A person who does not come to the aid of another person who is in direct danger of loss of life or of severe impairment to his health, although he may help him without exposing himself or another person to the danger of loss of life or severe detriment to health is liable to a penalty of deprivation of freedom of up to 3 years

The Penal Code article 162

It is usually drivers who provide first aid to the wounded in car accidents. That is why it is vital that these people, who normally lack professional training, should have the necessary knowledge about how to proceed in specific situations. They should also know which actions not to take so as not to disturb the further relief effort and so they do not aggravate the condition of the wounded.

Remember:

In helping others, you never put your own safety at risk!

How to proceed at a road accident site:

People who witness an accident always act too emotionally, and sometimes even irrationally.

Few people know how to proceed in case of such an emergency. Most of them usually just watch or even actively hamper a relief operation. If there is a trained professional at the accident scene, they should announce it clearly and loudly and go on to ask the people present at the site to perform certain actions such as informing the passing vehicles of the accident and calling for help (112 for mobile phones, 999 or 997 for land lines). If none of the witnesses has a mobile phone, a piece of paper with information about the accident should be given to 2 drivers going in opposite directions (it is a legal obligation). The information should include the following data: place of the accident, number of victims, and the number of suspected casualties. The site should be marked with warning triangles or manned with people waving flashlights, flags or simply giving explicit warning signals. At night the site should be lit by passing lights of a car that was not involved in the accident (preferably horizontally or diagonally) and, if possible, also by the car involved in the accident.

Those who provide first aid should also make sure they watch the victims closely, cover them and calm them down. The engines of the involved vehicles should be switched off.

If needed, the witnesses should assist in resuscitation and note the time of particular actions- this is of great help to medical personnel.

How to start?

It is necessary to remember the correct sequence of actions in such circumstances. When assessing the condition of victims start from those who do not cry for help, as they may be unconscious. Before moving the injured make sure that they have not sustained spine injury. One person should take care of one victim while the person in charge of the relief operation should help those who are bleeding by applying pressure to the wound. Other victims that require immediate help are those who have problems breathing and turn blue, because these are symptoms of artificial pneumothorax. The last category in need of help are the people suffering form minor injuries, scared (a state which is often mistakenly called “trauma”) and in pain (without any visible injury). It is essential to calm down the victims and assure them that help will come shortly. If there is enough time, relatives should be notified of the accident. If there were animals involved in the accident they should be taken care of, too.

Caution!

Every type of breath, even gentle and irregular, is a sign that the circulation has not stopped.

Resuscitation- what is it and and when it is needed?

Resuscitation is a process whereby circulation and lung ventilation are artificially supported at least until the moment when the heart starts beating again. It involves cardiac massage , i.e applying pressure to chest which results in blood being forced out of the heart to the arteries. It also involves breathing the air from the rescuer's lungs into the mouth or nose of the victim. This procedure should be used in case of cardiac arrest caused by heart attack, massive injury, stroke or other sudden injuries. If you suspect cardiac arrest, the first thing to do is to try to bring the injured person round. Advisable actions in such a case include: trying to elicit a verbal answer, pinching or shaking the person's hand vehemently (if there is no sign of injury). Very often the loss of consciousness turns out to be just a faint. In such a case resuscitation is not recommended and it can be harmful. If there is no reaction or movement, the hands and legs remain limp and there is not even a faint breath, a rescuer should feel the pulse by checking shallow arteries. If a victim does not breathe but has a pulse, air should be provided by means of mouth-to-mouth resuscitation or, in the case of children, mouth-to-mouth-and-nose. Before doing that, it is necessary to check the victim's mouth for vomit, blood, mucous or debris and remove it with a finger wrapped in a tissue or cloth. The victim's head should be tilted back and their lower jaw should be moved forward. When providing the air you should hold the lower jaw with one hand and apply pressure to the forehead to ensure that the the air can flow freely. When exhaling, you should watch the victim's ribcage. It should go down. If there is no pulse in the main arteries (carotid or radial artery), start cardiac massage . You should start reanimation with a single hit on the left side of the ribcage. If, after 2 such hits, you still cannot feel the heartbeat, cardiac massage is necessary. The victim should be lying on his back on a hard surface. The rescuer should kneel beside him and place his palms one on top of the other on the lower 1/3 of the victim's breastbone. The elbows should be straight and the palms should rest on their base, not on the fingers. It is necessary to press using all the body (effective pressure requires the strength of around 30 kgs). If there is one rescuer the right sequence is: 2 exhales followed by 15 pressures. If there are two 1 exhale should be followed by 5 pressures. You do not need to stop the pressure when breathing in. In case of infants or small children the cardiac massage should be handled in a different way. In case of infants it should be done with 2 fingers and and in case of newborn with just 1. In such a case the breastbone should be pressed below the line between the nipples. When providing the air it is necessary to breath it into the baby's mouth and nose and to take into account smaller lung volume.

