After The Accident

I have been asked to make a presentation to the BMW rider’s club of Tampa on what to do after a motorcycle accident occurs from the perspective of a paramedic who also rides a motorcycle.  The following is an article I wrote to supplement that presentation.

After the Accident

It seems like whenever the subject of motorcycles is discussed it frequently turns to motorcycle accidents. Every motorcyclist has heard someone bring it up. There is always that person who delves into the litany of reasons not to own one and why they will never ride. Heaven help the young man trying to talk his mom into letting him have one. She is an instant expert on motorcycle wrecks. I know my mother was. There is, unfortunately, a reason for that. Motorcycle accidents typically result in more severe injuries than the equivalent accident in a car. We each make the personal decision how much risk is acceptable, then we must be willing to suffer the consequences should fate fall on the wrong side of our decision.

When I was 19 years old I totaled my jeep hitting a tree head on at 55 mph. I was able to escape unscathed and even helped the firefighters push my vehicle off the road. The jeep took the brunt of the impact and did what it was supposed to do in protecting me. The same accident on a motorcycle would have resulted in a far different outcome. Enter the search terms “motorcycle wreck” into the youtube search bar and what comes up is page after page of videos showing motorcycle accidents. Some of them are funny as nothing more than the rider’s pride gets hurt. Other videos are predictable; the stunt riders who push the envelope, the guy pushing his speed through a crowded city road that kisses the back of a bus and the first thought is not of surprise, but “what an idiot”. The last category is more sobering. Many of the videos uploaded are of events that could happen to any of us despite our best defensive riding, such as the car that pulls across our lane of travel without warning, the driver who isn’t paying attention while texting and rear ends the bike at a stop light, or the truck that runs a red light. The point being that serious accidents can and do occur. Without seatbelts, airbags, and an engineered cage around us injury can be more significant and possibly deadly.

This last week I contacted a crew member of Bayflite 4 based out of Hernando County. I asked him what percentage of flights were for motorcycle wrecks. The flight medic pulled up his computer and counted them out for me. The result was that of thirty five flights as of the 27th of May, fourteen were for motorcyclists. The remainder are the typical car accidents, falls, equestrian incidents, shootings, strokes, etc. A little math shows that it is 40 % of all their calls for service this month. Injured motorcyclists are by far the highest category of patients requiring air transport to a trauma center. The month of May for one air ambulance helicopter is just a sampling, but it is representative of a typical month for a service that exists to treat trauma patients.

I am not going to spend time discussing how to avoid these accidents or defensive riding as there are others far more equipped to lead that discussion. I am not going to go in depth on choosing the right safety gear. Although I am going to adamantly insist that if you ride you NEED to be wearing head to toe quality gear.

I am also not going to discuss insurance, but I will say that it isn’t just a good idea, it could be the difference between a financial inconvenience and being responsible for the staggering medical bills that you will receive. Review your policy with your agent. Ambulance services can typically charge between $450 and $700 plus mileage. Bayflite has a formula that includes the transport, mileage, hours, fuel costs, and services rendered to arrive at a typical bill that runs in the neigborhood of $10,000. Other air ambulance services can run as high as $25,000. You haven’t even reached the emergency room yet, or seen a trauma surgeon, or a neurosurgeon, or been stuffed into an MRI or CT, or gotten x-rays, medications, blood transfusions, or any other procedure to save life or limb. Ask your agent what a typical payout is. You could find you are under- insured.

What this article is intended to cover is some advice for the motorcyclist about what to do after the accident. I have been involved in emergency medicine as a firefighter/paramedic for thirteen years. I am currently employed as a FireMedic by Hernando County Fire Rescue. Another duty of mine is to precept new paramedics for the department. I have also worked at various local hospital emergency rooms as side jobs over the years. In that time I have gained insight to the injuries that occur to motorcyclists. My hope is that you walk away from this having a better idea of what to do or just as important, what not to do if you or someone with you should experience the misfortune of being involved in an accident. This article is not a substitute for training either. A good first aid/CPR class would be beneficial to attend.

