions even if that meant risking my life. But it was a calculated risk. Use your judgment; think about your family, girlfriend, friends, dog, cat, hobbies and life. Is it worth it? Use common sense. And don’t get hurt or overreact.

Matt

You have received excellent advice from the various posters who have already responded to your question. Pete

WOW! Great feedback.
The professionals, Not Me, tend to look at the aid you would give and the legal implications involved; an unfortunate necessity in this day and age of lawyers, gypsies, tramps and thieves.
The non-professionals, me included, tend to move faster with a little less thought perhaps.
Some place in the middle for a non-professional seems to be the best approach.
Without being demeaning to anyone, a lot of it is common sense, but not necessarily all that I would have considered prior to reading this input.
I would find it difficult to do "nothing" if common sense and an evaluation of the situation dictated that "something postive" could be done, even if just to warn oncoming traffic.
I guess the main thing for a non-professional to do would be to "offer no advice" to anyone involved in the accident. Speaks volumes in itself.

I appreciate the feedback, good food for thought.

Thanks very much.

I think the biggest problem which I encountered in bigger cities is the possibility of getting sued. I mean on rural road in Jersey you can pull out a farmer from under a cow that broke his pelvis and femur, stabilize him, drive him to the hospital, save his life and he will be thankful for life (plus you get to marry his daughter and have dairy supplies for life). You do the same in NYC and farmer would sue you for leaving the cow unattended and causing her psychological damage which produced half a pint less milk per year and costed him one billion dollars in income. But he will settle for everything you have.

When I get to the accident scene and I'm off duty I will secure the scene check for life thratening injuries (which I will treat) but rest is up to the arriving police and EMS crew. No point in risking everything you worked hard for (maybe that's the reason why most EMS members keep their assets under their parents' or spouse's name).

Matt

It is good to find the humor in your writing.

"Wrinkles only go where smiles have been"

I thought the courts had ruled that a person who helps others in the event of an accident is covered by the "Good Samaritan" statute? The only restriction I remember hearing is that once you start giving aid (like CPR), you have to continue until other help arrives.

Here is a link that has the statues listed by state:

Medi-Smart