HEALTH and road safety experts worldwide agree that rapid removal of motor vehicle crash victims to hospital will most likely improve their chances of survival. However, they caution that untrained individuals who attempt to extricate crash victims run the risk of exacerbating their injuries.

The universal advice, therefore, is to call qualified emergency responders as they know how to remove crash victims in a way that does not make their injuries worse.

It’s a sort of catch-22 for people who witness road crashes and instinctively rush to help victims. But Dr Romayne Edwards, an emergency medicine consultant who has been working at University Hospital of the West Indies’ Accident and Emergency Department since 2004, points out that there are life-saving manoeuvres that trained emergency medical technicians (EMTs) can perform at crash scenes that Good Samaritans are unable to apply.

“For example, they will have portable suction devices to clear the victim’s airway, if needed. They are trained to do simple airway manoeuvres like jaw thrust that can remove the tongue from the back of the throat. There are also paramedic EMTs, very highly trained ones, who can literally secure the patient’s airway [do endotracheal intubation] at the scene,” Dr Edwards told the Jamaica Observer.

“Patients who are in motor vehicle accidents, and especially high-speed collisions, the first thing you want to do is you want to ensure that you don’t cause any further harm as a first responder. You have to ensure that the airway is patent and there is cervical spine protection. If there is catastrophic haemorrhage, you can tamponade the bleeding. You also have to ensure that in lifting them or removing them, it has to be done in a way that you protect the cervical spine and you protect the vertebrae from further damage. So there are techniques with which you remove somebody from a vehicle…. The Good Samaritan, which is usually the passer-by, the friends, the relatives, usually are just trying to help by what is called scoop and run, which is basically taking the victim from the crash site and running to the nearest medical centre or hospital,” Dr Edwards said.

“So there’s a risk that if the person has head injury, is unconscious, cervical spine injury has to be presumed. The untrained individual may make a spinal cord injury worse by not keeping the alignment with the head and neck depending on how they remove the patient from the vehicle, then the person may end up with more severe injuries,” she added.

Dr Edwards explained that trained paramedics know that when lifting crash victims they need to ensure that the head and neck are in one plane. They are equipped with hard cervical spine collars, head blocks, and backboards on which to transport the patients. They are also trained in techniques to remove helmets.

Dr Edwards was responding to a Sunday Observer query posed as part of the newspaper’s focus on the role of first responders, especially given the worrying number of road crashes in the country over the years.

On Friday, the Island Traffic Authority (ITA) reiterated its caution to road users, even as it noted that road fatalities declined in the first half of 2024.

“Up to June 30, 2024, Jamaica recorded 202 road fatalities. This is a six per cent decline when compared to the corresponding period last year,” the ITA said in its weekly traffic crash report for the period January 1 – July 26, 2024.

“Motorcyclists, pedestrians and private motor vehicle drivers were the top three road user categories with the highest number of road fatalities during the first half of 2024,” the ITA said, adding that the main causes of those fatalities were speeding, failure to keep to the proper traffic lane, and pedestrians walking out or standing in the road.

It also said that as at July 26, 2024, Jamaica recorded 214 road fatalities, resulting from 187 fatal collisions.

The ITA data show that most of the fatal crashes occurred in rural parishes. Against that background, the Sunday Observer asked Dr Edwards what advice would she offer to people who witness a crash in a remote area — do they call for an ambulance, despite knowing that the location is so remote it would be better if they try to get the injured to hospital?

“That’s a little tricky in the sense that, ideally, you want the person to get to medical care urgently,” she said and pointed to a number of ambulance services that people can call.

“Or let’s say you call and they can’t respond, then what you have to do is to make sure that, as I say, you don’t make the situation worse. Ensure the scene is safe for you as the responder. You don’t want to become another victim trying to respond. Then the airway needs to be patent and you need to make sure that the head and neck are in one plane during movement. You want to ensure that you don’t have any movement of the neck at all. And if you can get a board to put under them, lift the person and put them on the board,” Dr Edwards advised.

“If you get the ambulance, fine, they have long spine boards, hard cervical collars, and head blocks, that’s why getting the ambulance there is the best thing, especially if the person needs assistance to get out of the vehicle and you suspect that they have neck and head injury.”