19.1 Crash-Scene Priorities and Examining the Casualty

A crash on a Guyana public road is a first-aid problem before it is a licence, insurance, or blame problem. The Guyana Police Force learner package treats Emergency First Aid as its own subject. Candidates study Emergency First Aid for Caribbean Communities together with the Guyana Road Traffic Code page headed First Aid on the Road. This chapter is independent study of those GPF package texts. It does not claim official approval, review, or partnership with the Guyana Police Force, the Licensing Department at Traffic Headquarters, Eve Leary, or the booklet publishers.

Control traffic on a left-hand road

Picture a collision on the East Bank Public Road, the East Coast corridor, the Soesdyke–Linden Highway, or on the approaches to the Demerara Harbour Bridge or the Canje Bridge. Guyana is left-hand traffic. Vehicles keep to the near (left) side. Other traffic will still be moving toward the wreck from both directions unless someone controls traffic so as to avoid further accidents. The Road Traffic Code tells you to ask motorists and bystanders for help with that control. A helper who only stares at the injured person while a minibus still has a clear run at the scene has not started first aid. A second collision creates more casualties and can kill the person you meant to help.

When a Fire Service, ambulance, or Police vehicle is answering the call, other drivers must pull to the left and STOP. At night they also dim lights. That left-side stop is the same left-hand rule you study for ordinary driving. Until those services arrive, your job at the wreck is to keep the carriageway from producing a second crash. On a narrow bridge approach, such as the Demerara Harbour Bridge or the Canje Bridge, there may be little verge. That is exactly when bystanders must be organised into traffic control rather than into a crowd around the injured person.

Petrol, fire, and when you may move the casualty

Spilled petrol changes the whole picture. The Code says no smoking if petrol is spilled. A cigarette, a spark, or a running engine beside a leaking tank can turn a survivable injury into a fire. Move the casualty only if there is immediate danger of fire from spilled petrol, or if danger from traffic cannot be averted. Those are the two move-triggers on the first-aid-on-the-road page. Do not move someone merely because they are on wet asphalt, because they asked to sit up, because you want them off a white or yellow centre line, or because a hospital trolley seems more dignified. The Caribbean first-aid book is equally firm: ask the casualty not to move, then examine; do not change position unless you have to.

When you must move because of fire or unavertable traffic, handle with great care, particularly if broken bones are suspected or pain in the back is complained of. Force that smashed a windscreen or folded a door can also have injured the spine or pelvis. The Caribbean book says that if force caused the injury, assume there are injuries you cannot see. Dragging a person by the arms, twisting the neck, or sitting them up to make them comfortable can convert a hidden back injury into a lasting one. Decide how to move the casualty if you have to — do not invent a lift in the panic of the moment.

Before you touch anyone, understand dangers to the casualty and yourself. The Caribbean book names live electricity and traffic. A downed line after a night crash on an open road, or a vehicle still in gear, can injure the helper. You may have to get a helper to stop the traffic or to switch off an electric current. Becoming a second casualty helps no one.

Examining the casualty

Once the scene is as safe as you can make it, examine the casualty quickly and in the right order. Before you can decide what to do, you need to know what is wrong. The book’s three opening questions are:

1. Is he breathing?
2. Is he conscious?
3. Is he bleeding badly?

Then: ask questions to find out what is wrong; examine for injuries; give first aid and reassure; call qualified aid. First aid cannot replace qualified aid. You must call or arrange qualified aid as soon as you can. On a Guyana road that usually means getting motorists and bystanders to summon ambulance, doctor, and police, as the Code instructs.

Accident duties, warmth, and fluids

A driver involved in an accident must stop the vehicle at the scene, give name and address and the registered number, and exhibit the driver’s licence to an injured person if practicable, to the other driver or occupant, and to a person with reasonable cause such as a relative or witness. The Code also states that the driver must render assistance to any injured person, including taking that person to a doctor or hospital for medical attention. Those accident duties sit beside first aid; they do not replace the breathing–consciousness–bleeding check.

The Caribbean book describes a good first aider as someone who knows how much he can do. First aid is temporary care to save life, to prevent further injury, and to reduce pain. Reassure the casualty: talk to him, call him, show you care. Do not let the casualty get cold; protect him from weather — a real issue on an exposed East Coast verge or a rain-soaked Linden Highway shoulder. Do not give anything to drink — not alcohol, tea, or other fluid — because the casualty may require an anaesthetic at hospital. The Code’s crash page is explicit on that point. A well-meant tot of rum after a Georgetown crash is not first aid; it is a hazard.

Stop obvious bleeding with dry dressings or clean handkerchiefs and firm manual pressure, then bandage firmly, as the Code states. Cover burns with dry dressings or clean handkerchiefs when you are using the car kit at the roadside. The Emergency First Aid book’s full burns sequence — clean cold water first — is the subject of section 19.3; use that sequence whenever you can get clean cold water to the burn. Carry simple first-aid materials in the car. The Code points learners to the St. John Ambulance Association or the Red Society for aid materials.

Work that order on any named Guyana road: make the scene safer, then find whether the person is breathing, conscious, and bleeding badly, then treat what you find, keep talking, and get qualified help coming. The next section takes the airway, unconsciousness, and the recovery position in the same book order.