While I do not intend to endorse one brand of safety gear over another or get into leather versus exotic fabrics, I will lend my testimony to the fact that safety gear makes a world of difference to what occurs after the accident. If you are reading this then you are probably an avid motorcyclist and I am sure you have seen the acronym A.T.G.A.T.T. which stands for “All The Gear All The Time”. The phrases, “dress for the crash, not for the ride”, and “it is better to sweat than to bleed”, should also be mantras that are familiar.  I have seen the stereotypical big bad biker cry and whimper in the back of my rig when the doors are closed. I have also responded to accidents that coming over the radio sounded horrific, but when we arrive the witnesses tell us that the rider slid down the road, got up, retrieved his bike and rode away before we arrived. The difference? Gear. Wear it!

While on this subject I will confess that I am a big proponent of full face helmets. Skid lids are a joke. They don’t count. Some of them even state on the inside that they are a novelty item only. They do not offer sufficient protection in my opinion. I responded to a motorcyclist once who was riding a very nice custom chopper who was making a slow speed u-turn and fell over striking the side of his head on a curb while wearing one. The result was a very preventable, but bad head injury. We put him into a medical coma, intubated him, and he bought a ride in a very expensive custom chopper of another kind that air lifted him to a trauma center. My wife is both a trauma nurse and a paramedic, she has stories of her own. One of them is a situation where they believe that style of helmet actually contributed to the death of a rider she worked. Half face helmets, while a step in the right direction, leave a significant and important portion of the head exposed to impact. I won’t get into the gore of the injuries I am familiar with, but it doesn’t take much to understand that asphalt acts like sandpaper and the human face is softer than the helmet. Which is going to give first, and which is more likely to be left when everything comes to a stop? Again, we all take the risks that are acceptable to us, but as a paramedic, I have very definitive opinions as to what acceptable risk is, and what foolish risk is.

While I think many riders will concede that a helmet and jacket are the bare minimum, I advocate for good gloves, riding pants, a set of quality boots, and eye protection. Most motorcycle accidents will also involve the hands. You reach out instinctively to protect yourself. How long will you be out of work while you recoup from the surgery needed to graft skin back onto your hands? I have seen injuries where the fingers were ground away and mangled to the point that nothing was left. What are your hands and fingers worth to you? Please understand that while I am refraining from describing vividly the gore I have seen, I am adamant that quality gloves make a difference for a reason. Don’t get cheap and buy the automotive gloves at the auto parts store either. Look for something with reinforced leather.

I also frequently hear how standard blue jeans will hold up in a slide up to “X” miles per hour. If you are one of those people who can put a number to “X”, then consider yourself lucky. That is NOT typical of the protective qualities of blue jeans. My experience says otherwise. Jeans pants and jeans jackets do not have the ability to hold up to the friction of the road. We see many injuries where the clothing ripped away exposing flesh, leading to preventable injuries. As an example, a few weeks ago I transported a young man who grabbed a fistful of front brake on I-75 in the morning light rain to avoid a stopping vehicle. He had a full face helmet, leather jacket, and tall leather boots. The leather was more for the style of his outfit, but it was thick and did the job. His jeans pants, on the other hand, wore through and the road ground deep into his patellas (knee caps). His hands were useless hamburger. Had he been wearing full gear he would have been another one to have picked up his bike and ridden away. The only damage to the bike were scuff marks and broken turn signals. Another accident I worked last year was out in Aripeka, near Hernando Beach. It was a woman who came off the back of a Harley when her boyfriend lost control and dumped it. Her right arm got pinned under her body as she slid. The forearm bore the brunt of her weight against the asphalt. When we arrived her arm was an anatomy lesson with tendons, muscle, adipose tissue, and blood vessels all exposed and damaged. She landed on the bank of the canal. Before we could dress and wrap the wound we had to pick sticks and pampas grass out of it. A $200 dollar riding jacket or the multiple thousands that surgery will cost, not to mention the pain and lost time? It seems like an easy answer to me.

