Oooo Matron!

A Safety Officer's Guide to First Aid

Let me say at the outset that very little of what follows is my own work. This will come as no surprise to those who watched my performance on Who Wants to be a Millionaire when I answered that band-aid was a pop concert at Wembley.

However, as Chief Safety Officer on Rallye Sunseeker, I thought it only right that I should get an understanding of how my rescue crews respond to life-threatening incidents on the rally. The problem is that my normal reaction to blood is to pass out in the arms of the nearest attractive nurse.

I am therefore, extremely grateful to the Association of Motorsport Recovery Operators (and particularly to Harold Lowe) for the chance to learn the basics. If I have misinterpreted the correct procedure to follow in any particular incident, the fault lies entirely with me for not listening properly. My hearing was impaired on several occasions during the course on account of the nurse who attended me during my fainting fits being rather well-endowed.

First Principles

On arrival at the scene of an accident with more than one casualty, find the noisiest first and gag them. After all, there's nothing worse than someone screaming and shouting when you're trying to panic.

If a casualty has a large open wound, first aid should be applied by picking up the nearest fire extinguisher, moving it in a circular motion and bringing it down smartly on the wound. A two-gallon foam is the preferred type because the water adds to the centrifugal force. The resulting swelling will close the wound and stop the bleeding.

In the case of rowdy casualties, the same procedure can be applied. However, the extinguisher should be brought down on the cranium, preferably the rear. This renders the casualty into a tranquil, relaxed and horizontal position. The added benefit of this treatment is that other casualties recover with miraculous speed.

Now that all the casualties are relaxed and horizontal, we can start dealing with the…….

Minor Injuries

The best thing for headaches, bruising, etc., is a 4lb lump hammer. For more severe bruising, a 14lb shaft hammer is recommended.

External Bleeding

Best dealt with by using a tree defender wrapped around the wound with one end attached to a suitable anchor and the other attached to the vehicle. Use of 1st gear, high box normally does the trick but more severe cases may require 1st gear, low box with the diff lock engaged. In the event of either procedure failing to stem the blood loss, you need to use the pressure points, the main ones being the brachial (arm) and the femoral (thigh) - and I thought the femoral was that area of rain forest between the equator and the tropics. To leave both hands free, treatment is best administered by parking your vehicle on the appropriate pressure point.

Breathing and Circulation

If you lose both breathing and circulation, you have a problem. Checking breathing is simple. Just stand your coffee mug on the patient's chest and if you spill any liquid the patient is OK.

If not, there may be an obstruction in the throat. Check for foreign bodies in the mouth (Only necessary with British casualties as overseas visitors already have foreign bodies). Obstructions can often be removed by a good kick up the rectum with a size 10 boot. If you have small feet, i.e. size 5, kick twice. Alternatively, remove obstructions by placing the foot pump adaptor in the patient's mouth, having sealed the nose with tank tape and applied bicycle clips to the legs. Five rapid pumps normally does the trick.

Having got the patient breathing, check the pulse. If you have been very careless and lost breathing and pulse, you have less than three minutes to revive the patient before the smelly stuff hits the fan. Drastic measures are called for such as ……

Defibrillation

No, this isn't a lie detector test for co-drivers who claim not to have misread the notes, but the process of taking the jump leads from the tool box and attaching them to the patient's nipples in a final attempt to revive them.

However, it is important to remember that the patient's right nipple is positive and the left negative. Failure to comply with this polarity can seriously damage your vehicle's electrics. It's also a good idea to run the engine to avoid battery drain. Because water is a good conductor of electricity, wherever possible place the patient in a river or stream before commencing treatment.

Fire

If a rally car catches fire, get the occupants out as quickly as possible. Failure to do so causes a smell of burning flesh which tends to attract a large crowd who mistakenly think the burger van has finally turned-up. As an aside, the fire beaters provided by the Forestry Commission are an excellent crowd control tool, especially in ensuring you get to the front of the queue at the aforementioned burger van.

If tackling a fire, make sure you use the right extinguisher. Water is excellent at washing mud from under the vehicle, but bugger all use on magnesium wheels for those who watched the pathetic attempts by the fire brigade on last year's Jim Clark Rally can testify. If the crew is stroppy, always use Powder because it really messes-up the upholstery and clogs up the fuel injector jets.

Mistaking the oxygen bottle for an extinguisher is easily done, but not to be recommended. Apart from the obvious use of inflating a flat tyre, Oxygen is best left for use in sub-zero temperatures when there is a danger of the fire going out with a consequent risk that rescue and recovery crew might get …..

Hypothermia

The treatment for this is straightforward. Place the casualty in a black plastic rubbish sack, seal with tank tape, attach a large bore pipe from the exhaust to the bag and start the engine. Leave for approximately 5 minutes at 1200 revs. However, do remember to leave the patient's head outside the bag.

Hyperventilation

The same black plastic sack comes in very handy for this as well. Merely place over the patient's head. Alternatively, open the sunroof.

Poisons

Giving poisons to patients is not recommended.

Amputation

Again, this is not a recommended procedure because of the limited range of spare parts carried.

Spinal Traction

A specialist job for the recovery crew using the suspended tow unit. Secure arms to a suitable tree, suspend toes with hooks and crank away. Two turns of the handle is normally sufficient to effect a full recovery and a promise from the patient to buy the drinks all night.

Shock

Shock can be very serious and should not be ignored. The shock to the first-aider of all that blood can be quite overwhelming. Go and sit down for five minutes with a large brandy to give you time to acclimatise to the conditions. Should you feel faint, have another brandy. Should you continue to feel faint, put your head between the knees of someone of the opposite sex.

If the patient is not suffering from shock, go and tell them that their rally car is a complete write-off. This invariably triggers the classic symptoms of sweating and palpitations.

Stretcher Case

Everyone knows that this is the smart bag in which the stretcher is kept to stop it getting muddy. However, should you need to put a patient on the stretcher, ensure that they are wearing warm, waterproof clothing. The general rubbish in the back of the rescue unit means that there is usually insufficient room for stretchers and they have to be carried on the roof rack. Although Hawkeye never had problems with patients developing hypothermia in M.A.S.H, the Vietnamese climate is obviously kinder than that of mid-Wales.