Within moments I found myself at the scene of a hit-and-run.  Anything can happen, at anytime.

Last Sunday, I was at my desk when I heard the sound of a motor vehicle collision right outside of our office. As I turned my head to see what happened, I witnessed a man on a scooter get hit head-on and fly straight up 12 feet in the air. His helmet flew off as he was somersaulting over the vehicle and hitting the pavement hard with an awful sounding THUMP.  I couldn’t believe my eyes and I knew that I had to spring into action and do the very thing that I had trained others to do for the last 20 years as the owner of Heart to Heart First Aid CPR Services Inc., and Instructor Trainer for the Canadian Red Cross.  There are two incredibly important teaching opportunities here that I would like to share with everyone.  Both lessons come with a compelling video. PART 1 is CCTV footage and PART 2 is footage taken by a bystander at the scene while we were giving first aid. Disclaimer:  Both videos do not show the injured person’s face and all immediate family members have already been informed of the accident. The purpose of showing these videos is strictly for educational purposes.

PART 1

This footage was pulled from our surveillance camera, which captured the entire incident and the vehicle that caused the accident fleeing from the scene.  This video was given to the police and used as evidence. Keep your eye on the top left corner of the screen, and about 20 seconds after the streetcar drives by, you will see a black car making a left onto Carlton St.  Keep your eye on the black car. At the end of the clip you will see me running outside and then down the stairs to get my instructor John Devlan to bring our AED and first aid kit and bring it to the scene.

Lessons

The importance of driving safely and preventively can mean the difference between life and death. This video is a good example of how one car can hit another car forcing it to swerve into oncoming traffic.  Within seconds your life can be over at no fault of your own. Knowing this, PLEASE wear seat belts at ALL TIMES and NEVER take chances, even if you are going a short distance. This video is also a reminder to wear helmets and to  ensure that they are secured properly. The other important point is to NEVER leave the scene of an accident that you were a part of. Even though the car that caused this accident did not actually come into contact with the injured person, they are still responsible.

Persons causing an accident directly or indirectly must stay at the scene, otherwise they are committing a serious offence that can lead to a much more serious punishment. Don’t risk it because the chances of being caught are very high – as in this case.  The person fleeing the scene was caught thanks to a bystander that wrote down their license plate. Another crucial lesson here is to SLOW DOWN and DON’T SPEED! As confirmed by the police and EMS professionals, the main reason why this injured person didn’t die or become critically injured was due to low-speed impact. Even though the car that hit him was travelling at low speed, the impact was still great enough for the injured person’s shoes and helmet to fly off while while somersaulting 12 feet in the air.

Part 2

This video shows myself and others providing first aid to a seriously injured person after being hit head-on by a car (as seen in the Part 1 video).  You will see how I manage the scene and conduct a process called “Check, Call, Care” with the help of my instructor, John Devlan, and several bystanders. It is a series of steps that allows you to conduct a rescue in a logical and effective way. You will see how trained and untrained bystanders work together as a team to provide the best care possible. Taking proper training is a “life-skill” that I firmly believe everyone should have. Proper training with the right company will allow you to become  more confident, which increases your willingness to act in a moment of crisis. Developing lifesaving knowledge and skills could be one of the most important things someone can do for themselves or someone else.

Lessons

I felt confident and ready to act- and so I did.  As I was running outside, I quickly ran down the stairs to our training floor and luckily one of my instructors, John Devlan, was finishing his paperwork after teaching a first aid course.  I had him grab our AED and Red Cross first aid kit and told him to bring it to the scene.

As I approached the injured person, I noticed that someone had already stopped traffic which confirmed that the area was safe for me and others to help.  I yelled out for someone to call 911. The first thing I told the injured person was NOT to move. The mechanism of injury was serious enough for me to consider a possible head and spinal injury. The injured man was in a state of shock and pain.  He was conscious but clearly hurt. He was able to blink his eyes when asked and was responding to my questions – these are all good signs that his ABC’s (Airway, Breathing, Circulation) were okay for now. There was no deadly bleeding but clearly he was in a state of shock which could become life-threatening, so it  was something I knew we had to monitor.

