The ABC of resuscitation. Review on Dealing with Road Accident Victims

*Imagine the scenario*

You are walking along the road, happily ogling at all the girls(or guys) on view, when a car turns suddenly to avoid a head on collision and** ZAP, ** rams into a motorcyclist who was happily overtaking him through the wrong side! Result: One twenty-year-old lying on the road, bleeding to death, while fifty people stand by and watch, refusing to touch him or take him to a hospital, fearing police harassment.

*What to do? *

First of all, remember that even the Supreme Court has passed orders preventing police from harassing good Samaritans. All you have to do while registering a victim of an accident at a hospital is to give your name and address, and state that you were a bystander. Additionally, remember that NO hospital can refuse treatment(at least first aid) for an accident victim.

*ABC*

Modern first aid management has been reduced to simple steps, so that anyone can remember them and carry them out from memory.

The first step is to secure the **A**irway so that the victim does not choke to death on blood or vomitus. Make sure that the tongue is not falling back and obstructing the throat. If necessary, use a firm object(even a piece of a plastic tube or small hose will do) to keep the tongue away from the roof of the mouth(the soft palate). If the patient is bleeding from the mouth or has vomited, clear the secretions away using a piece of cloth. If bleeding is continuous, turn him/her on to a side, so that the blood can flow out the mouth and does not obstruct the throat.

Next, check to see that the patient is **B**reathing. This can be done by putting your hand just below the rib cage and feeling for the up-and-down movement of breathing, if chest movements cannot be seen. If he is not breathing, start artificial mouth-to-mouth respiration(yuck, especially if he has bad breath, but remember, you are a good Samaritan)! Give 10-15 breaths every minute.

Finally check the **C**irculation. See if he has a good pulse(put your fingers on the wrist, below the thumb). If the pulse is weak and thready, it means he has lost a lot of blood and needs urgent attention. Maybe you can phone the hospital while transferring him, so that the authorities are ready to resuscitate him as soon as he arrives. If there is severe bleeding from a wound anywhere in the body, put a bandage over that area and bind it tightly, so that the pressure reduces the bleeding. More complicated maneuvers are best left to specialists.

*Transportation*

Once you have ensured that the victim will not die of asphyxiation or bleeding while being taken to a hospital, it is time to get him into the next available vehicle and scoot. The point to remember here is that while he appears perfectly normal, he may have fractured his vertebrae or ribs in the fall. Movements occurring while shifting him may cause injury to the spinal cord, leading to permanent paralysis, or the broken ends of the ribs may puncture his lungs.

The ideal way to transport a patient is to move him gently to a plank or trolley, so that there is no stress on the vertebrae or chest. If this is not feasible, shift him with at least one person each holding him at the shoulders, hips legs and head. The rescuer looking after the head must pass one hand on either side of the head, so that the palms are under the shoulders and the forearms support the neck and head. If he has to be turned to a side(for example, if he vomits or has fits) the head, shoulders and hips should be turned at the same speed so that the body moves as a whole and does not get twisted. This technique is known as **log rolling**.

*Prevention*

While the steps mentioned above may help you to save a life, the best way to stay alive is to make sure that you don’t get into an accident in the first place. Here are a few common sense tips that may help to keep you out of trouble.

1. Don’t drink and drive

2. Always use a helmet(properly strapped) or seat belts

3. Don’t drive faster than your guardian angels can fly

4. Take a medical insurance(treatment for accidents can be extremely expensive)