DRIAD - Downed Rider Immediate Action Drill

I've copied this over from a post on the www.R3owners.com site - it was posted by a firefighter medic, and checked out & approved by some doctors etc we have over there - thought it would be useful. The more people who know this stuff, the better.........



These treatments are written in order of priority, they should be processed and practiced like this. "Call for help, C-spine control, level of conciousness, A, B, C, Fractures, Treat for Shock"

Downed Rider Immediate Action Drill

Whenever you are responding or reacting to an emergency incident, your first priority is YOU. If you cannot render aid without putting yourself in danger of life and/or limb, you are not morally obligated to lay hands on anyone. I am a firm believer in the guy that goes for help is just as much of a hero as the guy that renders care.

If you are the only one that appears to have a clue about care, because you have read a post on R3 owners, then POINT at someone and say "YOU, MAN IN THE GREEN SHIRT, GO CALL 911." Look this guy in the eye and make sure he understands what you are saying. This cuts the confusion about "I thought that other guy was gonna call."

After scene safety, life becomes much simpler and complicated at the same time. These are the things that you want going through your mind as you are SLOWLY WALKING toward the scene.

DO NOT REMOVE THE HELMET UNLESS IT IS INTERFERING WITH THE AIRWAY.

C-Spine control - this is the process of placing your hands on each side of the victims head. This should be done quickly and from an angle that keeps the victim from knowing you are about to do it. This allows you to control movement without the reflex head turn that normally comes with approaching someone. C-spine can also be done using the legs while kneeling. This should NEVER be let go once you have taken it, until you are sure the victim is dead, absolutely fine, or it is taken over by someone else. It is reasonable to take c-spine and carefully hand it off to someone who is not doing anything else, if you are the only one that knows what to do next.

Level of consciousness - this can immediately follow c-spine and it is done like this. “Hey, buddy are you okay?” no response can be followed by a small shake which should not compromise c-spine. If you still get no response, you need to call or send someone for help right now.

You need to remember ABC. This is the order of importance, and until you have fixed one, you CAN NOT move on to the next letter.

Airway – Open or closed? We are talking trauma so there is one way to open an airway and that is the ‘modified jaw thrust’. This entails taking your thumbs and placing them on the cheek bones of the victim just below the eyes. Take your index and middle fingers and place them behind the angle of the jaw under the ears. Lift and hold. If the victim is responsive to pain, now is when you will know it as this is VERY painful. It should not be done on a responsive person as it will cause them to become VERY unruly. This will make the lower jaw move up and open slightly and pull the tongue off the back of the throat.

Breathing – Are they breathing on their own? No? Then you CAN breathe for them. This is a scene safety issue. You are NOT morally obligated to put your unprotected mouth on anyone else’s. If you decide that this is what you will do, then take your mouth and cover theirs with yours. Pinch the nose and administer a slow breath until you notice the chest rise. If the air does not go in redo your modified jaw thrust and try again. If it still does not go in you can look in the mouth and see if there is something obstructing the airway that can be swept out with a finger. Once you have swept the mouth, attempt to blow again. If it still does not go in, you probably have a casualty on your hands. Once you get air to go in, then you can deal with the next step. Remembering to breathe for the victim about once every 5 count.

Circulation – Minor bleeding can wait. Major bleeding needs to be dealt with. The first way to control bleeding is with direct pressure. Take a t-shirt or other handy dressing material and place it directly over the wound. Apply firm pressure. This should slow the bleeding. If it is an arm or a leg and there is limited chance of fracture, you can elevate it above the level of the heart at this time. This will assist in slowing the bleeding as you have gravity working for you. If the bleeding has not stopped, you need to apply a pressure point. This can be found anywhere that a blood vessel crosses over a bone. The major ones are the brachial, found on the inside of the arm above the elbow just below where the bicep meets the upper arm bone. The second is the femoral; this is found where the leg meets the groin. You ought to be able to feel a bump bump of the heart beating when you find these. Apply pressure with your fingertips to these areas and you will find that bleeding can be controlled. The last technique that you can use is a tourniquet. These were not being used for a long time, but military surgeons are slowly bringing these back into use. You need a belt, band or piece of strong cloth at least 1 inch wide that will wrap all the way around the effected limb and tie/buckle off. Less than an inch is not really recommended as it can actually cut the limb off. Wrap this band around the limb just above the wound. NOT ON A JOINT. Tie or buckle this off. If you are using a belt, a lot of times you can just pull it really tight and it will stop the flow of blood. If you are using a band or piece of cloth, tie it loosely. You need to find a strong stick or rod of some type to slip between the limb and the knot and then twist it until the blood flow slows or stops. Note the time the tourniquet was put on and mark a T on the victim’s forehead, using a pen or even blood.

Angulated Fractures – NEVER try to straighten a limb that appears to be pointing in a different direction than normal. You can hold onto it to keep it from moving, or stabilize it, but don’t move it unless it is necessary to get the victim out of danger of further harm or death.

