EMS and Motorcycle accidents

Enginetech88

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I have spent alot of time on this forum and am now looking for some help. I have been an EMT for a few years. In the past few months I have noticed that the EMS, fire/ rescue, and first responders in my area are very under trained when it comes to responding to a motorcycle accident.

I am working at putting together a training presentation for first responders about motorcycle accidents. This will include specific dangers found on and around a bike, how to shut down a bike, common injuries and their treatment, helmet removal, and proper etiquette when dealing with motorcycle riders. I'm hoping that you folks will have some good pointers and things to include and real life experiances we can learn from. Also if any of you have recommended videos on helmet removal, or on this subject please include it. I greatly appreciate all the help!!!

Josh
 

bigbaldguy

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I have spent alot of time on this forum and am now looking for some help. I have been an EMT for a few years. In the past few months I have noticed that the EMS, fire/ rescue, and first responders in my area are very under trained when it comes to responding to a motorcycle accident.

I am working at putting together a training presentation for first responders about motorcycle accidents. This will include specific dangers found on and around a bike, how to shut down a bike, common injuries and their treatment, helmet removal, and proper etiquette when dealing with motorcycle riders. I'm hoping that you folks will have some good pointers and things to include and real life experiances we can learn from. Also if any of you have recommended videos on helmet removal, or on this subject please include it. I greatly appreciate all the help!!!

Josh

I'd be interested to know what you mean by proper etiquette? Are you referring to dealing with MC's or just riders in general. I've only got a few motorcycle accidents under my belt but they were basically treated in a fashion similar to ejection injuries. Helmet removal would be a good thing to cover, and also how to turn a bike off might be a good topic. I've seen a bike with the wheel spinning catch when it was lifted off of a rider and flip completely over, no injuries but could have been bad.
 

Shishkabob

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. This will include specific dangers found on and around a bike
The car driver that caused the accident

how to shut down a bike
Most modern bikes have a 'tilt sensor' (actually called a bank angle sensor) that detects when a motorcycle is, for a lack of a better way of putting it, no longer upright. When this happens, the bike automatically kills the engine.

On top of that, most motorcycles have the same basic handlebar layout, with electrical controls (such as horn, turn signals) being on the left and engine controls on the right. Look for a red switch on the right side, and that's the kill switch.

motorcycle-ignition-switch.jpg



common injuries and their treatment
You treat the injuries like you would any other time the injury appears outside of an unplanned dismount.


helmet removal
Most helmets include a single chin strap. Some of the higher end helmets (which I don't expect non-riders to recognize) also have inflatable cheekpads which you should deflate to make removal easier.

and proper etiquette when dealing with motorcycle riders
Our gear is expensive. Don't cut unless absolutely necessary, and if you must cut, attempt along a seam. A track suit can cost several thousand dollars. Gloves and boots can be several hundred. Don't make their day worse by going gung-ho with your sheers.

Motorcycle riders LOVE their bikes. They might ask how their bike is, so be ready.


I'm hoping that you folks will have some good pointers and things to include and real life experiances we can learn from.

If the rider is awake, check to see if they had a passenger. Not good to assume it's just one person and leave someone else in a ditch 50 feet away.
 
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Tigger

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I have spent alot of time on this forum and am now looking for some help. I have been an EMT for a few years. In the past few months I have noticed that the EMS, fire/ rescue, and first responders in my area are very under trained when it comes to responding to a motorcycle accident.

I am working at putting together a training presentation for first responders about motorcycle accidents. This will include specific dangers found on and around a bike, how to shut down a bike, common injuries and their treatment, helmet removal, and proper etiquette when dealing with motorcycle riders. I'm hoping that you folks will have some good pointers and things to include and real life experiances we can learn from. Also if any of you have recommended videos on helmet removal, or on this subject please include it. I greatly appreciate all the help!!!

Josh

Helmet removal is probably one of those skills that people are a bit rusty on since many will not have done it since their class. Personally I think it should always be a two person job unless there is emergent airway issue, so if you have people showing up on scene alone (first responders, fly car, etc), they do not need to be removing a helmet until there are more hands available.

Shutting down a bike is a good idea, I have no idea how to do that. Both times I've been on scene for one it was already off. As for etiquette I'm not sure what you mean?
 

bigbaldguy

Former medic seven years 911 service in houston
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The car driver that caused the accident

Most modern bikes have a 'tilt sensor' (actually called a bank angle sensor) that detects when a motorcycle is, for a lack of a better way of putting it, no longer upright. When this happens, the bike automatically kills the engine.


