Failed air bags, no seat belt

[ladybear]

Ok.. so I'm posting this as a learning lesson for myself. I'm interested in YOUR responses.

The incident involved is a freeway speed MVA, major front end damage to the rear car, I believe it was a Toyota, two door sports car type. Young male driver, mid 20's. No seat belt and the air bag failed to deploy.

Upon arriving at the scene, the driver of the vehicle initially was unconscious but breathing, aroused to noise. He unlocked the door. At that point I opened the door and told him to not move anything any further. Having no rescue equipment, and having just called 911, what would you suggest from this point on?

My inital assessment of this gentleman... rapid shallow respiration rate, complaint of "not being able to breath", positive jugular distention, equal radial pulses bilaterally, under 100 beats per minute, positive tenderness to mild pressure to the abdomen, positive cervical neck tenderness.

[Dustdevil]

...what would you suggest from this point on?

A lot of small-talk.

What did he hit, and why? And what are the chances of somebody now hitting you? Probably pretty good. I probably wouldn't have stopped. You're not really accomplishing anything after you call 911.

[Just Plain Ruff]

I'd first give him the number to a good product liability attorney based on airbags not deploying.

But seriously, did you check to make sure that you and he were out of lanes of traffic? Common mistake among emergency services people who stop and render aid on the side of the road. They don't look to see what else was gonna hit them. And BAM your'e dead

You have no equipment, you have no medications you have nothing but the hands on your arms and your voice so you can use your hands to hold c-spine or his hand because that's all you can do.

You can use your voice to calm the guy but apart from anything else you have nothing to offer this injured person.

Seriously, what can the average good samaritan do for an injured person with no equipment? Do we really think we are being helpful on scene when all we can do is wait for the equipment we don't have to show up?

[MedicNorth]

Well, now that you're there and have called it in, pretty much all you can do (assuming a reasonably safe scene) is C-spine support and wait until the folks with the toys arrive. The failed airbag would worry me - stay away from it, because they can deploy at strange times when malfunctioning.

[DwayneEMTP]

Seriously, what can the average good samaritan do for an injured person with no equipment? Do we really think we are being helpful on scene when all we can do is wait for the equipment we don't have to show up?

Actually she had simple, possible options, such as adjusting the airway, pressure on severe bleeding, etc. I don't need much equipment for that. Neither of these things is going to help this guy, who sounds like he's going to be in pretty big trouble if equipment doesn't arrive soon.

Should you have stopped...It's a dangerous, but personal choice. But as said, once you've decided to do so you have very few options and have exposed yourself to massive risk as well as possible liability.

I wonder, and I know I've been taught this but can't remember....First on scene, what do you do about the undeployed airbag? One thing fire and medic school did a great job of is convincing me that this man is not going to get any assessment until I can do so without being exposed to the air bags sudden deployment. We usually stand back until fire tapes it and cuts power....I've not had to deal with this on my own before...

Would it be acceptable to lay the seat back if possible, to distance him from the the full force and direct path of the airbag until rescue arrives?

Every brand new basic here probably knows this answer...But...I....Just can't...re...member! (Yeah..that was supposed to be a William Shatner impersionation.... :oops: )

Dwayne

[VentMedic]

Another thing to consider besides personal safety, will your vehicle and the many other vehicles of well meaning citizens delay/hamper the EMS and Rescue vehicles by taking the good parking spots? If EMS/Rescue have to park a half mile away, that is not productive. The more vehicles that park at scene the more attention and rubber neckers it attracks even tempting more to stop to see what all the excitement is about. Thus, the traffic slows even more delaying EMS.

[AnthonyM83]

You could certainly help by opening the airway and holding c-spine, as well as emotional support. The fear of a being in that situation alone not knowing how seriously injured you are or aren't can be more painful/fear-causing than the injuries themselves. I think that benefit would outweigh making the ambulance park a little farther away...

I'd hope being out of the lanes of traffic are a given. Was it daytime? I've seen and heard of relatively low numbers of daytime accidents on the side of the road WITHOUT flashing lights being rear-ended.

It's not like you stopped at a fender bender...

[Eydawn]

Calling 911 is the absolute best thing you can do. After that, yep, your options are limited... so C-spine, airway, and support are all you can do. But it's better than doing nothing!

I've stopped at accident scenes before. Actually, I stopped at a pretty gnarly one on my way home from work last Friday... at 10:00pm. Shan't give details, but let us just say that the dude who got nailed by the drunk driver was exceedingly lucky in that he only had some minor glass lacerations and minor bruises. From the way his car looked, and the kind of intrusion into the passenger compartment, I expected him to be way worse off. As a matter of fact, seeing the vehicle was what prompted me to stop...

Hazards? Definitely dark. I parked a good 400 yards up from the accident scene. Broken auto glass *everywhere.* Traffic at 50mph driving next to us. But the guy got knocked back into a dead end driveway, so the vehicle was fairly removed from the flow of traffic.

Some other people stopped as well... and one of them beat me to the cell phone. So I got the driver to sit down (he had self extricated) and let him borrow my cell phone so he could call his folks... and then I explained what was going to happen next as the cops, FD, EMS etc. began to roll up. You know what? He calmed down significantly when he learned how the process was going to work... and as soon as the cop came over, I identified him to the cop and left. That's it.

Did I contribute much by stopping? Nah... Did I put myself in danger? No more so than walking along that street on Friday night normally entails... and I certainly didn't neglect other responsibilities in order to stop. I got to reassure a pretty shaken dude, keep my eye on other bystanders so *they* didn't get hurt, and bail as soon as the pros got there.

The take home message is that you can't do much when you stop, but if it is a severe accident and you're willing to take the risk, do what seems right to you. If it's really gnarly in a rural area and you *know* it's gonna be a while, stopping might be a valuable idea.

Wendy

CO EMT-B

[ladybear]

So that's pretty much what I did do. Due to the failed air bag I was reluctant to do a more thorough assessment for both of our safety.. so instead I kept talking to the guy, monitored his respiratory status and maintained his c-spine until a medic actually took over and placed a collar. I let him know that help was on the way, when I could see the ambulance coming, etc... As soon as the medics took over and I told them what I knew of what had happened I got the ok to leave and was on my merry way.

I was the only one who actually stopped. I drove ahead and parked and walked back. The dipsticks who stopped to yell and cuss were causing more delay than I did. Oh.. and the tow truck driver who thought he would be helpful and tell us to move it to the side of the road.

The accident happened in the fast lane, along a concrete border, next to a construction zone during rush hour traffic. I was on my way to work.

[Dustdevil]

So that's pretty much what I did do. Due to the failed air bag I was reluctant to do a more thorough assessment for both of our safety...

That's a good point. I'd be worried about that thing firing off while I was in there trying to assess the patient. :shock:

BTW, I wasn't saying you shouldn't have stopped. You were there and I was not. It's a personal choice that should be based on a case-by-case evaluation. I was just saying that I probably would not have. I definitely would not parked up ahead of the accident, right where the ambulance is going to be parking. Poor form.