I have also witnessed some horrific foot injuries. Chains and sprockets do not go well with flesh. The pegs which were designed for the ultimate grip on the bottom of your shoe have the potential (I have seen it) to rip your flesh off when the tennis shoes go away from the friction of the road. A quality riding boot can be the difference between a bruised foot or ankle and something much worse.

Proper eye protection can go a long way towards preventing accidents and injuries. If you can’t see then how can you be in control? In the state of Florida it is the only piece of safety equipment that is mandated by law regardless of age or insurance, Florida Statute 316.211. Windshields on the front of your bike don’t meet the requirement. Wear your eye protection.

The last piece of safety gear I am adamant about sits between your ears. If you are not in the right frame of mind, then sit the ride out. We all ride for enjoyment and for the ability of a motorcycle to take the stress away, but sometimes we can be so stressed as to be distracted from the task of riding safely. You need to be able to focus. I shouldn’t even have to get into the stupidity of riding while high or intoxicated, but enough people do it that I really question their intelligence. I recently responded to a couple on a bike doing well in excess of one hundred miles per hour while high on meth. They impacted a car making a turn out of a neighborhood at that high rate of speed. The husband was killed. The wife won the award for the most road rash I have ever in my career seen, as well as a compound fracture of her lower leg. She landed in a huge pile of fire ants in the median. The ants swarmed over her abraded skin and stung her mercilessly. She survived with bad injuries, and was wearing the only helmet (full face by the way) between the two of them. Had they not been high they likely would have made better decisions. He might still be alive and she would not have the injuries she sustained. Had they been wearing gear the outcome would have very likely been much better concerning their injuries. He would perhaps not have died from head injuries and she would not have suffered the extreme road rash. If you want to do drugs or drink, stay off the bike, period. The Florida Motorcycle Handbook on page 26 states, “Injuries occur in 90% of motorcycle crashes and 33% of automobile crashes that involve abuse of substances.” Do me a favor, if you are high or drunk, don’t ride with me, near me, by me, or even on the same road as me. I would rather not die or be injured from that kind of stupidity.


Damage after hitting a car at over 100 mph. Rider was high on Meth.

While I am a strong advocate of A.T..G.A.T.T. and have seen enough to know it makes a difference, I also recognize it doesn’t make a rider bullet proof. It is still very possible to receive severe injuries fully geared up. It comes back to that balance of risk and defensive riding.

When an accident involving a motorcycle does occur there are some immediate concerns that need to be addressed. Assuming you are not the one in the accident, the first and most important thing to be concerned about is yourself. I know, I know. I hear it now. How can I say that you should be concerned about yourself when your best friend just hit the ground or a car and is in critical condition on the highway? That moment is the moment that you MUST stay in control and not panic. If you run out into the road and get hit who is going to help your friend at that moment? Who is going to call 911? If your injuries are worse than your friend’s injuries, you just delayed help because you are the first to be hauled away in the first responding ambulance. Your friend now has to wait on the second ambulance. Some friend you are.

When teaching new EMT’s we drill it into their heads that scene safety is the number one priority. You are number one. The safety of everyone with you is number two and the patient is the last priority. Don’t make the situation worse with panicked behaviors. Before you do ANYTHING, stop and evaluate what happened and what the current situation is. Being on a remote rural highway with no traffic is a highly different situation than being in the middle of a six lane highway at rush hour. Your response should be appropriate for the situation. Use your motorcycles and whatever else you have at hand to divert traffic. Even if it means using an extra shirt or something for a flag. It is better for the motorcycles to get hit than you. Have you ever been upset that traffic has been shut down to one lane impeding the flow of traffic around an accident? The big red fire engine has blocked two lanes, the deputies or state troopers have their cars lining the road forcing everyone over. There is a reason for that. In spite of having the brightest strobes on the market, the latest D.O.T. mandated triangle reflective striping, and standing over ten feet tall and eight feet wide, our department still has drivers hitting our parked fire engines. Think about that. If someone still manages to not see our emergency vehicles, what are you to them in their field of vision? Do not ever make the fatal mistake of thinking that because there is an emergency situation that drivers will see you.

