Road Accident: The First Response Before the Ambulance Arrives

India has the highest road fatality rate globally — around 150,000 deaths annually. Many are preventable with prompt correct first response. The specific 'golden hour' after a road accident is when most survivable deaths become unsurvivable. The Good Samaritan law protects those who help. Knowing what to do makes the specific difference between helping and either freezing or unwittingly making things worse.

The immediate scene assessment

• Ensure your own safety first — approaching traffic, fuel leak, fire risk.
• Call ambulance (108) and police (100 or 112).
• Note location precisely (nearest landmark, kilometre marker, or GPS).
• Signal to oncoming traffic to slow or stop (hazard triangle if available).
• Do not move seriously injured persons unless immediate danger (fire).
• If moving is necessary: support the head, keep spine aligned.

Assessing casualties

• Check consciousness: shake gently, ask 'Are you okay?'.
• Check breathing: watch chest for rise and fall.
• Check for major bleeding.
• Prioritise: unconscious not breathing needs CPR immediately.
• Multiple casualties: quickest assessment first, treat most critical.

The unconscious but breathing casualty

• Place in recovery position (unless spine injury suspected).
• Keep airway clear.
• Loosen tight clothing.
• Cover with blanket for warmth.
• Monitor breathing until ambulance arrives.
• Talk to them even if unresponsive — hearing may still be intact.

The unconscious not breathing casualty

• Begin CPR immediately.
• 100-120 chest compressions per minute.
• Compression depth 5-6 cm (adult), 5 cm (child), 4 cm (infant).
• 30 compressions to 2 rescue breaths (if trained).
• Continue until ambulance arrives or person recovers.
• Use AED if available.

Major bleeding

• Apply firm direct pressure with cloth.
• Do NOT remove impaled objects — pressure around them.
• Elevate the bleeding limb if possible and no fracture suspected.
• Tourniquet as last resort for life-threatening limb bleeding — note the time applied.
• Continue pressure until medical help arrives.
• Watch for shock: pale, cold, rapid pulse, confusion.

Suspected spinal injury

• Any high-speed accident, fall, or motor vehicle crash — assume until proven otherwise.
• Do NOT move the person if breathing is adequate.
• Support the head and neck in the position found.
• Stabilise until medical help arrives.
• If must move (fire, drowning): log-roll technique to keep spine aligned.

Fractures

• Do NOT try to straighten a fractured limb.
• Stabilise in the position found.
• Splint if trained (use rigid materials — cardboard, rolled newspaper, wood).
• Include joints above and below the fracture.
• Check circulation below the fracture (pulse, colour, sensation).
• Loosen if swelling increases or circulation compromised.

Motorcycle helmet — the specific issue

If the injured person is wearing a helmet, do NOT remove it unless absolutely necessary. Removing incorrectly can worsen spinal injury. Only remove if: person is not breathing and helmet prevents CPR, or airway is blocked and cannot be cleared with helmet on. Ideally, wait for trained ambulance crew.

The Good Samaritan law

• India has protection for bystanders who help road accident victims.
• No obligation to provide identity or witness in court.
• Cannot be forced to pay for treatment.
• Legal protection from liability if acting in good faith.
• Aim: to encourage more people to help without fear.

Information for the ambulance / hospital

• Time of accident.
• Mechanism (car crash, motorcycle, pedestrian, fall).
• Number of casualties.
• Level of consciousness.
• Obvious injuries.
• Any first aid given.
• Any information about the injured person if known.

What to record for the family later

• Time and location of accident.
• Nature of injuries.
• Initial treatment received.
• Hospital details.
• Any witness or good samaritan information.
• Police FIR number.
• Insurance details.
• Vehicle information.

The specific personal preparation

• Emergency contact number saved in phone (visible from lock screen).
• Medical ID on phone with blood group, allergies, chronic conditions, medications.
• Basic first aid kit in car.
• Fire extinguisher in car.
• Hazard triangle.
• Know your insurance emergency number.
• Consider first aid course — Red Cross India runs them.

The specific act of helping — even in small ways — during an accident can be the difference between a person surviving or not. The Good Samaritan law removes most reasons not to help. What remains is knowing what to do.

References

• MoRTH — road safety India
• Good Samaritan Law — Supreme Court of India
• IRC — Indian Resuscitation Council