I'm First. Now What?
by David Gorham

I'm not a doctor, and I don't play one on TV. I'm not a paramedic. I prefer to have my splinters pulled by a softer hand than my own. And I'm not a crisis manager. On the other hand, I do know CPR. I have earned my Boy Scout First Aid merit badge (some 20+ years ago). Thanks to Uncle Sam, I've spent many hours in a gas chamber and know how to inject myself with a number of "remedies" to counteract various toxins that might be thrown in my general direction. Professionally, I've dealt with crisis after crisis that involves millions and millions of dollars. I've even helped pull an injured car driver out of a burning and upside down car.

But what does that mean when your friend crashes his motorcycle? That depends. It might mean everything. Or, in my case, it might mean nothing - which is indeed something. I don't like blood and guts. Worse, I don't like seeing my friends bloody and gutty. My first impulse is to run the other way in an emergency, but the last six months have taught me a few things about what happens when friends crash motorcycles. I've been first on the scene three times in the last six months. Three friends, three different hospitals, one Life Flight, one ambulance, three tow trucks and three totaled bikes. I think I might have learned thing or two that I can pass on to you.

Being the first (or one of the first) on the scene of a motorcycle wreck, whether it's a friend or not, can mean the difference between life and death. I'm sure you hope that this won't happen to you. I'm sure you hope that if it does happen to you, somebody will be there who knows emergency First Aid and you can be left to more mundane chores like directing traffic. I'm sure you'll comfort yourself with the knowledge that in these days of cell phones and Life Flights, help is just a heartbeat away. You might even hope that if you yourself crash, you'll certainly have an EMT nearby; or at least somebody who "can call the shots", direct others and make critical decisions. I'm here to say this ain't so. Not once in my three situations did anybody at the site have a passing medical background until the professionals arrived. Not once could we get connected properly with the cell phone. Not once did help arrive sooner than 45 minutes.

So what have I learned by being first on the scene? Interesting question. I think most importantly, I've learned that my hurt friend has no option but to depend on me. Wow. If you know me, you know how scary that thought might be. But you also must know that there are a lot of people out there just like me! You must accept this if you find yourself first on the scene. The injured rider has no choice but to depend on you for his life (at the most) and his comfort (at the least). There's nothing you can do to change this.

Next, I've learned that you can only do what you can do. If you're not a doctor or a paramedic, then maybe you can't stop the bleeding, but you can slow it. You may not be able to set a broken bone or stop the pain, but you can comfort the injured (part of being a friend, yes?). If others are there and just standing around, you can direct one to call for help, one to direct traffic, one to find a site for the helicopter to land. You can direct another to stuff a clean soft cloth (be prepared to sacrifice your T-shirt) into the wound to help slow the bleeding. You may even have to direct a hysterical spouse/friend - give them a job, get their minds off the tragedy and on the task at hand: getting help and comforting/aiding. I've learned though, that sending a frantic spouse/friend away from their loved one - like going to call for help - is a mistake. Get them busy, get them calm, and keep them nearby. Let somebody who is already calm and capable ride off for help. All this while you do nothing but hold and comfort your friend. Easy.

But what makes you different from all the others "just standing around"? The rider may be your friend or spouse; the others may not know the injured at all. You may have more experience (little though it may be) than the others. Most times, if somebody is experienced in these things, they come forward. If nobody comes forward, it is up to you. Bite the bullet and move toward your friend.

Pretty much anything else involves an active, rather than re-active role. Take a CPR course. Take a basic First Aid course. Learn what to do in an emergency. Maybe take that First Aid course with all your riding buddies. Hey! - maybe arrange for a First Aid course to be taught at your next club meeting! There's an old saying that goes something like, "You are judged by the friends you keep". So take a look at who you're riding with. Can they save your life, or will they make you save theirs?

What can you do as a rider? If you find yourself in the unfortunate position of lying on the ground while your friend calls for Life Flight, then not much at this point. But you can make a few "pre-emptive" strikes, if you will. First, wear the right gear. Naturally, the most important benefactor of this will be you, the wearer. But please think of the people who have to look at you and who have to clean you up. A riding suit or leathers will dramatically cut down on the blood and gore. So instead of wasting time vomiting, your friends can be doing more important things. You can also keep a list of important people and phone numbers in your wallet, and on the bike ! What if your wallet gets tumbled out of your jeans as you crash through the weeds? What if the zipper on your leather jacket bursts, spilling its contents (and your wallet) over a few hundred feet. Sure, your tank bag may separate from the bike, or your underseat storage may be compromised, but hey - give your rescuers every chance to find those important phone numbers quickly.

That brings up another point. Emergency contacts. Do you ride with the same guys over and over? Then it would behoove you to have an emergency plan in case one of your friends goes down. Who's allergic to what medications? That's reasonable to know. Do you regularly ride in an area where "911" doesn't work, or emergency response is far, far away? In the event of an emergency, who wants whom called - or not called. Think of your friends stuck in the emergency room waiting area, while you're being worked on. What could they be doing to help you? Figure it all out next time you're all together. Keeping an important phone number of theirs in your wallet isn't as corny as it sounds! Figure it all out before your next ride, or it may be too late.

Also, know where you are. You may be half a country away from home, riding a road you've never been on before. But if you're lucky enough to get a phone or 2-way radio to work, then it's just plain irresponsible to not be able to tell rescuers where you are and where the crash site is.

There are literally hundreds of details to deal with at a crash site. Remove the helmet, don't remove the helmet. Move the injured, don't move the injured. Give a painkiller (aspirin or Tylenol) before the paramedics arrive, don't give anything - even water - before the paramedics arrive. And the list goes on. Prioritize. Put your efforts where they will be most beneficial. Remember: even a planned surgery requires that you take nothing by mouth, not even water, after midnight (or earlier) on the night before the surgery. If it's obvious your friend will soon need surgery, resist all temptations to give food or water. Did you know that in many cases you can request that the ambulance take the injured to a particular hospital? If the injuries are not life threatening and the hospital you request is within the ambulance crew's region, then tell the driver your hospital preference. And don't forget to get the name and phone number of the wrecker company that arrives to haul off the mangled bike. If your hands are too shaky to write down the information, then take a picture of the tow truck - it will have all the information you need on it.

This piece isn't meant to be the end-all of "emergency medical response for the first on the scene of a motorcycle crash." This isn't meant to be kept in your tank bag and used as a "check list" in the event one of your friends goes down. This is meant to get you to think about what might happen, what could happen, what does happen, and what you might and can do about it. The Boy Scout's motto is "Be Prepared.", and with good reason. If you knowingly put yourself in harm's way (many will argue that riding a motorcycle will qualify), then it is your duty to know what might happen and what you will do about it.

You're not alone. At every crash site, somebody had to be the first to arrive. Just remember this: "When we cannot act as we wish, we must act as we can." Terrence

For information on emergency First Aid courses, contact your local community college, Fire Station, or hospital. Nothing can substitute for a good First Aid course, but you can also find abundant information in your local public library.

David Gorham