Treating for shock – GIVE NOTHING BY MOUTH. Shocky victims are thirsty victims. Tell them anything but do not give them anything to eat or drink. Treating for shock goes something like this. ‘Face is pale, raise the tail.’ Elevating some ones feet can be done to assist blood flow into a victim’s body core. Raising the feet 12 inches is fine as long as there is no chance of fracture to the legs. Two legs are better than one, but one is better than none. Think in terms of your own comfort, if the victim is too warm, loosen some clothing without compromising c-spine. Too cool, cover them up.

Some fine points to consider:

Straightening C-Spine – In order to get and maintain an airway, it may be necessary to roll a victim onto their back and/or place their head into a more natural position. If this is necessary a victim should be rolled with more than one person, constantly being aware of keeping their spine in a straight or neutral position. The head, if turned to the side, may be straightened or placed in a neutral position initially upon taking c-spine. IF THERE IS RESISTASNCE OF ANY SORT STOP and hold the head in the position in which you stopped.

The helmet is the best protection for a rider before AND after a crash. If the helmet prohibts you from maintaining an open airway, it can be removed using a pocket knife and TWO people. CUT the chin strap. Do not try to unbuckle the strap as while futzing around it is very easy to compromise c-spine. One person will be in charge of the head, and one person will be in charge of removing the helmet. The head man will cut the strap and slid his hands very carefully up into the helmet on both sides of the victims jaws. He can then slightly spread his hands using fingertips as pivot points. The helmet person, will carefully stabilize the head while the hand insertion is done. Once the head guy has his hands securely in the helmet, the helmet guy can CAREFULLY remove the helmet using steady pressure straight toward the top of the head. The head person has to be the one in charge of this operation as he has the GREAT responsibility to keep the head in a neutral position as the helmet is coming off and after it comes off. again I point out this is ONLY if you can not maintain an airway with the helmet on.

Moving a Victim – If to protect the victim from further serious damage or death, you find it necessary to move them, this should be done on a stiff board of some sort or if necessary, the victim can be moved by means of dragging them in a straight line in the same direction that their spine is pointing. Always maintaining C-spine control.

Sucking Chest Wound – You may find a victim that has had a puncture wound to the chest. This is considered an Airway issue. If you do not fix it, they cannot breath. You should cover this type of wound first with a hand if nothing else, then find some type of plastic, even the plastic off a pack of cigarettes, and cover the wound with this. You will notice that when the victim breathes in, the plastic will try to suck in as well. When the victim breathes out, the plastic will try to push or blow off. The whole point of the plastic is to allow air out, but not in, to the wound. When the victim breathes out, allow a corner of the plastic to lift and the air to escape.

Yall read it again.
I have been properly trained as I am sure some of yall have. It is most important to have at least some knowledge of rescue. I hope and pray that I have to never use the knowledge I have been taught. I hope and pray that none of you have to have the procedures used on you. Myself included.
Yall ride safe.

Moon

Great advice to all. Rule number one is to take action. Too many people just gawk and say ohh damn someone should help. Call for help then get in there and do something. Just the few guidelines above could and will make the difference between life and death. I have been a medical first responder for a little over 20 years and you would be surprised the whens and wheres that the training comes into use.
Everything from doing the heimlich on my own kids to doing it on strangers in restaurants. Pulling a drowned teen out of the river and reviving him with cpr to a downed coworker that was brought back through cpr.
You can't save them all but the sucess stories far out weigh the losses. Sure enough the 6 people mentioned above would have all died had I not been there to take action.
The people that were lost were lost before I took any action.

Just remember that the most important thing is to keep yourself safe and do not become part of the hysteria that comes a long with a lot of scenes. Generally if you can give the most hysteric person a function to perform they can and will calm down. Which has a tendency to calm the crowd.
See you out there
Smokey

Owl,
Good stuff. Up to date and to the point. The basics of this is being taught to our soldiers in the battlefield. Immediate action battlefield medics are normal soldiers who are saving their battle-buddies. Thanks for the post. Semper-fi

I had a friend who had an accident in the hill country riding with her husband. The next group of bikers that came on the scend just stopped and went into action. She said it was like a group of paramedics had arrived. It's important for us to know this stuff. You never know if/when we'll need it, but it happens.

My wife and I have come across two accidents in our life. Both died, but we at least tried. One was a heart attack and one was a major wreck.

Thanks for this post. Reminds me that I need to bone up on this stuff....(and check my first aid kit!)

Anyone have a recommended first aid kit? One that will fit in a saddlebag?

Thanks owl, very good article.
Will send it to the members of our MC.

Put one of these on your key ring:

http://shop.nsc.org/CPR-Barrier-Keychain-with-gloves-P1846.aspx

I carry one at work and have one on every set of keys. You can pick them up at your local Med Supply store for $5.
Mine do not have gloves.

Note - those of us that were trained in CPR years ago. Take a refresher course- the procedure has changed. 30/2

Also take the time to learn how to set up an AED. They are becoming more and more common place. They run themselves after you set it up

Thanks Owl and Thanks Big Fred
we take our safety seriously even though we ride a car tire.