[First Aid] Central America: Came across an unconscious boy on the side of the road - how should I have responded?

March 20, 2010 10:23 AM

You're driving in backwater Central America and find an unconscious, bleeding boy lying on the side of the road - What do you do? (Happened to me yesterday)

My first thought was "this is some kind of trap to rob me" - but I had to stop. It wasn't. He either crashed his bicycle which was near him, or got beat up by someone. He was unconscious, breathing steadily, and had drying blood on his legs (looked like scrapes/ road rash) and face (came from his mouth).

I took his pulse, checked for rapid blood loss (none), tried to wake him by pouring water on him, and couldn't. I didn't move him for fear of spinal injury. I jumped in my car and went to get help - and 200 feet down the road encountered a truck coming from town to help him. My part of the story ends there.

No 911, 30+ miles to anywhere larger than a village. What do you do in this situation?

posted by Merlin144 to health & fitness (13 answers total)

I think Merlin's question is "What would you have done in this situation if it had happened to you?" My thoughts were just like yours, Merlin - "Is this a trap? If I stop will I get jumped?" I think you did the best thing you could have. The only other option would have been to NOT stop and alert someone in the next village. I might even have done that if I had been alone.
posted by ThatCanadianGirl at 10:53 AM on March 20, 2010

Call an ambulance? I'm kind of sharing Chocolate Pickle's confusion.
posted by Dr. Send at 10:53 AM on March 20, 2010

It sounds to me like you did exactly the right thing. You stopped, checked on him, avoided moving him, and then went to get help. I'm not sure what else you could have done beyond that.

Good on you for stopping.
posted by corey flood at 10:55 AM on March 20, 2010 [1 favorite]

Chocolate Pickle - I think the asker wants to be sure of doing the right thing if they are in this situation again.

There is a whole Red Cross course on this called Wilderness First Aid. From what I remember, what they teach you is pretty much "do not move the victim if there is any possibility of head or neck injury, stabilize wounds (this is stuff you learn in First Aid), get them out of danger if you can (hypothermia wrap, etc). Don't leave them alone if there is any alternative. Get help as quickly as you can." The book they taught my class from is called "When Help is Delayed". There is a very shallow and incomplete summary at this web site.
posted by yomimono at 10:58 AM on March 20, 2010 [1 favorite]

It sounds like you followed the proper first aid procedures of check (he's breathing, not bleeding profusely, but unconscious), call (not an option) and care (try to wake him, go into town and get help.)

Since he was already on the side of the road, then you didn't have to move him to keep him safe. Had he been in the road, I'd say that it would have been better to risk the spinal injury to keep him safe from cars that might come around the bend too quickly.

He wasn't bleeding, so there was no need to make a tourniquet. Breathing, so no need for CPR. Just unconscious and clearly injured. Best not to move him -- unless this was an area with lots of wild animals or if he was in any other sort of imminent danger if he was left. At that point, you might have tried to find something sturdy to use as a backboard to secure him to (to prevent spinal torsion) and then load him into your car. But, again, no danger so you did the right thing.

It's a good thing that a truck was on the way already to rescue him. Take this as a sign that another person about 60 miles before you had already discovered this boy and made the exact same decision that you did -- and probably saved his life.
posted by nayrb5 at 11:00 AM on March 20, 2010

I think you did fine under the circumstances. Checked vitals, determined that moving him was a risk, and went for help -- which turned out to be unnecessary. If he was in more dire state moving him may have been work the risk.

Given what I know of Central America, though (clearly less than you), it was definitely wise to consider the possibility of a trap.

Maybe you would benefit from a first aid course, including resuscitation. It would give you more confidence in a similar situation.
posted by dhartung at 11:00 AM on March 20, 2010 [1 favorite]

30 minutes is actually within the bounds of the 1+ hour figure they give you in WFA courses. Check for bleeding, do not move the patient, call 911.
posted by rr at 11:03 AM on March 20, 2010

It may have been better to have remained with him, and then flagged down whoever came next to go get help.

However, not every choice is so simple: it seems like waiting around for help would have put your own life in significant danger, so you made the best choice you could.
posted by KokuRyu at 11:07 AM on March 20, 2010

OK, glad to hear that my rudimentary first aid knowledge led to the right decisions. I agree with KokoRyu and was very torn about leaving vs staying, but felt in danger staying for too long (it was me and my wife) due to the fact that there were some very sketchy people about 1/2 mile down the road.

Another odd tidbit - a car just in front of us (locals, not visitors) slowed down, looked at the boy for 15 seconds, then took off. That made me very wary about traps, but my guess was that they saw him breathing and chose to go get help - or just be indifferent.

