What to do if you’re first at a car crash scene

21 February 2024  By: Ruth Callaghan

For most of us, there is a sinking horror that comes when passing a serious road crash that is lit by the flashing lights of emergency services, working to save people at the scene.

But in most of those crashes, the person first on the scene was likely an ordinary bystander, not a trained professional — and how that person responds is critical to the outcomes of all involved.

There are about 30,000 road crashes a year in WA, with around one in 10 of those involving injuries severe enough that those involved need hospital attention.

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The number of fatal crashes is smaller, with 158 people killed on WA roads in 2023. St John WA estimates 15 per cent of road fatalities could be prevented with the right first aid and the moments immediately following a crash are a critical time for those injured.

Before you rush in

The first instinct when you come across a serious crash might be to rush in to help injured people, but there are steps you must take before you do.

St John WA provides a free first aid course targeted at drivers, which provides an action plan applicable for all emergencies, known as DRS-ABCD. This steps through the right responses in the right order for anyone who needs to provide first aid assistance at a scene.

Before any action is taken to try to treat or move an injured person, the first step is to check the scene for danger.

A former policeman who retrained five years ago as a paramedic, Tiq Rehman from St John WA says taking a moment to assess the situation avoids putting yourself in danger or increasing the risk to those injured in the crash.

“You need to zoom out and see the bigger picture,” he says.

“Is that fluid leaking out of the car? Where have you parked — does that put you in danger or anyone else who's in your vehicle?

“These assessments are really subjective and different based on the time, place and circumstance, but before you put yourself in danger, look at what danger that person is in as well.”

Those details observed in the first moments on the scene can also be critical for other emergency services.

Multiple first responders work together

Nathan Wilcock is Rescue Manager with WA’s Department of Fire and Emergency Services (DFES). With 21 years in the fire service, he has attended countless road crashes.

“It really is a multi-agency response,” he says.

“Police are what's known as the Hazard Management Agency and are in charge of the incident. They provide control and coordination and will deploy resources.

“The support agencies are St John WA and ourselves amongst others, and we need to work closely together to determine the casualty extrication pathways and timings.

“The contemporary approach to road rescue is really about minimising time in the pre-hospital environment. So it's about getting them out and getting into advanced medical care as soon as we can.”

Wilcock says observing the situation means looking for dangers that might not be obvious at first glance.

“Has the car hit a power pole and are those power lines still active or on the road? Are the vehicles leaking fuel? Are they carrying a load and is that load loose or precariously balanced now? That’s the type of information people need to be aware of for their own safety, but what the emergency services would also like to know prior to arrival.”

Call for help

The second and third steps of the DRS-ABCD pathway are to check for a response from injured people— to determine if they are conscious — and to send for help.

Checking for a response can be as simple as asking the name of the person or squeezing their shoulders if safe to do so, before calling Triple Zero (000).

If people are injured, ask for an ambulance, and the operator will ask questions to determine what other services might be needed.

“Once you’ve checked for danger and checked for a response then the ‘S’ stands for sending for help,” says St. John’s Tiq Rehman.

“That means getting somebody else to make that call or making the call yourself. It’s vital to call quickly, because even as an off-duty paramedic if I come across something, after I've checked for danger and a response, the first thing I need is more people to help.”

When you reach an operator, stay calm and provide as much information as you can about your location and the situation in front of you.

Share your location

Knowing how to find your location is critical, so an operator might ask for details about the road you are on, the direction you were travelling, any cross streets, road signs you might see, or the last town you passed if you are in a rural area with few landmarks.

Pinpointing your position can be a challenge if it is dark, you are on a long unbroken stretch of road, or near a landmark with several entry and exit points. But that’s where technology can assist.

St John WA has a First Responder App which includes free first aid guides and transmits the GPS location of the caller if they phone Triple Zero (000) from the app.

For everyone else, knowing how to find your exact location is as simple as using Google Maps on your phone, dropping a pin where you are standing (usually the blue dot) and reading the longitude and latitude that appears to the operator.

But if this is confusing, a third alternative is to use an app called What Three Words, says Wilcock, which maps the entire globe in three square metre blocks and gives each of these locations a specific text description.

A spot along Great Eastern Highway might be labelled ‘coast.earnest.starlight’, for example, but when those words are provided to emergency services, they know to head to a location just past Grancy Avenue on the road towards Mundaring.

“A lot of people know how to provide coordinates on their phone, but if you don’t, this is an app that is easy to use,” Wilcock says.

“It allows our communications centre to see who the closest responders might be and then it allows those responders to plan their route to the incident to get there the quickest way, avoiding any known hazards or roadworks.”

Provide clear information and seek instruction

Once the location has been established, operators will want to know more about the situation and here, the types of information needed will depend on the emergency.

When requesting an ambulance, the condition of any people injured will be important, and the operator will talk those on the scene through what to do.

That might mean providing simple first aid with injured people still in the vehicle, but depending on the situation, you might need to move them away for safety.

“In general, it’s better to try and give first aid where the person is found,” Rehman says.

“If the patient is not in danger, it's best not to move them because we don't know what other injuries they might have.

“Sometimes you have to move them if they're in what is considered a life-threatening condition or in a position that makes it impossible to give first aid.

“In that case, you might need to move to a safer space or a space you can work with.

“When you call emergency services, you will be on the phone to the operator and they will stay with you until they tell you to hang up, while they provide instructions.

“You can tell them what you're seeing and they can assist you on how to help as safely as possible. Even if you have to start CPR, they can instruct you how to do that as well.”

While safety is the most critical concern, other information you can see and relay can also help emergency services respond.

“Realistically, at a serious road crash, you're going to need all three agencies,” Wilcock says.

From a Fire and Emergency Services perspective, “we need to ascertain what's actually occurred. Is it a truck versus a car or is it two cars head-on — provide a brief description of the incident when you’re describing injuries.”

Wait for help to arrive

With emergency services on the way, it is important to remain at the scene and follow any instructions from the operator to continue to keep victims and bystanders safe.

If the victim’s car engine is still running, it is best to turn it off — but don’t take away the key.

“Often vehicles will stall if they have been involved in an accident but if they haven't, we like the ignition turned off,” Wilcock says.

“Traditionally, when we got to motor vehicle accidents, we would remove the keys and disconnect the battery to reduce the likelihood of airbags going off or to eliminate sparks from damaged battery cabling.

“But what we find now in modern passenger vehicles is everything's electric. Now if we isolate the batteries and remove the keys but then discover that it will be beneficial to move a seat or wind the windows down, we've lost the ability to do that without putting the key back in the ignition which could potentially set off undeployed airbags.

“The advice is, turn the ignition off, but leave the key in accessory mode for now.”

Nathan Wilcock says that once emergency services arrive, they will take control of the scene, but witnesses and first responders should wait to answer questions as needed.

“Just be cognizant that you're not going to be first on the priority list when an officer gets there, they will have a few things to do to ensure the safety of the crew and people involved in the incident,” he says.

“Once management of the incident is underway, somebody will definitely want to talk to you either from the Police, DFES or St John WA.”

Provide whatever assistance you can

Throughout the process, those first on the scene may feel a range of emotions — from panic to adrenalin to distress.

Rehman says all of these are normal, and while having first aid training can help you go through the correct steps more confidently, a lack of training shouldn’t hold you back.

“It’s always better to do something rather than nothing — just to the best of your abilities,” he says.

“It’s why we will always stay on the phone and talk you through. We will not hang up on you. We will just work it through together.”