What are the initial steps to take as a first responder at a car crash scene?

First Response Steps at a Car Crash Scene

When arriving first at a car crash scene, your primary responsibility is to ensure scene safety before assessing victims and activating emergency services. 1

Initial Assessment and Safety

• Assess the scene for hazards (electrical dangers, fire, traffic, fuel leaks) before approaching victims to ensure your own safety 1
• Remove any immediate dangers if possible and safe to do so (e.g., isolating electrical sources with non-conducting objects) 1
• Approach victims from the direction they are facing to avoid startling them and causing unnecessary movement 1
• Introduce yourself and state your intention to help 1

Victim Assessment

• Check for responsiveness by gently shaking the victim's shoulders and asking loudly, "Are you all right?" 1
• If the victim responds by answering or moving, check for injuries and monitor them until help arrives 1
• If unresponsive, shout for help and proceed to check for breathing 1
• Look for chest movements, listen for breath sounds, and feel for air on your cheek 1

Emergency Response Activation

• Call emergency services (911) or direct someone specific to do so 1
• If alone with an unresponsive victim, activate emergency response before beginning CPR 1
• When multiple rescuers are present, one should begin assessment/care while another calls for help 1
• Provide clear information about the location and nature of the crash when calling emergency services 1

Airway and Breathing Management

• For an unresponsive victim, open the airway by tilting the head back and lifting the chin 1
• Remove visible obstructions from the mouth (loose dentures, debris) but leave well-fitting dentures in place 1
• If the victim is breathing, place them in the recovery position unless this would aggravate injuries 1
• If not breathing normally, begin CPR immediately 1

CPR and Defibrillation

• For adults without normal breathing, begin chest compressions at a rate of at least 100/min and a depth of at least 2 inches (5 cm) 1
• If trained, provide 30 compressions followed by 2 rescue breaths 1
• If an AED is available nearby, retrieve it and follow the prompts 1
• Ensure no one is touching the victim during AED analysis or shock delivery by making both verbal and visual checks 1

Bleeding Control

• Control severe bleeding by applying direct pressure to the wound 1
• If available, use sterile pads or clean cloths to cover wounds 1
• For life-threatening bleeding that cannot be controlled with direct pressure, apply a tourniquet if available and trained to do so 1

Common Pitfalls and Caveats

• Do not move victims unless they are in immediate danger, as this could worsen spinal injuries 1
• Avoid the temptation to remove helmets from motorcycle crash victims unless absolutely necessary for airway management 1
• Remember that crash victims may be in shock even if they appear alert; monitor them closely for deterioration 1
• Perform triage if multiple victims are present, prioritizing those with airway, breathing, and circulation problems 2
• Use the term "crash" rather than "accident" as most vehicle incidents are preventable and not truly accidental 3

By following these steps, you can provide critical assistance until emergency medical services arrive, potentially saving lives and reducing morbidity at crash scenes 4.