People Present at Road Traffic Crash Scene: Challenges in Defining and Categorising
Aidin Aryankhesal1, Davoud Khorasani-Zavareh2, Mohammad Heidari3
1 Associate Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
2 Associate Professor, Safety Promotion and Injury Prevention Research Center, Department of Health in Disaster and Emergency, Shahid Beheshti University of Medical Science, Tehran, Iran.
3 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Health in Emergency and Disaster, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Dr. Mohammad Heidari, School of Health Management and Information Sciences, Iran University of Medical Sciences, No 6, Rashid Yasemi Street, Vali-e-asr Avenue, Tehran, Iran.
E-mail: mo.heydari@yahoo.com
Dear Editor,
One of the main ways to reduce deaths and injuries after road traffic crashes are quick relief, treatment and transfer of the victims to specialised treatment centers [1]. Studies have shown that unreasonable gathering of people at the crash scene are among the factors that affect the process of helping the victims of road traffic crashes [2-5].
Two groups of people are usually present at the crash scene. The first group are member from public those who come to the crash scene and call for help from relief agencies [2,6]. People present at road traffic crash scene can play different roles, including bystander, laypeople, and first responder [7]. The second group who attend the road traffic crash scene as first responders are usually relief agencies and trained to render basic emergency care [5].
In past studies, no comprehensive and resolute definition has been given for categorising people at road traffic crash scene [8-12]. The World Health Organisation (WHO) considers all those who attend at road traffic crash scene and have no training regarding aid and relief as bystander. WHO highlights the importance of training for this group in order to make them primary responders [2,7]. Other related studies have regarded people present at the road traffic crash scene as laypeople (layperson and layman) [2,8,13].
Thus, proper definitions and clear roles will help to better understand the location and performance of people on the traffic crash scene. Based on the literature, the role of people with respect to their impact on the road traffic crash scene can be classified as follows:
“Bystander” is defined as a person who is present at the crash scene but does not play any role and is a mere spectator [14]. These people usually stay at the scene for their curiosity and sometimes cause a new road traffic crash or hinder the timely arrival of relief organisations to the crash site.
“Laypeople” is defined as one who is not intimately familiar with a given subject or activity [15,16]. These people are also called layman, layperson, lay public and member from public. In the other words, there are some people who attend at the crash scene but have no knowledge and awareness about relief, rescue and first aid to the victims or “Laypeople” refers to community members who have no professional certificate or health education degree [16].
By their gathering at the crash scene, laypeople hinder prompt and appropriate operations of relief organisations to the victims. They may also try to help the victims despite having no knowledge about the relief and aid process. Laypeople, a crowd at the crash scene may result in wasting critical time in providing effective care and also, in some circumstances, may contribute to secondary injuries for the victims and even lead to a new crash [5]. Its worth mentioning that if a person attends crash scene as a bystander and prevent appropriate aid to the victims and try to help them without having the necessary knowledge, he/she will be considered a lay bystander.
“First responder” is defined in theoretical and literal definitions, as trained people that are able to provide primary medical care and relief to the injured at the time of an crash [17]. In practice, first responders are all individuals and aid workers with necessary training to help, relief, and manage road traffic injuries, such as pre-hospital emergency personnel, Red Crescent workers and all individuals who have passed courses of first aid and initial measures to preserve life. People must have the necessary training about basic level of pre-hospital trauma care will be regarded as first responders if they attend at the crash scene and take appropriate measures for helping the victims.
“Lay first responder” has rarely used in the literature, and refers to first responders with not having enough first aid skills to appropriate aid and transfer of injured [13]. In other words, aid organisations workers that have no skill regarding life support for trauma victims are lay first responders. For e.g., police, members of Red Crescent, firefighter and road maintenance organisation who despite having no training about basic life support for trauma victims, attempt to help the victims and in some cases, incur more injury to them unintentionally, can be categorised in this group.
Accepting the fact that in most cases, people are the first to be present at the crash scene and that time is important factor in helping victims and reducing deaths and injuries [2,18]. Therefore, paying attention to the optimal use of this people’s presence and training by increasing the number of laypeople to first responders can have a significant impact on the reduction of the complications caused by road traffic crashes.
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