You treat the injuries like you would any other time the injury appears outside of an unplanned dismount.


Most helmets include a single strap. Some of the higher end helmets (which I don't expect non-riders to recognize) also have inflatable cheekpads which you should deflate to make removal easier.

Our gear is expense. Don't cut unless absolutely necessary, and if you must cut, attempt along a seam. A track suit can cost several thousand dollars. Gloves and boots can be several hundred. Don't make their day worse by going gung-ho with your sheers.




If the rider is awake, check to see if they had a passenger. Not good to assume it's just one person and leave someone else in a ditch 50 feet away.

Last two are very good points. Cutting gear hadn't occurred to me.
 

workworkwork

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you would maintain c spine, but a little differently minding the gap the helmet creates.

as for the motorcyclists, immobilization of entire body will be that much more important considering they were thrown somewhere off their bike. not like a car passenger with airbags, a seat-belt, and in a sitting position.

side note, we transported a patient to rehab today that was in a motorcycle accident (he was on the bike) he had several fractures, several avulsions, too many abrasions to count, and a subdural hematoma. in other words, don't buy a motorcycle.
 

Shishkabob

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you would maintain c spine, but a little differently minding the gap the helmet creates.
What gap? That helmet is coming off once I get on scene. These aren't football helmets where we tend to keep them on because of the elevation that shoulder pads create. Their head is at an odd angle due to the thickness of the helmet and their shoulders touching the ground.

as for the motorcyclists, immobilization of entire body will be that much more important considering they were thrown somewhere off their bike. not like a car passenger with airbags, a seat-belt, and in a sitting position.
Disagree. I've been tossed off a motorcycle going 40ish and left with bruised ribs. I've seen people in car accidents at lower speeds with compound fractures.

Assess the patient.

side note, we transported a patient to rehab today that was in a motorcycle accident (he was on the bike) he had several fractures, several avulsions, too many abrasions to count, and a subdural hematoma. in other words, don't buy a motorcycle.

Most accidents involving motorcycles are either due to stupid car drivers violating the riders right-of-way, or a drunk rider. If all left hand turns required a green arrow, I guarantee motorcycle fatalities would decrease.
 

workworkwork

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What gap? That helmet is coming off once I get on scene. These aren't football helmets where we tend to keep them on because of the elevation that shoulder pads create. Their head is at an odd angle due to the thickness of the helmet and their shoulders touching the ground.

Disagree. I've been tossed off a motorcycle going 40ish and left with bruised ribs. I've seen people in car accidents at lower speeds with compound fractures.

Assess the patient.



Most accidents involving motorcycles are either due to stupid car drivers violating the riders right-of-way, or a drunk rider. If all left hand turns required a green arrow, I guarantee motorcycle fatalities would decrease.
was your motive to disagree with everything?

if your supine with a motorcycle helmet on, your neck is pushed forward much like a pediatrics as many helmets, not all, become thicker towards the back and top, therefore if you were to remove a helmet without holding correctly, someones head could drop as much as four inches. i'm talking about the gap between the head and the ground.

as for your experience, i couldn't care any less. if someone is thrown off a motorcylcle, i'm immobilizing everything i can, just because YOU got lucky doesn't mean i'm overlooking anything. do you hear yourself? next time i have a car accident i'll just tell my patient when i was in a car accident like they were i was fine and i wont take precautions. hows that sound?

as for your last little comment, i was making a joke, but besides either of our points, the simple fact is motorcyclists have a whole hell of a lot more chance of dying or getting seriously injured.
 
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Enginetech88

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This is exactly what I am looking for. Great information! Keep it coming.

As far as etiquette; yes dealing with MC's, respecting the very expensive gear, not cutting through a patch if it can be avoided, not acting like the rider is an "organ donor". As many people use this term, it makes riders feel like they will get sub standard care because "they know they are doing a risky hobby."

Linuss.... some great points I will definatly be including!

Thanks!
 

flhtci01

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I have spent alot of time on this forum and am now looking for some help. I have been an EMT for a few years. In the past few months I have noticed that the EMS, fire/ rescue, and first responders in my area are very under trained when it comes to responding to a motorcycle accident.

I am working at putting together a training presentation for first responders about motorcycle accidents. This will include specific dangers found on and around a bike, how to shut down a bike, common injuries and their treatment, helmet removal, and proper etiquette when dealing with motorcycle riders. I'm hoping that you folks will have some good pointers and things to include and real life experiances we can learn from. Also if any of you have recommended videos on helmet removal, or on this subject please include it. I greatly appreciate all the help!!!


