what to know @ scene of accident

Blee O'Myacin, BSN, RN · Jul 17, 2007

I graduate in May but I feel like I don't know very much, especially about emergency care. If there was a car accident or other trauma before me I don't know what I could do. Stop bleeding, CPR, comfort. That's all I have to offer at this point. Anyone have ideas on what I could search on my own to be prepared if such a situation arises? I really want to be able to help if a situation warrants and I just don't feel educated enough yet.

What else could you do even with a degree? Off duty nurses don't carry a bag of emergency meds. Your job would be to call 911, and then see if you can help out. If the first responders are already on scene, they have it under control - they were specially trained to do so and have the equipment necessary.

You could carry a CPR mask with you if you felt so inclined. Mr. O'Myacin has one in his police gear that stays in the trunk of the car, but never in 14 years of him being a police officer (a trained first responder) has he ever had to use it off duty.

If anything did happen in front of you, instinct will kick in. I wouldn't worry about it.

Blee

goshin706 · Jul 17, 2007

ok so if you pulled up on an accident: first thing to do, is make sure the scene is safe enough for you to respond. are there any hazards, more traffic, haz-mat, downed lines, gas leaks, fire etc. as you are assessing count your potential patients, # vehicles, are they trapped?, is there fire? call 911 let them know what u see, and get the buses in route. did anyone else stop? do you need help?

now triage the patients you have. do your ABC's, head to toe assessment, comfort the stablized pts. and get working on the others if req. get/keep them breathing, get/keep the hearts going, stop the bleeding. only move them if they are in danger, other than that, get some help to hold c spine where necessary and continue checking on your pts till the medics arrive.

you could get into an EMT class...that would help you too

AnnieOaklyRN, BSN, RN, EMT-P · Jul 17, 2007

I agree with the others...

Also AHA no longers requires mouth to mask or mouth to mouth ventilation- compressions only if you do not have a BVM, as infection can still be transferred even mouth to mask.

Remember your safety comes first, ALWAYS. So if they are bleeding and you don't have gloves of if the scene is dangerous... As we say in EMS we do not want to become a patient.

Swtooth EMT-P, RN

fleur-de-lis, BSN, RN · Jul 18, 2007

Weird that this was posted today, I was thinking about this when I saw a near miss collision today and was going to post the same question! Thanks for the advice everyone, and to the OP for posting the question!

wonderbee, BSN, RN · Jul 18, 2007

Funny you should bring this up. Just such an incident occurred a couple of months ago. As fate would have it, I was on my way home when I passed a large billboard that said "Nurses, every day heroes". I think it was an advertisement for a nursing program. Not less than 5 minutes later, I was on the scene of a head on collision. When I got out iof my car in my scrubs, bystanders got out of my way. I can see how EMS workers feel. The driver was trapped in the car. No breath. No pulse. Broken glass and mangled metal everywhere. The guy was blue. I reached through the broken window and gave compressions. It was all I could do. Looking back, it was not a safe scenario for CPR with all the broken glass. And the compressions were of no use because he needed to be on a hard surface and laying flat. He died. Heck, he was already dead, dead, dead. A young man with a family to support. Sad.

You do what comes to your mind. You eyeball the scene real quick and remember your ABCs. HYou look for hazards. When EMS gets there, you get out of the way and let them work. They're the experts at being first responders. You remember when you get back in your car to buckle your seatbelt.

TazziRN, RN · Jul 18, 2007

I know this will sound callous and I'm going to hear about it, but I wouldn't bother with CPR. Traumatic arrests happened because of things that just plain CPR will not be able to reverse: brain death, cardiac trauma, aortic transection, etc. You can compress to your heart's content and you will not bring these people back. With medical codes CPR keeps the blood circulating until the heart can be jump-started. In traumatic arrests there often isn't any blood to circulate, or no where for it to go.

Do not try to maintain c-spine if you haven't learned how to do it. Well-meaning people can actually do more harm than good because of unintentional misalignment. Best thing to do: call 911, then see who needs help NOW: active arterial bleeding, for example. Otherwise just try to keep the victims still and wait for help to arrive.

kstec, LPN · Jul 18, 2007

My question is in regards to this thread is: Don't all RN's come out of school knowing exactly what to do in a traumatic event? I know as a LPN, I don't. I would know the ABC's and CPR and thats about it. I could casually assess the situation and do the above and then I would probably stand there looking dumb. Are RN's who do this specifically trained on the job? Thanks for any responses.

TazziRN, RN · Jul 18, 2007

My question is in regards to this thread is: Don't all RN's come out of school knowing exactly what to do in a traumatic event? I know as a LPN, I don't. I would know the ABC's and CPR and thats about it. I could casually assess the situation and do the above and then I would probably stand there looking dumb. Are RN's who do this specifically trained on the job? Thanks for any responses.

Nope. ER nurses would know, and ICU/PACU, since those nurses see these victims fresh out of the ambulance. I would not expect a medsurg nurse to know just because they're RNs.

vamedic4, EMT-P · Jul 18, 2007

My question is in regards to this thread is: Don't all RN's come out of school knowing exactly what to do in a traumatic event? I know as a LPN, I don't. I would know the ABC's and CPR and thats about it. I could casually assess the situation and do the above and then I would probably stand there looking dumb. Are RN's who do this specifically trained on the job? Thanks for any responses.

The answer to your question is no, they don't come out of school knowing what to do in a traumatic event. ABCs and BLS all the way, because as a new nurse you've not had either the clinical time or the experience to know what to do should such a situation present itself. Don't get me wrong - they have an idea, but unless you are specifically trained in trauma management then the basics are really all anyone can expect of you.

vamedic4;)

I love summer!!

pagandeva2000, LPN · Jul 18, 2007

I have been an LPN for a year, and I still don't know what to do in case of an emergency. I feel the same way; I am a NURSE. I have certain expectations of myself and I do admit that I have had and continue to have certain expectations of all nurses, so, I worry about it frequently.

The only suggestion I have is to continue reading and if all fails, get help. I do home care sometimes, and I do not accept cases that I am not confident in. My reponsibilities at the home are to know the ailment, therefore, I read up on what is expected and so far, I have not screwed up. I make sure that I speak to the nursing supervisor and she has been great. She tells me what to expect, and that if the patient is going down, to CALL 911. While I am at the house, I question the family about the patient's normal behavior so, I can better know if there is a change in behavior. Better safe than sorry. These things come with experience, bottom line.

pagandeva2000, LPN · Jul 18, 2007

My question is in regards to this thread is: Don't all RN's come out of school knowing exactly what to do in a traumatic event? I know as a LPN, I don't. I would know the ABC's and CPR and thats about it. I could casually assess the situation and do the above and then I would probably stand there looking dumb. Are RN's who do this specifically trained on the job? Thanks for any responses.

I feel the same as you!