How to help an unconscious person who breathes without support

It is of utmost importance that an unconscious person should be positioned so that they can breathe freely without the risk of choking on saliva, blood and vomit. An injured person should be placed on a “propped” side, which means that a leg lying on the ground (“lower”) should be bent at a hip joint and a knee joint, which makes it impossible for an injured person to roll over onto their belly. The “upper” leg should be straight. The “lower” hand should be straightened behind the body which makes it impossible for an injured person to roll over onto their back into such a position that the airways could be blocked by the tongue. The “upper” hand should stabilise the injured person and the palm should be placed under the chin. In this way the victim's mouth will not be blocked by such substances as sand or gravel.

How to help in case of a haemorrhage

Haemorrhages and bleeding are the result of broken blood vessels. At the site of an accident it is only possible to help in the case of external haemorrhages as the internal ones (e.g in liver or spleen injury) are very difficult to stop in such circumstances. External haemorrhages can be divided into:

arterial, in which light red blood gushes from a wound in waves; venous in which dark red blood flows in a steady stream and capillary bleeding in which blood runs in a trickle. The last kind is not dangerous and can be easily stopped. Each kind of bleeding should be stemmed as soon as possible because as a result important organs receive less blood than usual. However, only a large and sudden haemorrhage can pose an immediate threat to human life. The first thing to remember while helping a bleeding person is to lay them down. A bleeding limb should be placed above the heart level and the wound should be covered with a pressure dressing, i.e. a thick layer of sterile gauze followed by cotton wool, an ordinary bandage and an elastic one (or one of them depending on our supplies). If you do not have such materials at your disposal you can stop the bleeding temporarily using you finger or palm. A pressure dressing should only be used above the place of bleeding as a last resort, and even then only above an elbow or a knee because its use may lead to serious complications such as necrosis of limbs or even a stronger haemorrhage. If the bleeding persists you can add cellulose wadding or gauze dressing between the layers of the bandage. You can also apply pressure on the artery (if you can feel the pulses). If the source of bleeding is inside the nose, throat or mouth the victim should sit with their head tilted forward so as not to swallow blood or choke on it. If you are sure that the nose has not been broken you can apply pressure to it for 5 minutes. If possible, the wounds with less profuse bleeding should be cleansed, disinfected, and dressed with a sterile bandage. In the case of a bleeding palm, forearm or arm it is important to remove all objects such as rings, bracelets or watches).

How to proceed in the case of spine injury

The possibility of spine injury should be taken into account whenever a victim is unconscious. Such injury is not always connected with spinal cord injury (paralysis) but a person providing first aid should always assume such a possibility. The most important rule is to keep the victim's head and corpus in a position between bending and straightening. Whenever a victim is unconscious or reports neck ache or nape ache an orthopaedic collar or else a collar made of cotton wool and bandages should be used. When evacuating the victim from the crash site it is essential not to lift the person by the head and hips or by shoulders and hips because in such a position the spine is too contorted. If you do not have even makeshift stretchers, the victim should be evacuated in the lying position and held by their legs, hands or clothes. After the evacuation the victim should lie still until a doctor arrives.

An accident can happen even if a car is motionless so it essential to remember that engine wires are live, the battery contains acid, and the exhaust pipe is hot enough to cause a burn. It is important not to open a radiator with your bare hands because hot vapor may burn. It is advisable to be careful when leaning over an engine because a fan belt can catch hair, a tie or clothes. A jack should only be placed on hard ground and in a vertical position, wheels should always be secured by blocks. It is absolutely essential not to crawl under the car, smoke cigarettes or strike matches in its vicinity.