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VEHICLE CRASHES

Unfortunately, vehicle crashes occur. Most often citizen will be at the scene of a crash before fire units are there, and it is important that they know what to do correctly or, in some cases, what not to do.

• Be sure that someone has called 9-1-1.
  
• Is the scene itself life-threatening? For example, a car hits a tanker that is now leaking an unknown substance. Since you are dealing with an unknown, the patient should immediately be removed a safe distance from the leak regardless of his condition. As best as possible, however, immobilize the patient's head and neck during movement.
  
• If the scene is not immediately life-threatening, assess the patient's condition and manage critical situations first. Does the patient have a clear airway? Is the patient breathing? Is there excessive bleeding?
  
• If you know CPR, and the patient needs it, administer it immediately. If there is excessive bleeding anywhere, apply direct pressure to the wound with a dry, clean cloth.
  
• If there is no immediate danger to the patient and he doesn't need any management of the ABC's, do nothing. Keep the patient as he is in the vehicle until fire units can get on the scene. There may be cervical spine damage of which you are unaware, and movement by the patient could only make it worse. Many times, people who have just been in a car crash will want to jump out of the car and move about. But, as best as you are able, keep them still.
  
• The scene can be a combination of environmental hazards such as downed electrical wires, unknown substance leakage, gasoline spills, fire. If you are on the scene before law enforcement officers or fire units, be aware of such dangers.
  
• Often, spilled gasoline is present. Allow no smoking. Turn all vehicle ignitions off.
  
• If the car is on fire, and firefighting personnel have not yet arrived, decide if you can remove the passengers quickly enough or whether you should fight the fire. If the passengers are not trapped, move them first. If they cannot be extricated quickly, deal with the fire. The main cause of most vehicle fires after a crash is from a ruptured fuel tank or fuel lines that have been ignited by internal or external sources. The most common ignition point, however, is under the hood, which rarely presents a serious hazard to vehicle occupants unless combustion is enhanced by gasoline. Most under hood fires will not spread unless fueled by an external source.
  
• Once emergency units do arrive, tell them what you know and then get out of their way. They are trained professionals and know what to do from that point.
  

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