The second item on the checklist of things we drill into new EMT’s and paramedics is B.S.I. They must start out every practice scenario with “Is the scene safe?, my B.S.I. is in place, and what is the number of patients?” They must ensure that the scene is safe for them and if you did your job and didn’t add to the patient count by getting creamed by traffic then the only other immediate concern is one you need to be concerned with as well. B.S.I. stands for Body Substance Isolation. In essence it is latex or vinyl gloves and protective eye wear. It is the simple precautions that responders take to ensure that we don’t get exposed to bloodborne pathogens. HIV (AIDS) and Hepatitis B & C are some of the top things to be concerned about. Back before B.S.I. adherence was as strict as it is today, roughly five percent of emergency responders got infected with a bloodborne pathogen during the course of their careers. Just because you don’t do this for a living doesn’t mean that the risk isn’t there for you as well. Head injury patients are often combative. It is actually one of the signs we look for in determining injury to the brain. That means your normally very calm, collected friend is going to be freaking out and will be extremely confused. The blood that is streaming out of their head will now be slung around covering everything as they fight to get up and shake their head back and forth. Guess what? Your eyes are a perfect place for bloodborne pathogens to infect you. You helped to render aid and when it is all over you walked away and thoughtlessly wiped the sweat out of your eyes or off your face. You have just possibly infected yourself. Have you ever used alcohol based hand sanitizer and felt the burn in an open cut you didn’t know was there? That same cut is enough to give a pathogen an opportunity to infect you. Broken glass and mangled metal only increase the odds that you will cut yourself, but you are there for your buddy, right? You survived the accident and didn’t go down with him, but now you will know the agony of having your liver shut down in future years from that simple mistake. “But I only ride with a bunch of old farts. We’re good to go”, you say.  Age doesn’t make you safe from disease. The next time you are in CVS or Walgreens pick up a box of medical gloves in your size. Carry a few pairs somewhere on the bike, your backpack or in your small first aid kit. Replace them yearly. They also double as hand protection to keep oil and grease off your hands should you need to work on the motor or chain while out riding. As for your eyes, the sunglasses you wear every day will work just fine in protecting you. Just remember to clean them afterward with soap and hot water or better yet a bleach solution.

Hopefully if an accident occurs you stay calm, assess the situation, keep yourself and others safe, and have the means of protecting yourself from bloodborne pathogens. Now what? Call 911. A world renowned surgeon could be on scene, but even he can’t do much good there. That would be like asking your mechanic to fix your broken valves and pistons roadside with his leatherman tool. There is only so much that can be done roadside. The sooner you get help on the way, the better. Most everyone has heard of the Golden Hour. It is the time period in which a person has a higher percentage of survival if they receive definitive care. In this case, it is the bright lights of a surgical room and the cold steel of a scalpel that a victim needs. I also want YOU to call 911. Don’t just shout for someone to call 911. It is frustrating to receive a tone out dispatched as, “caller requested an ambulance, no further information as caller disconnected.” As a medic I am then asking myself, “Where am I going? Am I going lights and sirens or not? Do I need to get a helicopter warmed up? Do I need more than one ambulance? Is law enforcement needed for traffic control?” There is more going on from our end than you might think. If the caller states, “I am at the corner of Oak Street and 491 with one unconscious motorcyclist who hit a curb”, that makes a world of difference. I then know that I need to get the air ambulance crew to start the warm up for their helicopter, I need law enforcement to direct traffic, I need another engine crew to both assist in patient care and to land the helicopter. As a responder, I now have the resources responding to your emergency in a timely manner instead of taking my time to get to you because it did not come across as someone in dire need. We don’t risk our lives and push traffic out of the way for an unknown problem. Too many people call 911 now days for trivial things. Secondly, the dispatcher is trained to provide you with simple first aid procedures that you can do while you wait. Even if you take a first aid class and forget everything you ever learned, that dispatcher will walk you through step by step in a calm, reassuring voice what to do.

