Motor vehicle accidents are often messy affairs, especially when they involve vehicles of disparate size, such as semi vs. car or truck vs. motorcycle.
Motorcycle accidents, in particular, can be tough—for bystanders, who are often the first on the scene and unaware what they should do until professional help arrives, and for the EMS providers because there’s not a lot of formal training on how to handle the kinds of circumstances and injuries found at the scene. It’s why Accident Scene Management, Inc.—now ASMI/Road Guardians—was established in 1996, with the goal of reducing injuries and fatalities to motorcyclists through education.
Vicki Sanfelipo, RN, EMT and executive director ASMI/Road Guardians, would be considered by many people to be well prepared to handle a motorcycle trauma. But she didn’t always feel that way.
“As a nurse who rides a motorcycle, people would frequently say to me, ‘Thank God we have a nurse with us. If something happens, you’ll know what to do,’ ” says Sanfelipo. “But while I knew more than the average person, I did not feel my training adequately prepared me for a motorcycle trauma.”
She looked around for a program but never found one which sufficiently addressed motorcycle trauma, until she stumbled on a pig farmer and EMT in Iowa named “Slider” Gilmore.
“Slider was doing a presentation called ‘Two Wheel Trauma,’ and talked about some of the things which made me uncomfortable,” Sanfelipo explains. “I suddenly became concerned about myself. I wondered who would take care of me if I was the one who needed help. So, I developed a basic program for motorcyclists and bystanders called ‘A Crash Course for the Motorcyclist,’ and then went on to create an advanced program and a program for EMS called ‘Anatomy of a Motorcycle Crash.’ To date we’ve trained more than 20,000 students and have instructors in 24 states, as well as Australia.”
That training has paid off. In 2005, the most recent year for which data is available, ASMI/Road Guardians surveyed 2,000 students who had completed one or more of its classes in the preceding two years. Out of 846 responses (42%), 29% reported they had used the information with patients since taking the class.
While EMS providers know all too well that motorcycle trauma tends to result in more severe injuries than a typical MVA, there are also specific issues involving the safety gear and the motorcycle itself which providers need to be aware of.
“For instance, if a motorcyclist is trapped under a bike they’re also likely to be injured,” Sanfelipo says, “making moving them even more challenging. Handling the bike can be hazardous and unfamiliar to EMS providers. Of course, full-faced helmets may also create a challenge if they interfere with the airway. There are many protocols regarding helmets, and learning proper helmet removal is not a required skill, even though the current recommended method of helmet removal involves two trained people.”
In addition to safety and apparel concerns, adds Sanfelipo, the ASMI/Road Guardian training addresses “psychosocial” aspects of motorcyclists, explaining the brotherhood and patches, 1% clubs, and how to recognize potential issues and gain cooperation.
Whatever bias the EMS provider might bring to scene can have an impact as well, Sanfelipo says.
“Motorcyclists are often thought to be the cause of the crash, when in fact it is more often the fault of a car driver violating a motorcyclist’s right of way,” she says. “EMS providers sometimes have personal feelings about the motorcyclist which can affect care. For instance, motorcyclists know they are sometimes referred to as ‘organ donors.’ Most motorcyclists are offended by that and some actually think they won’t receive quality care if injured because they’re just wanted for their organs.”
Cutting through patches on jackets or vests can also cause issues. It is best, and considered respectful, to cut around the patches, advises Sanfelipo.