A vehicular accident (VA) can lead to suspected broken bones that needs stabilization such as a hand injury that will require a SAM Splint Soft Shell (NAR). There are many things that will happen during such accident and it’s important that you respond appropriately should there be delays in health care delivery.
The Accident Scene
The first you have to do if you respond to a VA is to survey the scene and assess the safety. Here’s a small checklist.
Area Safety
- Is it safe for you to approach?
- Is it safe to perform emergency health care on the site?
- Is it safe to keep the patient on the scene until ready for transport?
The important thing is to remember you have to be uninjured if you’re going to help. In some departments, patients are moved immediately away from the wreckage in case of explosions which can happen if the gas tanks are punctured.
Stabilizing the Patient
There are several pressing injuries or suspected injuries that you need to address. The mnemonics ABC is still useful in keeping the patient safe until transportation.
- A – Airway
- B – Breathing
- C – Circulation
In a vehicular accident, airway can be obstructed or compromised by the following:
- Spine damage – especially the cervical vertebrae.
- Mechanical obstruction – Anything that can block the mouth, nose and throat. The tongue in particular can roll back to cause obstruction.
- Head posture – the posture of the neck and head can deviate and cause obstruction to the airway.
Rather than waiting to determine which can obstruct the airway, most emergency response personnel will apply a Cervical Collar Soft, TOPCARE which helps solve or at least reduce any of the mentioned obstructions to airway and solve breathing problems.
Circulation is another problem with especially when bleeding occurs. Most superficial wounds can be closed with Silk sutures, but deep ones might require institutional care like in a minor operating room. Sutures such as Vicryl 3/0, Plain 2/0 strand Softcat, B-BRAUN (12’s) and even Chromic 3/0s and 2/0s will be needed to close any wounds.
Dealing with Fractures and Sprains
Vehicular accidents will sometimes cause fractures and sprains. They are usually immobilized with splints or for bigger fractures, with orthopedic casts such as a circular mold which covers the whole extremity or a partial mold that’s either anterior or post mold. They are immobilized to help the bones and sprain heal. After a set amount of time, circular molds need to be cut away with a tool such as a Plaster Cutter 10” and the patient can proceed to rehabilitation to improve strength on the injured part.
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