I also want you to be the one calling 911 because you witnessed the accident and know your friend. Dispatch has a lot of questions to ask you. The moment you identify that an ambulance is needed and where it is needed then the closest one is dispatched. We receive further information relayed from you to our computers while on the way. Dispatchers do not wait until the end of your call to tone us out. Stay on the line and answer their questions. This list is directly from our 911 call center as to what they initially want to know:
1.Where is the location of the incident?
2.What type of injuries are present?
3. Where on the body are the injuries?
4.Is there any road blockage?
5.Are there any hazards present or any hazardous materials?
6.Describe the vehicle(s) involved
7.Is the location of the incident on a public road, a business parking lot, or on private property?
8.If it is on a public highway, what lane is it in? North, South, East, or West bound?
9.Is there any smoke or fire?
10.What is your name and the phone number you are calling from?
11.If it is a motorcycle accident, was the victim wearing a helmet or not?
Your statements determine what instructions you receive. You will never be told to remove a helmet over the phone. You will also never be instructed to move a patient unless there is an immediate danger to the patient. Staying on the line helps everyone, but most importantly it helps your friend who is in trouble.

There are a few common situations that you may encounter with motorcycle accidents. The following descriptions are just that, descriptions. This is not training. You need to know what you are seeing and what steps you can take to avoid injuring the victim any further and what you can do to help if it is warranted.

The first issue that is going to be assumed on nearly every accident involving a motorcycle will be a spinal injury. The human body is not designed to impact immovable objects at high speed. Squishy things tend to pop and rigid things tend to snap. Your spine is essentially the frame by which everything else is suspended. Inside it is the spinal cord, the information highway by which signals pass back and forth between your brain and your body. It is vitally important that the spinal cord stays intact. Sometimes the vertebrae will fracture without injuring the cord. It is for this reason that we do our best to not needlessly move a trauma patient. In moving such a patient incorrectly the spine may move along the fracture injuring the spinal cord. There is a proper technique for doing this. My advice and the advice you will receive from the dispatcher on the phone is to not move the patient if at all possible.

X-ray of a severed spine due to a motorcycle accident.

X-ray of a severed spine due to a motorcycle accident.

That brings up the next question. When is it permissible to move a patient? Again, let me emphasize, nearly never. The only reason to move a patient with a potential spinal injury is when there is IMMINENT danger of death. Everything in medicine is risk versus benefit. Is the risk of surgery worth the possible benefit of a successful outcome? Are the medication side effects worth enduring for it to work? This is one of those times. It would not be a good trade off to leave the victim on the highway so he could have a perfectly intact spine just before he was run over by an 18 wheeler semi truck. If you are unable to stop traffic and there is imminent danger of death, then that may be one of the few times it is permissible to move someone. In doing so, grab hold of the shoulders or under their arms while cradling the head in your forearms to drag them in line with their spine. Try not to bend the spine and definitely do not let their head drop backwards limply. A second bystander can assist by holding the hips to assist in moving. The victim’s belt makes a great hand hold. Another situation could be if they are face down and not breathing. If you are willing to perform mouth to mouth resuscitation then the victim may need to be rolled over while keeping the head inline with the body as the patient is rolled over. (Keeping in mind Body Substance Isolation, there are small protective filter masks that are readily available from online for protecting yourself from disease if you perform mouth to mouth resuscitation.) If you are wrong in your judgment though, you may open yourself to liability. Be absolutely certain before endangering someone’s spine that way. The most common instance I see where someone moves a patient when they should not is after an automobile accident where the airbags deployed. Airbags contain corn starch or talcum powder to prevent the bag from sticking together during the years of non-use. When it does go off there is always a lot of airborne dust. Drivers with spinal injuries have been pulled out of the vehicle because the bystander who “rescued” the driver thought the dust was smoke from a fire. Believe me, the paramedic will document who pulled the driver out. The Good Samaritan laws do not protect the well meaning rescuers when the driver turns out to have suffered paralysis due to that rescue. The key to the law is the phrase “reasonably prudent ordinary person”. It is not reasonable nor prudent to rush in without examining the situation first and instead to just make rash decisions without regard to the consequences. When faced with a possible spinal injury, use good judgment. You can also refer to the Good Samaritan laws of Florida under statute 768.13.