We started a secondary survey with my instructor and a few other bystanders at the scene. I asked him if he could wiggle his fingers and toes to quickly check for spinal cord injury. We checked his head and pupils, and looked for bumps or deformities and any other potential injuries from his head down to his toes. I asked him where he felt the most pain and he pointed toward his femur.  A broken femur can be very serious since the femoral artery is close to it and can severe causing internal bleeding. At this point he was on the injured side. I constantly checked his vital signs by assessing his quality of consciousness and breathing. I noticed that his consciousness and breathing was becoming impaired. A couple of times we had to position him in a way that helped him to breathe better. Since breathing is part of the ABC’s this must take priority, even though he may have a potential head and spinal injury. “Life over limb”. Keeping this in mind, we kept his head immobilized and in-line with his spinal column (log roll). We kept him comfortable and put a blanket over him.  I was constantly reassuring him that help is on the way.

Firefighters were the first to arrive on scene 4 minutes from the point of calling. WOW, such an amazing response time Toronto Fire! I provided them a report on all of our findings. They instructed me to continue with my immobilization of his head and neck while they interviewed the person and started their protocols. When they instructed me to “handover” care to them, I took a big sigh of relief and removed my gloves. I knew that my job and role was done and the chain of survival continues. This is when the adrenaline stops and you begin to feel shock yourself. I had to debrief with my instructor and the other bystanders to start to relax and calm down.

I’ve been involved in many first aid situations over the years, but not quite like this. Here are some of the key learning points for me:

• Bystander Effect

In our first aid courses, we discuss the “bystander effect” as a barrier to action that prevents someone from approaching the scene because there are people around already helping.  What we don’t discuss is the opposite of the “bystander effect” which is when a scene becomes inundated with too many bystanders wanting to help.

There were at least 5 people that came up to me saying that they are a nurse, physician or first responder. Some of them also wanted to take charge by directing us to do things I was uncomfortable doing.  An example would be when someone was persistently telling me not to move them when I knew that ABC’s are more important and the injured person verified that he was having breathing issues and felt he could breathe better on his side. Knowing that I was more than qualified to help, I realized that I had to prove myself to others in order to gain their trust. This prompted me to consciously make the decision to verbalize everything I was doing and thinking out loud. This allowed them to hear and see my thought processes.

• Communication

In one ear I have the injured person telling me he can’t breathe and wants to go on his side so he can breathe better and in the other ear I have two physicians telling me not to move him. ABC’s are most important. I kept telling myself and others that. This is interesting because there is no protocol on how to integrate other trained bystanders who may have equal or higher medical authority into a rescue. Does the old saying  “the first rescuer is always in charge” still hold true? What happens if the first rescuer is not doing a good job at all? What happens if you know you can do a better job and want to take the lead? These are all good questions and not really discussed in training courses. I think that it’s all about education and communication among the bystanders.

Keeping calm is important and having discussions on best practices, in real time, is the way to go. We should remember the scene is already stressful. So the question becomes how to help and in what way without impeding or creating more anxiety for the injured person and those around. I will be sure to take this whole situation and use it to train my instructors to start incorporating these lessons into their class.

Conclusion

I must say that the amazing thing was that right from the beginning of the rescue, everyone worked together and each of them filled a role that was needed. Some were involved in traffic control, getting blankets, calling the injured person’s family, protecting the person’s belongings, escorting EMS to the scene, and giving eyewitness testimonies.. Being in the business and running my company for 20 years now, I am still able to pull lessons and learn new things every time I am involved in an emergency. We are always growing to become better first aiders and, in turn, being better human beings. There is nothing better than the feeling of making a difference.  Learn first aid and CPR. Get trained.  Contact your local Canadian Red Cross training partner and be prepared in the event that you are called to act.

Written by: Nick Rondinelli

CEO/Owner of Heart to Heart First Aid CPR Services Inc.

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