In most of the EU Countries people learn First Aid as part of their driving test – this does not happen in the UK and it is therefore more than likely that a driver involved in an accident will not be equipped with the necessary skills to help. This article helps to give to a brief overview as to what to do, but it is strongly advised that you undertake a First Aid course to properly gain the confidence to help.

Cyclists are particularly vulnerable road users and it is vitally important that all cyclists know what to do (and what not to do) if someone is involved in an accident. If you are cycling with children and teenagers, reinforce the importance of not overtaking lorries, buses and other large vehicles on the inside and explain about their blind spots.

All road users should have basic first aid supplies with them, even if it is just a couple of calico triangular bandages. Car drivers and motorcyclists should have an appropriately stocked kit: advice as to what to put into your kit can be found here. 

The following is a step by step approach as guidance should you be the first on scene at an accident:

• When approaching an accident scene it is really important to ensure your own safety. Make sure that all traffic has stopped and it is flagged up that there has been an accident otherwise there may be additional casualties. Be aware of oncoming traffic to ensure that is not posing an additional danger. Note if there is any fuel spillage or potential fire risk – turn off car ignitions if possible. Put on vehicle hazard lights and use a warning triangle if there is one available.
• If other people are around; get them to phone the emergency services – if you are on your own, assess the situation and treat any life threatening conditions first.
• Quickly establish how many vehicles have been involved and assess the occupants of all the vehicles to ensure no one has life threatening injuries.

• People screaming, crying and making a noise have to be breathing – your initial priority is therefore to check anyone quiet and not moving.
• Quickly check if quiet casualties are responsive: – if there is no response check if they are breathing. If they are unresponsive and breathing ensure they are in a position where they are leaning forward or to one side in a position where the airway will remain open. Move them the minimum necessary and avoid twisting them. Keep talking to the casualty calmly as they can hear you even if they are unconscious. Keep them warm.

• Support the head and neck to avoid them twisting – do not cover their ears, keeping talking to them calmly and keep checking that they are still breathing
• If the person is not breathing you will need to resuscitate – if you are on your own and have not called an ambulance – do this now and ask their advice as to the best way to resuscitate, as this is not easy to do in a car.
• Only remove an unconscious person from a vehicle if there is an immediate danger to their life from fire, flood, and explosion….ask the emergency services over the phone for their advice as to what you should do. It is very difficult to remove an unconscious person from a vehicle and there is a major danger that you could worsen their injuries and injure yourself in the process.
• Conscious casualties should be entrusted to the care of bystanders and removed from the wreckage to a safe area. Be aware of confused and dazed casualties who may wander into danger. Brief the bystanders to keep the casualties warm and calm and help them to contact next of kin. Look for any major bleeding and life threatening injuries and treat these first.
• Note the nature of the wreckage and be aware of possible injuries as a result: bodies are softer than metalwork, so if there is major damage to the vehicle it is possible that there could be internal injuries to the casualty – ensure the bystanders notify you if there is any change in the casualty’s condition.
• People thrown from horses, motorbikes or bicycles are at particular risk of damaging their pelvis. If you know how to stabilise someone’s pelvis then do this and keep monitoring them for signs of shock as a fractured pelvis can lead to internal bleeding.
• Anyone trapped in a vehicle should be monitored carefully and the emergency services notified immediately. If someone is crushed, note the exact time when the accident happened as this is important in deciding on how and when to release the casualty). If there are additional people around, show them how to support the person’s neck to avoid them twisting as there is the possibility of a spinal injury.
• If there is severe bleeding this will need to be controlled – wear gloves and apply dressings.
• Do not allow anyone to smoke at the scene or give the casualties anything to eat or drink following the accident in case they later need an operation.

• If a motorcyclist is involved only remove their helmet if they are unconscious and there is no other way to assess their breathing or their airway is in danger. There is usually a way of lifting the visor, it may be sensible to loosen their chin strap.
• If a casualty has been hit by a car and they are lying on their back unconscious and breathing – they should be carefully rolled into the recovery position to keep their spine in line. This should ideally be done with the support of others to avoid twisting the spine.
• (If you have received advanced training on MILS and recognition of early airway obstruction and are confident that you are able to react quickly if their airway is in danger – then maintain MILS and continuous airway monitoring and roll them into the recovery position immediately should they begin to obstruct).
• If a casualty has been hit by a vehicle or thrown from one and they are conscious in the road, they should be encouraged to keep still. Ensure that someone is directing traffic and maintaining safety. Support their head and neck, keep them warm and dry and wait for the emergency services.

Everyone on the road should have a suitably stocked First Aid kit and know how to use its contents.