Last week, we discussed the need for keeping yourself safe while approaching a Motor Vehicle Collision (MVC) that you might encounter while on the road. As a reminder, one of the first lessons that healthcare professionals are taught is that no one’s safety is more important than their own. I now want to turn our attention to what to do after you have accessed the patient/victim. Keep in mind, you should never assume that someone has called 911 prior to your arrival. Make sure you know the location of the incident and, yes, what county the accident took place inside. Getting help on the way should be your first action after securing your own safety.
When approaching an MVC, the vehicle might look terrible from the roadway. However, modern vehicles are remarkably strong. As someone who has spent many years responding to crashes, I can honestly say I have noticed a dramatic decrease in the number of injuries/deaths from MVCs. The Center for Disease Control reports that the number of deaths from crashes has steadily decreased over the last ten years from a high of 43,005 in 2001 to a low of 32,744 in 2013. That being said, the United States still leads industrial nations by a large margin in the number of MVCs that we encounter.
Once you have made contact with the patient, it is best to leave them in place unless it would be hazardous to their health to do so. For example, if the vehicle is burning or submerged, it is considered an emergency move for the patient and should be done when it is safe. Otherwise, it’s a good idea to keep them in the position in which you found them. Emergency workers on scene will assess for injury to the spinal cord and possibly placed them on a spine board that will keep their neck in a neutral position. The danger of a broken neck or back is not necessarily that the bones are broken, although this can be quite painful. The true risk comes from damaging the narrow spinal cord (a group of nerves descending from the brain) that lies within the spinal column (the vertebrae). Damage to the nerves of the spinal cord is what causes temporary and long-term movement deficits. Unless there are imminent threats to life from staying in the vehicle, it is best to leave them as they lie in order for the emergency crews to do their jobs.
While working with the patient, you might encounter a variety of injuries. Broken bones can either be opened on or closed. If they are not actively bleeding, you are best to leave them in place and not try to splint without the proper equipment. Never, under any circumstances, try to “reset” a broken bone unless you have been trained to do so. Speaking of bleeds, the treatment for any cuts or lacerations is direct pressure with a clean dressing. Do not attempt to locate a pressure point or elevate the limb. These are old treatments that are not taught any longer. A great investment is a small first aid kit that can be stowed in your vehicle. In it, you will find clean gloves to protect yourself as well as many bandages for traumatic injuries. Just remember that the chances are good that you will encounter an MVC in your lifetime. A little planning on your part can go a long way on theirs. Stay safe out there.
M. Eric Williams, MS, NR-P is a syndicated columnist and the assistant director of emergency medical education at Jones County Junior College. He is a current doctoral researcher at Delta State University and has 15 years’ experience in emergency medicine.