What's your location? ABATE of Iowa has sponsored Two Wheel Trauma training. I have coordinated this training in the past. Slider, Anita and Frank have been doing it for years and are very knowledgeable. Slider has taught this and Accident Scene Management across the country.

Wayne starts off the day by telling about a van crossing the center line and killing four of his friends on impact.

This is followed responder hazards associated with motorcycles, environmetal considerations, spinal immobilization, helmet removal considerations and more.

They offer EMT and Nursing continuing ed for the course.

The link to ABATE of Iowa's page http://www.abateiowa.org/two_wheel_trauma.html

Two Wheel Trauma brochure http://www.abateiowa.org/pdf/two_wheel_trauma_brochure.pdf
 
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Shishkabob

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was your motive to disagree with everything?
My motive was to hand out education, experience, and information. What was yours?

if your supine with a motorcycle helmet on, your neck is pushed forward much like a pediatrics
That is precisely what I said, is it not?

as for your experience, i couldn't care any less. if someone is thrown off a motorcylcle, i'm immobilizing everything i can, just because YOU got lucky doesn't mean i'm overlooking anything. do you hear yourself?
So, since I had no neck or back pain and was otherwise unharmed, you'd still do a complete immobilization?




as for your last little comment, i was making a joke
Sorry, I must have missed the joke. Was it your severely injured patient that was funny, or the way that he got there?
 
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Enginetech88

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I am from NY. I will look into those programs. Maybe they can get me part of their presentations so I can teach the same principles here. The two wheel trauma is pretty much the same idea of what I want to do with my program. Thank you!
 
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workworkwork

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My motive was to hand out education, experience, and information. What was yours?

That is precisely what I said, is it not?

So, since I had no neck or back pain and was otherwise unharmed, you'd still do a complete immobilization?




Sorry, I must have missed the joke. Was it your severely injured patient that was funny, or the way that he got there?

My motive was the help the OP.

As for the helmet, you said "What gap? That helmet is coming off once I get on scene." Then referenced football players, which helped no one.

As for immobolization, yes I agree with you, assess, but if I get the call to respond to motorcycle vs. anything, the first thing that pops into my mind is cervical collar and longboard.

As for my joke, it was "in other words, don't by a motorcycle" try reading more thoroughly, i hear it helps!
 
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Tigger

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As for immobolization, yes I agree with you, assess, but if I get the call to respond to motorcycle vs. anything, the first thing that pops into my mind is cervical collar and longboard.

The first thing that should pop into your head is that mechanism of injury is an incredibly poor predictor of injury.

Assess your patient and determine if they need spinal motion restriction. While you might be holding manual c-spine while an assessment is done, this does not mean you have to board the patient if there is no indication to do so. Will many of these patients require it? Yes, especially because of the likely presence of distracting injuries. However, if you're someone like Linuss that wears proper gear while riding, there is a fairly good chance you won't be seriously hurt if you leave your bike.
 

workworkwork

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The first thing that should pop into your head is that mechanism of injury is an incredibly poor predictor of injury.

Assess your patient and determine if they need spinal motion restriction. While you might be holding manual c-spine while an assessment is done, this does not mean you have to board the patient if there is no indication to do so. Will many of these patients require it? Yes, especially because of the likely presence of distracting injuries. However, if you're someone like Linuss that wears proper gear while riding, there is a fairly good chance you won't be seriously hurt if you leave your bike.
I'm talking about when I get the call. When I'm sitting in my ambulance and they radio there's MVA with a motorcycle the FIRST ORGANIC THOUGHT is c spine and longboard. When you get to the scene that can all change, but those are the two pieces of equipment I would think about using first ON THE WAY to the call.

As for gear while riding, I guess I've seen way to many people cruising around without anything. There are parts of Boston and south of Boston that have pretty active motorcycle gangs and just morons with pants down to their knees going 80mph shirtless. Theres a town called mattapan everyone calls murderpan, just sayin.
 

crazycajun

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was your motive to disagree with everything?

if your supine with a motorcycle helmet on, your neck is pushed forward much like a pediatrics as many helmets, not all, become thicker towards the back and top, therefore if you were to remove a helmet without holding correctly, someones head could drop as much as four inches. i'm talking about the gap between the head and the ground.

as for your experience, i couldn't care any less. if someone is thrown off a motorcylcle, i'm immobilizing everything i can, just because YOU got lucky doesn't mean i'm overlooking anything. do you hear yourself? next time i have a car accident i'll just tell my patient when i was in a car accident like they were i was fine and i wont take precautions. hows that sound?

as for your last little comment, i was making a joke, but besides either of our points, the simple fact is motorcyclists have a whole hell of a lot more chance of dying or getting seriously injured.

