I copied this over from the Long Distance Riders website and thought it might be useful reading. This was posted there from another list. The context was a discussion of helmets and the circumstances surrounding their removal in an emergency. Here is the post.
I am a firefighter and have responded to my fair share of motorcycle
accidents. I also have training in the subject of removing helmets (not
just motorcycle helmets either -- lots of other sports involve
First off, I would like to point out that the concern is Mr. Motorcycle
Crash Victim broke bones in his neck without without severing the spinal
cord. The fear is that in removing the helmet, broken bone shards will
sever the unprotected nerves.
Now, someone in an open face helmet who has unintentionally departed
from a motorcycle at sufficient speed to receive c-spine damage has a
greater risk of drowning in their own blood before anyone has a chance
to remove their helmet. And while it is possible that someone with a
broken neck may not already have permanent spinal cord damage, the odds
are really slim. If you think removing their helmet will jostle their
head, what do you think the tumble just did? I've been to a few car
accidents where the seatbelt may have caused some injury but they are
far outweighed by the accidents where the seatbelt prevented injury or
death. Using fear of post-accident trauma as a justification for wearing
an open face helmet is just plain stupid. Odds are the full face helmet
will save far more riders than will be injured.
Now, as for what to do in case of an accident involving a fellow rider.
The prime rule of medicine is "Above all, do no harm." That often means
if you don't know what to do, do nothing. It also means that sometimes
you must weigh the danger of doing nothing against the danger of taking
action. The first rule of rescue is "Don't make more victims". That
means identifying danger to yourself and taking measures to prevent
becoming another victim. So keep calm, take a deep breath and
Let's put this into a scenario: You and your buddies are out for a ride.
The lead rider runs smack dab into a deer in the middle of a curve. Bike
rider and deer end up a mess of bloody pulp in the middle of the road.
All other riders stop safely.
Among the dangers and risks:
-Other traffic coming around the curve
-Spilt fuel may ignite
-The deer may start kicking
-Downed wires or other environmental hazards
Among the medical concerns:
-Other internal injuries
-Minor broken bones
(When evaluating the medical concerns, it helps if you have had first
aid training. Take a course now, before you need it)
Someone must take charge. Everyone else must follow orders. It's usually
obvious in the first few seconds who is going to be competent. Remember
that there are 4 kinds of people at these things. Those that know what
they are doing and take appropriate action, those that freeze up and are
of no use to anyone, those that don't know what to do but will follow
orders and those that think they must act and do the first thing that
pops into their head.
If you are going to take charge then do it. Watch out for the person
running towards the downed rider -- they are type 4 and will get
themselves or others hurt.
First thing is to make the scene safe. Position someone to stop traffic.
(If you have to, park a bike in the middle of the road before the curve
-- at least the sound of the crash will let you know someone is coming!)
Don't forget traffic can come from either direction. Call to the rider
and tell him to lie still. Look for other hazards (such as downed wires)
surrounding the incident. Shut off all sources of ignition, including
the crashed bike. Avoid lighting up that nerve-calming cigarette. If
it's not tangled up with the injured rider, grab the deer by the hooves
and drag it over to the ditch. Approach the injured rider from his front
(so he doesn't try turning his head to see you), and continue to tell
him to stay calm and lie still.
Evaluate his condition and circumstances. If you made the scene safe,
and if he is breathing and has a pulse, then there is no reason to move
him immediately. You can apply direct pressure with the cleanest
available material to any bleeding and call for help. If he is not
breathing, or does not have a pulse, or you cannot make the scene safe
(for example, he is lying in a pool of fuel and the bike is dripping
more onto a hot engine) then you may have to take further action. If you
MUST move him, then move him as a unit in the position found if
possible. One person should hold the head, applying light traction (a
very LIGHT "pull" away from the shoulders) Others can grasp his
clothing. The person at the head will direct the movement. On his
3-count, everyone moves together to slowly extricate the patient. Do
only what is necessary. If the patient is not breathing or has
no pulse, you will need to position them onto their back. It should be
done in stages at the direction of the person at the head:
"Ok, you and you will lift the bike. On 3 the three of us will pull him
straight out from under as far as the yellow line over there. When we
are clear, I will rotate his head, then Joe will straighten his right
leg and we will roll him onto his back. If anybody spots a problem call
'Freeze' and we will all stop. Does everybody understand?"
"Ok guys, lift the bike. Ready? One, Two, Three."
"That's good there. Hold for a moment." <Still applying light traction,
the head person gently rotates the head so it is in neutral alignment --
straight with the torso and neither tipped towards or away from the
chest. Stop immediately if any resistance or grinding is felt>
"Now Joe, straighten the leg out." <Joe applies light traction to the
leg while straightening it out>
"Good. On 3 we will roll him onto his back. One, Two, Three." <Still
applying light traction, the head person keeps it in neutral alignment
as the patient is rolled>
If the patient is not breathing, you will have to remove the helmet.
Breathing and circulation take precedence over spinal injury. Cutting it
off is not an option in the field, so you will have to proceed the hard
way. With at least two guys, unfasten the helmet buckle and attempt to
maintain neutral alignment and LIGHT traction while slowly and gently
removing the helmet. Usually this means one fellow at the side will
slide his hand up the back of the neck to support the head while the
other fellow removes the helmet. You may have to rotate the helmet
forward slightly as you draw it off to prevent movement of the head.
Once clear, proceed with CPR and/or Rescue Breathing as required by your
first aid training.
Needless to say folks, the above few paragraphs will not make you an
expert. I offer this for emergency use only, with the understanding that
qualified help is some time away. If the patient is not breathing, then
they are already dead. You can't hurt them further, but you MIGHT save
them. Which brings us back to point #1: Above all, do no harm. Do not
take any action unless you have to. Usually, the best thing is to make
the scene safe and call for help. Keep the patient re-assured and calm
if they are conscious.
And keep any Type 4 guys under control away from the patient...