When you arrive on an accident scene

[canoehead]

Any EMS people here? If there is an MVA and an ER nurse is driving by do you prefer we stop and offer help, or just let you do your thing? I would generally go by.

[MauraRN]

I have stopped twice in the past 6 months, both times no police or EMS on scene, right in my own neighborhood. First one I just convinced the kid to stop moving his around so much. Second, I got the door of one car opened because the young driver was in the backseat, decreased LOC, lots of head lac bleeding. I had gloves in my lab coat as I was on my way home from work, instructed a bystander to just hold her head to maintain c-spine and checked the other driver who was wandering around out in the street. She said she was fine, but her jaw and neck hurt. Maintained c-spine until EMS got there and headed the last 1/2 mile home, very grateful that my son does not drive yet! BTW, all 3 of those drivers were on their cell phones when they crashed.

[ZippyGBR, BSN, RN]

Oh, you bad, suppressive person. Lulz.

I did have a question: If you are the only one at the scene of an accident, how do you protect someone's C-spine? There's no collar or backboard at your disposal, so what do you do?

manual in-line stabilisation - the core underpinnin technique of anything to do with C spine precautions

[Aliakey]

I'm a paramedic with a large 9-1-1 EMS. I was in uniform and heading into work when I rounded a turn on a highway outside of the city and saw a group of people and an overturned pickup truck. EMS or fire had not arrived yet... the nearest station to that rural location was about five miles away. I pulled over and found a nurse (in scrubs and with an ID badge --- no licensure doubts there!) holding c-spine on the 25 year old male driver. She was calmly talking to both the driver and bystanders and successfully kept the "bystander chaos" to a very minimum by her quiet and professional actions.

She was probably the very first positive thing to happen to the patient... she very calmly told me that this group of bystanders "quickly extricated" the patient out of the vehicle, even though he had obvious head injuries and complained of severe neck pain. She arrived on scene after the patient had already been cut free from his seatbelt and dragged across the ground. The bystanders told her that they feared the (diesel, lol!) pickup truck would explode and pulled out the patient despite his yelling.

Anyway, she took over patient care from the bystanders before they attempted to sit the patient up ("so he could get his bearings"). The EMS unit was enroute; she maintained c-spine while I assessed the patient the best I could without sacrificing his self-respect and decency in front of the onlookers ;-). EMS arrived, the nurse and I assisted with immobilization, and I gave report to the receiving medic.

I don't know who that nurse was, but she was absolutely invaluable that day. She didn't have to do much intervention-wise for the patient, but IMHO, what was most important was the basic trauma management she did do and also her great ability to keep the bystanders from causing additional harm in a most professional way.