Head injuries are the leading cause of motorcycle fatalities according to the CDC. When helmet laws were repealed in Florida fatalities immediately increased. Back to my earlier statement, squishy things pop. Your brain is a squishy thing. Forceful impact with another object can result in bleeding occurring in the brain. In a motorcycle accident a victim with a head injury may exhibit certain behaviors. They may be confused or combative. They may be unconscious. Their breathing may be labored and irregular. Sometimes those injuries don’t manifest themselves immediately. It is always a good idea to immediately call 911 for a suspected head injury. Unfortunately, many riders who don’t wear their helmets say they would ‘rather just die in the impact’. Immediate death is not necessarily the case. Often times the victim will live for a while longer. The victim we flew out who was high on meth lived for another day before dying.

As for removing a helmet, there is a proper technique for removing it. Even if you know the technique there are devices that EMS will place on a patient to immobilize the head and neck that will not be present on an accident scene prior to EMS arriving. Removing a helmet is really a spectacularly bad idea following a motorcycle accident. The vertebrae in the neck protect the spinal cord and nerves that control breathing and the heart. Manipulating the head to remove a helmet can lead to death or possibly causing that person to be a quadriplegic. My advice is….don’t do it.

What emergency responders would appreciate you doing is simply doing what we call “holding C-spine”. Hold that person’s head either in the position found, or in the neutral position of the head facing forward if they are moving around. If they are combative then do not force their head to that position, as tensing their muscles can in and of itself cause further injury. Hold the head as still as possible and engage them in conversation. Don’t let them look around as people run up. Remind them to hold their head still and not to get up. This can be difficult with head injuries as the patient will be confused. You may have to repeat yourself many times.

We also need to discuss CPR. The reality is that less than 1% of trauma victims survive if they code. If the injury is so great as to stop the heart there is almost no chance of survival. Does this mean that you shouldn’t try? As with everything in life the answer is, it depends. There is a phrase, “injuries incompatible with life”. If the injury is such that nothing can be done and it is obvious then step back, secure the scene, and call 911. There is nothing else to do. Those injuries that you might expect to see that are incompatible with life would be decapitations, a severed body, brain matter outside the skull, or injuries so severe as to preclude CPR. While the chance of survival is likely to be dismal for any other trauma leading to cardiac arrest you should still initiate CPR if the victim is pulseless. There are a couple of things to remember. If they are pulseless because a lung has popped (pneumothorax) then there are procedures the arriving paramedics can do to fix that and your CPR will have served a purpose. Motorcycles are sometimes referred to as “donor cycles” because when a rider suffers a fatal head injury the rest of the organs may be used for organ transplant. While your fellow rider may not survive, there will be many others who will now live due to organ donation. CPR keeps those organs oxygenated and alive. If you are not willing to do mouth to mouth resuscitation that doesn’t mean you can’t at least do chest compressions. You are still moving blood through the circulatory system and air is still being moved in and out of the lungs with every compression.

There is no article that will replace CPR training so I am not going to expound on it here. If you are interested in learning this life saving skill then sign up for a class. It is one of those things you hope you will never need, but if you find yourself in the situation where you need it and didn’t learn it…

Another issue that may confront you might be severe bleeding. There are a few simple steps you can take to control bleeding. The first is direct pressure. What that means is to take a cloth, a rag, a shirt, or the dressings from your first aid kit, fold it and press it hard onto the site of the bleeding. If that does not stem the flow then elevate the extremity without compromising their spine. Use gravity to slow down the bleeding. If it continues then add more dressings over the wound. Never remove the blood soaked one, just add more. We just want you to do the best you can to slow or control the bleeding. A good first aid class will demonstrate arterial pressure points. Squeeze the main artery of the limb the injury is on. Press hard against the bone while keeping your fingers flat. You will do this with one hand while holding direct pressure and elevating the limb with the other hand. Lastly, do not move the limb around. Keep it as still as possible.

If the bleeding is coming from the body or the head, then direct pressure with a dressing is all you will be able to do. Bear in mind that the head bleeds profusely. When pressing in on the head make sure you are not pressing in on a fractured skull and driving skull fragments into the brain.

