[Rider]

10) Watch for signs of person going into shock

People invariably die due to shock. "you don't die by the gunshot wound but by the shock of the gunshot wound."

Signs of shock:
1. Inability to answer the 3 questions coherently (Who are you, etc.) (see 4)
2. Pale, cool, clammy skin
3. Delayed capillary refill press your fingernail so that it turns white. It should turn back to pink in less than 2 seconds. If it takes longer, that is not a good sign.
4. Radial pulse (pulse at the wrist) goes away but there is still a pulse on the neck

There isn't much we can do once someone starts going into shock, but a few minor things that may help:
1. Assure adequate breathing. This really comes with the AB of U-ABCC.
2. Loosen restrictive clothing.
3. Reassure victim.
4. Keep the person warm (not too hot though).
5. Elevate the feet ~6 in.
This is actually a judgment call since you shouldn't really do that with suspected spinal injuries.
6. Control bleeding.
This is probably obvious but if you don't realize the victim is bleeding and they are rapidly going into shock, this should tell you something.
7. Immobilize fractures.
This helps relieve pain and control bleeding.

11) Stop bleeding, using sterile bandages/dressings if available

Two important things here are to (a) stop any bleeding as soon as possible and (b) keep the wounds sanitary as much as possible. (a) is far more important than (b). Peripheral limbs are commonly lost to infection, but given the choice between stopping bleeding and using a nonsanitary cover, using the nonsanitary wrapping is preferred. Blood loss is bad. Wounds can be cleaned at a hospital.

If sterile dressings are not immediately available, women in the group may be carrying sanitary tampons, or Kotex napkins. Either can be used as a sterile dressing, although obviously the sanitary napkins would be superior.

Carry some sterile dressings with me in my tank bag, backpack or trunk space. They cost about $1 at your local drugstore. * Personally, I carry a Backpacker's First Aid kit. They are compact and don't take up too much space.

EXCEPTION: If there are cuts anywhere on the head, do NOT apply pressure. If there is a bone chip it is possible to push it into the brain. It is also possible that stopping the flow of blood or cerebral spinal fluid can lead to a buildup of pressure on the brain which is not good. You should still bandage the cuts loosely.

12) In case of femur injuries (extremely common in moto accidents), check for blood loss

Femur (the "thigh bone'') injuries are very frequent. There are huge arteries that run along the inner thigh; if these are compromised the person can bleed to death in a very short amount of time. It is important to minimize bleeding in this region! Use a pressure point above the cut to control blood flow out of the femur artery.

13) Ambulance arrives

Before the ambulance arrives, send people to the intersections in all directions to watch for/direct the ambulance.

When the ambulance arrives, it is important to stay out of their way as much as possible. Meet them and identify yourself as being "in charge'' and to be the person to contact if they need anything (bikes moved, people moved, whatever).

Make sure you:
1. Provide accessible parking for ambulance
2. Let EMT's know who's in charge
3. Give factual account of accident ("And then the car comes along at 154 feet per second and hits our buddy here!'' is probably not going to help anything). At 40 MPH, there are 60,000 units of kenetic energy. At 50MPH, there are 120,000. It is IMPORTANT for medical personnel to have an HONEST estimate of the speed and circumstances at the time of the accident.
4. Give them all of the information that has been written down (periodic vital signs and the three questions from U-ABCC at 5 minute intervals, personal information about the victim, etc.)
5. Give EMT's an honest evaluation of patient's drug/alcohol consumption
6. Stay back or leave if told
7. Give EMT's time to work

It is important to give the ambulance people the most accurate information possible! If the person just had 10 beers in the past hour, tell them! They are not the law enforcement officials and their only immediate concern is the safety of the patient. By underestimating, trying to cover up, or not telling the whole truth, you are only keeping important information away from them which may be necessary for the safety of the patient.

If the helmet was removed, send it along in the ambulance. The doctors may use the visible damage to the helmet to assist them in what to look for in terms of injuries.

If there were leaking fluids, let the medical personnel know. The fluids may have gotten on the patient and they need to know if there was oil, gas, brake fluid or something like that on an open wound.

14) At the hospital

Only have one or two people in the Emergency Room at a time. If the doctors have questions and neither of the people in the ER know the answer, send one of them out to the other people to find out the answer. Crowding everyone into the ER will only make it more stressful and difficult for the ER staff to do their jobs.

15) Dealing with law enforcement

As with the ambulance, when law enforcement arrives identify yourself as being "in charge''. Let them know that if there is anything they need, such as bikes moved or people moved, you are the person to talk to.

For them, walking on to a scene of bikers who are all in a very excited state is intimidating and this will help calm them and give them some easy way to control the bike people. Again, this is the psychological management.

It is obviously important to do whatever the law enforcement officials ask.

Before the officers do arrive, try to not move motorcycle parts any more than necessary! They may need to take accident scene notes and by moving things around you may confuse the situation for them. Parts will need to be moved off the road to avoid further accidents, but move them directly to the side so the law enforcement officials can determine roughly where it stopped if necessary. Try not to disturb the bike any more than necessary. (Electrics turned off, bike propped up vertically, etc.)

16) Thank you

A good number of the ambulance people are volunteers. Officers often get little or no recognition for helping out on the scene. It will cheer all of them up to no end to receive some kind of thanks for their help.

Any of the following are appropriate:
1. cards
2. in newspaper
3. in person

It will improve our image as bikers and rewards all those people who take time out of their own lives to help others. It is important!

17) Couple of miscellaneous notes

Leathers will have to be cut off by medical personnel. Be mentally prepared for it. If they do not cut off your clothes, they will not be able to do a proper assessment of the wounds and you are not being treated properly! If you are conscious and insist that they do not cut your leathers, they cannot by law. If you are unconscious, it is implied consent and they will remove them if in doubt.

Over 50% of fatalities are alcohol related. I know it's a cliche' but don't let friends drink and ride unless you're prepared to lose that friend.

Many accidents involve going over the handlebars. If your bladder is full, the extreme pressure can easily cause it to break. Make a pit stop by the bathroom before you leave.

In an emergency situation, psychological management is important. If a central person takes charge and is remaining calm, this will transfer to all of the other people on the scene and will help the victim far more than if everyone is overly excited and pumped with adrenaline. Take two deep breaths when you feel yourself losing it.

Take basic first aid and CPR courses! They are offered through the Red Cross and several other organizations periodically. Go with some riding buddies or get your club to have a class!

Nothing beats proper training.