In the immediate aftermath of a typical road traffic collision (RTC) the emergency services receive a number of 999 calls. The information given can vary enormously giving different roads and sometimes even towns. Based on that initial information the first responses are dispatched and where necessary further resources are allocated as more information becomes available or if applicable some of the initial resources stood down.
As the call comes in to the BASICS responder by SMS text, pager or phone call the initial details provide brief information and location information. Called out from home, work or wherever they happen to be at the time, the BASICS responder confirms they are responding gaining any updated information at the same time. Delaying only to get into their personal protective equipment (PPE) the responder sets off in their vehicle towards the incident. Specially trained to drive using emergency lights and sirens the journey to the incident is progressive rather than rushed because with so much traffic on the road, in-car entertainment systems and other distractions the chances of not being seen and heard are relatively high. As the incident gets closer congestion increases as traffic flow has stalled, some drivers attempt to turn around and others leave their vehicle to see what’s happening!
Arriving at the incident the BASICS responder takes care not to drive over debris wherever possible so as not to destroy any forensic evidence if a police enquiry follows. Having parked a quick scan of the area starts to provide more information on what’s happened and from this what mechanisms may have been involved and what injuries may have been sustained.
The BASICS responder works as part of a multi-disciplinary team that includes colleagues from the ambulance service, fire and rescue service and police as a minimum, on the motorways and other major A roads the Highways Agency are frequently encountered. To the casual observer the scene that unravels looks chaotic whereas in fact all involved are working collaboratively and with a common plan. The senior fire officer has the responsibility for the overall safe management of the incident.
From a medical point of view casualty management is based on the tried and tested ABC approach so that a rapid assessment of the casualty is made along with lifesaving interventions being carried out. If there is more than one casualty each is assessed as resources allow and their condition dictates. Within this initial assessment a picture of the casualties emerges and this is relayed to all involved in casualty care and to the fire services commander and a plan agreed for the casualties’ extrication. The fire and rescue service start to create space by simple measures such as forcing doors beyond their natural point of restraint. Whilst the BASICS responder works with the ambulance crew and one or two fire service colleagues the remainder of the fire and rescue crew(s) set about removing the car roof and freeing trapped limbs from within the debris.
On the medical front the casualty is methodically being treated against established priorities so that the casualties’ condition is stabilised and `reassessed. Where the casualties condition deteriorates the BASICS responder will alert the rest of the medical team and liaise with the fire services commander to arrange a rapid extrication forgoing some of the space making techniques in favour of getting the casualty out and on the way to hospital without delay.
Where the casualties condition warrants it the BASICS responder will bring their specialist skills to the fore to provide advanced airway techniques, on-scene anaesthesia, advanced pain killing strategies and even surgical intervention where required to save life.
Once the casualty is removed from the vehicle they are accompanied on their journey to hospital by the BASICS responder; those who have been seriously injured frequently require further specialist treatment en route and so from working within the confines of the twisted wreckage of a car care moves into the back of a swaying ambulance. At hospital the information given during the handover form the BASICS responder provides valuable insight to the waiting trauma team and the initial impressions gathered regarding what happened along with the injuries found and suspected point the way for the hospital team as they start their own assessment of the casualty using the same ABC format as used by the pre-hospital team.
At last it’s time to wind down, but only after kit has been cleaned up, restocked and the back of the ambulance cleaned and readied for the next call, but hopefully not before the BASICS responder is re-united with their car! A quick wash, if they’re lucky a shower, and its back to normal life – or bed, many calls involving BASICS coming in the small hours.
Will you help BASICS?
Has this story inspired you? Perhaps you’ve been involved in an accident and a BASICS responder helped save your life? BASICS is a voluntary organisation and as such relies on donation and legacies to continue providing its life-saving services throughout the UK. Please consider supporting the work of BASICS in any way that you can, you may wish to contact us to discuss what you can do, or make a one-offdonation or perhaps arrange a standing order, whatever it is you do you will be making a difference.