I think the point Linuss was making that a helmet needs to be removed ASAP if possible. You also cannot put a person in a correct C-spine position with a helmet on. You also claim that you will immobilize any PT that is thrown off and I am wondering why. What if that person is walking around or combative when you try to board him? Lastly. I get on a ton of members here for disrespecting Newbies like yourself. I always try to remind them to treat everyone with respect. Please remember that is a two way street and not bash people that are simply giving you input. Linuss was not rude or offensive however your comments were just the opposite.
 

workworkwork

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I think the point Linuss was making that a helmet needs to be removed ASAP if possible. You also cannot put a person in a correct C-spine position with a helmet on. You also claim that you will immobilize any PT that is thrown off and I am wondering why. What if that person is walking around or combative when you try to board him? Lastly. I get on a ton of members here for disrespecting Newbies like yourself. I always try to remind them to treat everyone with respect. Please remember that is a two way street and not bash people that are simply giving you input. Linuss was not rude or offensive however your comments were just the opposite.
Alright, fair enough. I've probably experienced too many forums with trolling know it alls. Never join a guitar forum.

When c spining a pateitn with a motorcycle helmet on, my practicals (in class, not in certification) included a two scenarios. A two man, and a three man operation of holding c spine while removing the helmet, measuring and applying collar etc.

As for "boarding everyone" I'm exaggerating, I'm just trying to make the point that it's one of the biggest concerns. I've transported several MVA patients and have responded to a few myself, every single one was gnarly.

I'll also point out in the "two wheel trauma" link, one of two pictures is a picture of someone being boarded.
 
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Shishkabob

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they radio there's MVA with a motorcycle the FIRST ORGANIC THOUGHT is c spine and longboard.

My first thought is whether or not I'd be able to finish my food before I get to the call.


Alright, fair enough. I've probably experienced too many forums with trolling know it alls.

A Paramedic who personally knows and has worked with a fair number of members on this forum, with 7,700 posts and 3.5 years on a forum who makes it a point that they don't like trolls / insulting members. I'd like to think I've proven that I'm not a troll :blink:


But yes, I do know it all.
 

CANDawg

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Most accidents involving motorcycles are either due to stupid car drivers violating the riders right-of-way, or a drunk rider. If all left hand turns required a green arrow, I guarantee motorcycle fatalities would decrease.

I STRONGLY disagree. I regularly see people on crotch rockets driving irrationally, excessively speeding, weaving in traffic, and the like. There seems to be this idea that just because they CAN fit, means they SHOULD. Just last week I had a middle aged guy, no helmet, ride his sport bike between my car and another, right up the lane dividing line. Probably had 4-5 inches of clearance on either side.

I know this isn't all bikers, and I admit that I can't remember the last time I've seen a dude on a Harley acting like that, but there seems to be a mentality that goes along with sport bikes and their owners.
 

Shishkabob

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I STRONGLY disagree.
Disagree all you want, the studies on the topic back it up, from the original 1981 Hurt Report, to the more recent ones released on the matter of motorcycle crashes.

I know this isn't all bikers, and I admit that I can't remember the last time I've seen a dude on a Harley acting like that, but there seems to be a mentality that goes along with sport bikes and their owners.

Granted, this part is going to be as anecdotal as your post, but speaking from a professional standpoint as a Paramedic, and a personal view as a motorcycle rider who rides said 'crotch rocket', sportbike riders tend to be the safer rides.

Sure, you won't see too many cruiser ("Harley") riders popping wheelies and weaving through traffic, BUT you are more likely to see a sportbike rider wearing ATLEAST a helmet, if not a full contingent of protective gear, than you are to see a cruiser rider wearing the same gear. Next time you are out driving, keep tab of how many sportbikes vs cruiser have helmets, jackets, suits, gloves, boots, etc etc, and I can all but guarantee that sportbike riders will be in the majority.

On top of that, sportbikes are built for high performance, built for quick turns, and built for quick stopping.



I ride a sportbike. I don't ride like an idiot. I ride with friends who ride on sportbikes, and they don't do it either. If we have someone join our group and they try that, we don't ride with them. There are sportbike groups in the DFW area who do the same thing.
 
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