Broken bones are another frequently seen injury. Sometimes the bone pokes through the skin and you have bleeding and a broken bone to deal with at the same time. That is called a compound fracture. This is not the time to play McGyver or be a Boy Scout and lash up a fancy splint. If you called 911 the average response time is around seven minutes in a city. All you need to do here is manually support the broken limb and prevent it from moving. Should you be further away from help the goal is still the same, prevent movement of the limb as much as possible. In the case of a compound fracture, do not attempt to reinsert the bone back in. Bleeding will need to be controlled by applying pressure to the artery above the injury. Attempting to straighten any broken bone can result in the sharp edges of the bone cutting blood vessels or nerves. Leave that to the emergency room to handle.

You have kept calm, assessed the situation, protected yourself from bloodborne pathogens, kept the rest of your group safe, called 911, held the victims head still, and dealt with the injuries as best as you could. Finally, you see the emergency lights and hear sirens. Your job is done, right? No.

Here is where a little reality needs to be inserted. There are interactions between responders and bystanders that would be ideal and then there is reality. The vast majority of my colleagues are extremely professional and will treat you with courtesy. There are some who are a little full of themselves and will not. On the other side of the equation are the bystanders who are so out of control with panic and fear that they are actually a hindrance to providing assistance to the victim. Those people will be asked to leave the scene even if law enforcement has to do it. Every paramedic I know has stories of family and friends that had to be removed. We also have stories where the bystanders were so calm and professional that we asked them if they were in EMS themselves, only to find out that they do something totally different and this is the first time they had ever experienced something like that. I am going to assume you are the latter category.

There are things you can do to help the arriving EMS and law enforcement. The first is, don’t stop doing what ever it was you were doing until advised to do so. Keep holding the head still (C-spine), keep applying pressure to the wound, keep performing CPR, keep directing traffic. We still have to park our rigs, unload equipment, set up that equipment, as well as assess the situation for ourselves. We will also need you to answer questions. As we take over care you will be bombarded with questions. What happened? Were they alone or was there someone else on the bike with them? Was anyone else involved? How fast were they going? If there is no helmet on, were they wearing one? Were they ever unconscious at any point? When did they go unconscious? What kind of medical history do they have? What medications do they take? Are they allergic to any medications? What is their full name? How old are they? Date of birth? Do they live locally or are they from somewhere else? (that could affect hospital destination) Any vomiting? Family contacts and phone numbers? Home address? And on and on and on. One of the things you can do to help yourself and your group is to have everyone in the group print out an emergency information page, fold it up, and put it in your wallets.

Law enforcement will need driver’s licenses, insurance cards, contact information, and a description of what happened. It is also law enforcement’s responsibility to keep the scene safe. You may be directed to move your bikes out of the way or to assist in moving the damaged bike. Even after the patient has been transported to the hospital there are things that must be taken care of. How is that bike getting back home? I have seen family members show up quickly with a pickup truck or a trailer to retrieve it. If not then a tow service will be called to remove the wreckage. It is also a time for you to gather your thoughts. Make sure that piece of safety gear between your ears is functioning properly before you get on your bike to head home or to the hospital.

It also needs to be made perfectly clear that rushing to the hospital under the misguided notion that there is something you can do there will only endanger yourself and others on the road. I have had family members tailgate me so dangerously close that I have stopped the transport to have a conversation with them. If it continues, I have no problem calling for a deputy to pull them over. Once at the hospital it will be a waiting game. You will not be allowed back to see your friend or loved one. The emergency room is doing everything they can. Your presence will only put you in the way, slowing them down. Please respect that. A typical minor injury will leave you in the waiting room at a minimum of thirty minutes. If there is surgery involved then you are waiting hours. Rushing to the hospital doesn’t serve any purpose but to endanger your own life and put you in the next surgical room over from your friend.

I certainly hope to never meet any of you in my professional capacity. Ride safely, wear the appropriate riding gear, and enjoy your experience.

Until next time, keep the rubber side down. It works better that way.

Chris Harbig
-aka DirtMedic-

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