You see it in a flash as you round the blind corner on the twisty mountain road—the cloud of dust, your friend’s bike jammed under the guardrail, and they’re lying on their back in the middle of the road, not moving. Your first thought is, “Wow, that’s a bad crash.” Your second thought is, “What the hell do I do now?”
Most motorcycle crashes don’t involve injuries except to the riders’ pride, their insurance premiums, and the amount of shit dished out to them by their riding buddies. But not everyone who eats asphalt is lucky enough to get up and walk away with nothing more than a bent lever and a story to tell. If you see a crash, or are among the first on the scene right after one, what you do next can mean the difference between someone having a bad day, and having the worst day of their lives.
The first thing to do is secure the scene. Pull off the road and park in a safe spot, leaving enough room for emergency vehicles to stop close to the victim. Go up the road, or send someone, to flag down oncoming traffic so there isn’t a second accident right after the first. Then see to the rider.
Now is when you determine whether to call 911. Crash victims can be loosely divided into three categories: not hurt; partially hurt; and badly hurt. But those aren’t clearly delineated categories—there can be some overlap depending on the circumstances.
If the crash was a simple low-side and the rider is already up, cursing the gravel on the road or the deer that jumped out of the forest (or more rarely, but more accurately, their lack of sufficient riding training) and trying to lift their bike back on its wheels, it’s a category one and you probably don’t have to call 911. If they were wearing good riding gear they might not even have a scratch.
But if you actually saw the crash as it happened, and they tumbled or hit their head or landed on their back, or they seem dazed and not entirely with it, get them to leave the bike, sit down, and chill. Neck and spine injuries don’t swell up right away, and they could do more damage to themselves with a feat of adrenaline-fueled weightlifting than is obvious at first. Any pain or tightness in the neck or back after 10 minutes or so pushes them into category two, and warrants a 911 call.
Other category two injuries worthy of dialing for help include closed fractures (broken bones that don’t poke through the skin) and any injury that bleeds a lot. Road rash looks bad but typically doesn’t bleed that much, although if it’s extensive, as it often is for riders who believe tats, a tan, and a tank-top constitute safety gear, you need to watch for signs of shock, such as glassy eyes, and pale, ashen skin. If it’s hot, try to keep the victim cool, and if it’s cold, keep them warm; the idea is to return their body temperature back to normal. Don’t give them any fluids until help arrives.
The best thing to do with a closed fracture is leave it alone until the EMTs arrive. Don’t try to take the boot off a broken foot or ankle, or the jeans, riding pants, or jacket off someone who has a broken arm, collarbone, or leg. Let the EMTs cut clothes off at the scene, and then the rider should thank that leather or textile riding gear for doing its job so they can ride another day. Compound or open fractures are another matter, as they often bleed, sometimes a lot. Stop the bleeding as soon as possible by putting pressure on the wound, cutting away whatever clothing prevents you from doing it.
You’ll know a category three crash when you see one: The rider will be unconscious, or not breathing, or both. You need to get the victim’s helmet off right away if the rider is not breathing and their airway is obstructed, even if you suspect a spinal injury. That’s because if they’re not breathing they’ll be dead in about four minutes anyway. This is a job for two people, one to support their neck and the other to lift the helmet off. Remove the helmet only if the airway is blocked and the helmet prevents you from clearing it. Otherwise leave the helmet on.
Now check their ABCs—airway, breathing, and circulation. First make sure their airway is clear. If they’re not breathing just clearing the airway might get them started again. Then look at their chest to see if it’s moving, or put your hand or cheek near their mouth to see if you can feel their breath. If they’re breathing they have circulation, but check it anyway by feeling for a pulse in the carotid artery. Keep them still and calm until the EMTs can take over.
There are first-aid kits small enough to fit in a saddlebag, tank bag, or backpack that are sufficient to treat minor cuts and scrapes, and bandage small bleeding wounds. You can find them at many camping supply stores or order them through some motorcycle accessory companies. Look for one that has at least the following items: four-by-four-inch gauze bandages; a CPR mask; latex gloves (or better yet non-latex to prevent an allergic reaction); alcohol wipes for sterilizing a dirty wound; and adhesive tape. Then add the following: a space blanket for shock victims; some Band-Aid-type adhesive bandages in several shapes and sizes; gauze pads larger than the four-by-fours; scissors in case you have to cut away clothing; and a pain reliever like ibuprofen or acetaminophen. Also carry a small flashlight to check for airway obstructions.
That should be enough to deal with all but the most serious crash injuries. Remember, the goal of first aid isn’t to heal or cure an injury, it’s to stabilize the victim until trained professionals arrive. Short of becoming one of those professionals yourself, you can take low-cost Red Cross CPR and emergency first-aid courses. If at least one rider in your group has basic first-aid skills, it increases the chance of all of you making it home to ride another day. Of course if that one rider is the one who crashes, then you’d better have two graduates in your group. Better yet, get together with all the people you ride with often and take a course together.
Jerry Smith’s latest book, Missed Shifts, spans a career riding fast bikes and covering the motorcycle industry. You can get it on Amazon here.
Update, Sept. 18: The language about when to remove a rider’s helmet has been revised. Thanks to reader mikemc127.