Thank you all!
posted by Merlin144 at 1:23 PM on March 20, 2010

Another odd tidbit - a car just in front of us (locals, not visitors) slowed down, looked at the boy for 15 seconds, then took off. That made me very wary about traps, but my guess was that they saw him breathing and chose to go get help - or just be indifferent.

I understand your reaction, but consider that you were lucky. It's happened more than once, that a foreigner stops in this situation, and has a devil of a time proving that he wasn't the cause of the accident. I've experienced it personally, and I've also seen it. Once driving through a Central European country at night, we saw a body in the middle of the highway. We stopped - it was a drunk, who possibly was hit. It was a real dilemma what to do, because standing there could have caused another accident (we were not far behind a curve), while leaving him there was asking for a big truck to kill him. My friend ran to a nearby house to ask them to call the police and ambulance. Long story short, we were accused of hitting the man, and the guy was drunk and didn't remember a thing. Another time, driving through the countryside in India - eerily similar situation to yours, a young boy and bike at the side of the road. In the next village the cops wanted to arrest the driver of our car, and the mob was getting very angry - we were lucky enough that the boy was conscious and told them it wasn't us that hit him... but it could've gotten very ugly had he been unconscious.

Having witnessed stuff like this often enough, I am not going to judge too harshly those who in such circumstances elect to "not see" the accident and keep going on their merry way, or in general not get involved as witnesses or Samaritans in whatever the deal is... lot of risk, and a kick in the teeth as a thank you. That's why we can't have nice things. Of course, sometimes it's a horrible situation, and you feel compelled to act (like the drunk lying in the middle of the highway at night, behind a curve - he'll get killed unless you take action), but at that point you resign yourself to being accused and do the right thing anyway - no good deed goes unpunished.
posted by VikingSword at 2:37 PM on March 20, 2010 [1 favorite]

Having witnessed stuff like this often enough, I am not going to judge too harshly those who in such circumstances elect to "not see" the accident and keep going on their merry way, or in general not get involved as witnesses or Samaritans in whatever the deal is... lot of risk, and a kick in the teeth as a thank you. That's why we can't have nice things. Of course, sometimes it's a horrible situation, and you feel compelled to act (like the drunk lying in the middle of the highway at night, behind a curve - he'll get killed unless you take action), but at that point you resign yourself to being accused and do the right thing anyway - no good deed goes unpunished.


+1 to that.

There are plenty of examples of someone seeing a situation, informing a Police Officer and then spending the next 5 hours being questioned about their involvement.

So there are two ways to look at this:

1) What to do for the health of the person/victim
-You did the right thing: checked for major injuries, tried to revive him but did not move him because you had no idea how the injury occurred. Then after that you went for help.

2) What to do for yourself
-The moment you take ANY physical action YOU become legally responsible/liable, at least partially. This is why in any Red Cross course they tell you do not transport someone in your vehicle because if you get in an accident then you are responsible for the health of the person, ...
-Depending on the outcome of a patient I imagine a DA could charge you with a crime.
posted by zombieApoc at 6:45 PM on March 20, 2010

no need to make a tourniquet.

DO NOT TIE A TOURNIQUET ON A BLEEDING PATIENT

EMT here. Most of the time, this sort of thing is waaaay overkill. You can stop most bleeding by the following methods:

- Direct Pressure: try this first. Apply direct pressure to the wound with an (ideally) sterile piece of gauze or cloth.

- Elevation: elevate the injured body part above the level of the heart, if you can. This will lower the blood pressure in that extremity and help to stop the bleeding. If it's a lower extremity, raise the feet (as long as you don't suspect a traumatic brain injury).

- Pressure point: If the bleeding continues, press on either the brachial (midpoint on the inside of the arm) or femoral artery (runs across the top of the leg when the pt. is lying down) to slow blood flow to the injured area.

ONLY when you've failed with the above methods should you ever try tying a tourniquet, and here's why: as soon as you stop all circulation to an extremity, all kinds of toxins begin to build up below the tie point. If you leave it on for too long and then remove it, those built-up toxins suddenly flood back into the body and can kill a person dead on the spot. We're taught to only use these as a last resort, and to clearly mark a tourniquet with TQ and the time it was tied if we're ever forced to resort to it.

More to the point of your question, though, you got it all pretty much right. Your priorities are:
Airway,
Breathing, and
Circulation.

ABC-- easy as pie. After that, seek either a doctor or a priest.
posted by The White Hat at 8:04 PM on March 20, 2010

Viking and Zombie - Fantastic points (as seen from your personal experience!!) - and also something I failed to consider. Will combine my humanity with these newly acquired street smarts and see what results. :)

White Hat - Thank you, that is good to know. Going to get some training! WFR here I come.
posted by Merlin144 at 9:22 PM on March 24, 2010