50.3 At the scene of the accident

A severe accident kills some patients instantly. Other patients die shortly afterwards from causes that could have been prevented, if they had been properly treated immediately after the accident. It is the purpose of first aid to prevent this unnecessary death and disability before the patient ever reaches hospital. The first people to help are usually the public passing by, so that the average knowledge of first aid in the community as a whole should be high. Try to do all you can to increase it, and particularly to teach the police first aid.

If possible, send a nurse or medical assistant with the ambulance. You will probably be unable to keep one on permanent standby, so put your most intelligent and interested driver in charge of the ambulance and teach him the first aid described below. Interest him by letting him see how you care for injured patients in the theatre. His tasks include the care of a patient’s airway, and transport in the recovery position. An ambulance driver should also be able to immobilize the joints on either side of a fracture until a patient reaches hospital, so as to minimize pain, bleeding, shock, and further damage to the tissues.

Figure 50.4: Fig. 50-4 EXTRACTING A TRAPPED PATIENT. One man uses the grip shown in the previous figure., another stabilizes the patient’s neck and keeps his airway clear, while a third eases his legs out. B, shows what the steering wheel has done to his chest. After Hans Pacy with kind permission.