1st on scene of accident yesterday...what would you do?

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Specializes in Geriatrics, pediatrics.

I'm a newly licensed LPN. Driving home, I passed a small convertible all smashed up and on it's side in a ditch. I stopped to find two teenage boys at the scene. The driver was barefoot and walking around with a small gash on his ankle. The other was sitting and complaining of leg pain 4/10. When I saw the car I was astounded that they weren't seriously injured. The passengers side door was completely smashed in and the windshield was cracked. They had extricated themselves from the vehicle and police were notified but not yet on the scene. Both were A&Ox3, not in any apparent distress. I assessed for signs of shock, internal bleeding, altered LOC, tachycardia... but I didn't know how to help them. I couldn't think of anything else to do. I knew I needed to stay with them until the ambulance arrived but I just felt helpless. What else could I have done?

TIA

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Sounds to me that you did all that anyone COULD do -- you sat them down, did an assessment and stayed on the scene. IMHO, the best thing anyone can do at a time like this is to be the voice of calm and reason. I have actually seen people that walked about from accidents stumble into oncoming traffic because they are not thinking clearly.

The sad reality is that, if there had been injuries, you would not have had a lot of equipment on hand to start any care.

Thank you for caring for these boys -- I know if I were their mother, I would want you there!

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Specializes in Rodeo Nursing (Neuro).

Sounds to me like you did exactly what you should have. The idea, it seems to me, is to keep the patients stable until they can get further treatment, if necessary. You assessed that they were apparently stable and waited with them until better-equipped help arrived. Excellent.

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Specializes in ER, ICU cath lab, remote med.

Sounds like you did what you could without any equipment. The only other thing I could suggest is to have them lay/sit down somewhere and keep them warm. The initial shock could be hiding spinal/internal injuries which could be exacerbated by movement.

Oh, and always protect yourself first.

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Specializes in midwifery, ophthalmics, general practice.

first; dont beat yourself up over what you could or should have done.

second; most nurses are not good in such a situation. we are used to have lots of kit around us!! In a crash situation, remember your own safety comes first- the last thing the paramedics need when they arrive is an extra patient! you would need to assess the situation and always call for help if its not on the way. then you can help people. if they are up and walking and talking; ignore them and move on the next person. it may be you can do nothing but give reassurance. I carry gloves and hope it never happens when i am around!

a funny story; a friend of mine was doing his medical training. he was a 4th year medical student when he saw an accident happen in the centre of Manchester (England). He ran over shouting that he was a medical student and he could help, he pulled a man away from helping someone. The man asked him who he was.. so my friend said (very proudly) I'm a medical student. The man smiled and said 'excellent. I'm the consultant in accident and emergency medicine at the Manchester Royal Infirmmary. get lost!'. my friend is now very careful about offering help... particulary after he had to do a house job at Manchester Royal working in A&E!!

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Specializes in long term care Alzheimers Patients.

I agree with all the above. I think you all you could. You were a wonderful nurse to stay with them. I also live on the Mass/NH . I live in Amesbury do you live near by have a good day

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Specializes in Geriatrics, pediatrics.

Thanks all!

I'm going to put together a little bag to keep in the car: gloves, bandages, blanket, flashlight, scissors, extra stethoscope.

Better late than never. :wink2:

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Specializes in Critical Care, Emergency, Education, Informatics.
I'm a newly licensed LPN. Driving home, I passed a small convertible all smashed up and on it's side in a ditch. I stopped to find two teenage boys at the scene. The driver was barefoot and walking around with a small gash on his ankle. The other was sitting and complaining of leg pain 4/10. When I saw the car I was astounded that they weren't seriously injured. The passengers side door was completely smashed in and the windshield was cracked. They had extricated themselves from the vehicle and police were notified but not yet on the scene. Both were A&Ox3, not in any apparent distress. I assessed for signs of shock, internal bleeding, altered LOC, tachycardia... but I didn't know how to help them. I couldn't think of anything else to do. I knew I needed to stay with them until the ambulance arrived but I just felt helpless. What else could I have done?

TIA

The first thing to do actualy has nothing to do with the accident victems, it has to do with you. It's BE SAFE, it's risky getting out of your car. Make sure your car is pulled out of traffic and isn't going to block emergency response vehicles. After that then just use common sense. ANd keep some gloves in your car.

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Specializes in ICU.

the only thing i can add ......lay them down flat, protect the spinal cord, keep them still and talking. you did a good job! :D

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Just remember your A B C's and control bleeding. Not much else you can do til help get there. I carry a large, one gallon ziplock bag under the seat of all my cars and use that as my 1st aid kit. It has gloves, pocket mask, 4 X 4's, vet wrap, Kotex pads (use to stop heavy bleeding from a laceration) and a flashlight. If it gets contaminated on an accident, I'm not out a lot of $ and with the clear plastic everything is easily visible.

But don't be offended if EMS cuts off your dressings--they may want to look at the injury themselves.

And EMS/hospital staff will get a chuckle when the Kotex falls out when the dressing is removed! But they are cheaper than ABD's.

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Specializes in Flight, ER, Transport, ICU/Critical Care.

Sounds like you did more than I might have.

I KNOW that EVERYONE wants to help - and thankfully many do.

The first thing I want EVERYONE/ANYONE to do is PROTECT YOURSELF.

I bought a new car a few months ago - and witnessed an wicked rollover MVC on the INTERSTATE (4 lanes) - 3 in - 1 partially ejected out, the others could self extricate - they were wandering into traffic once I got stopped - another had stopped to help and the partially ejected dude lie still (big gash, altered, ortho injuries and on PO methadone 160mg TID - no, not a typo - I saw the bottle) the 2 others were dazed and scrapped up.

I stayed till police and FD - advised what EMS was needed - HEMS for trauma transport - anyway - the point is this.

I did NOT do much at all. I did NOT touch bloody folks - and one of the fire guys knew me and he was all happy about the car (wow! nice car!) - but, as I told him I was (other than telling folks my opinion and keeping folks out of traffic) useless. We did have a "nice" visit on the interstate (stupid!) - should have just went by the station with cookies.

I had nothing in that new car that I could have used to save anyone's life. Heck, I didn't even have anything to protect my life. (I have since put a few things in the car.)

I had stuff in my SUV - but, I stopped without thinking. And I KNOW better.

Sometimes the safest place for would be rescuers is not obvious.

Practice SAFE!!!!

;)

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Specializes in ER,ICU,L+D,OR.

Driving by an accident. The key word is driving by. I call for help on my cell. I do not stop and render aid. I carry no supplies, no gloves, no airway barriers. I carry my cell and call 911.

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