PATIENT EDUCATION
Trauma / Road Traffic Accidents
This section is organised around situations rather than symptoms. After an accident, the important question is often what to do next and whether an injury needs urgent assessment.
If Someone Is Unresponsive and Not Breathing Normally
This is a situation where immediate bystander action can make a major difference.
- Check for a response. Shout and gently shake the shoulders.
- Call emergency help immediately. Ask a specific person nearby to make the call if possible.
- Check breathing. Occasional gasping, gurgling or irregular noisy breaths should not be assumed to be normal breathing.
- If they are not breathing normally, begin chest compressions. Place the heel of one hand in the centre of the chest, place the other hand on top, keep your arms straight and compress hard and fast while allowing the chest to recoil fully.
- Continue until emergency help arrives or the person shows clear signs of life.
If you have not been trained in rescue breathing, chest compressions alone are preferable to doing nothing while waiting for emergency help.
Consider completing a hands-on CPR course. Reading about CPR is not a substitute for practical training.
Select a situation below to view more information.
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Immediately After an Accident — When You Feel "Mostly Fine"
What you'll notice or feel
- Feeling shaken but apparently uninjured.
- Minor aches that seem manageable at the scene.
- Neck or back stiffness appearing or worsening over the following hours or days.
- Bruising that becomes obvious only the following day.
Why this matters
- Adrenaline can temporarily reduce the perception of pain.
- Some significant injuries can initially cause surprisingly little discomfort.
- Neck injuries commonly become stiffer over the following 24–48 hours.
What could be missed
- A spinal injury following significant impact.
- An internal chest or abdominal injury.
- A fracture masked by another more painful injury.
- A head injury with delayed symptoms.
What to do immediately
- Seek assessment after a significant accident even if you initially feel reasonably well.
- Avoid driving yourself if you sustained a head impact or remain shaken or confused.
- Have another person observe you after a head injury.
- Remember the mechanism of injury — speed, direction of impact, helmet or seatbelt use and any loss of consciousness.
When to seek help urgently
- A significant-speed collision, major impact, fall from height or being thrown from a vehicle.
- Any loss of consciousness.
- Neck or back pain following the accident.
- Chest pain, breathlessness or abdominal pain.
- Numbness, tingling or weakness.
When to see a doctor
- Pain or stiffness developing during the days after an apparently minor accident.
- Any accident-related symptom that is not settling appropriately.
Suspected Fracture
What you'll notice or feel
- Severe pain at a particular point, usually worse with movement or weight-bearing.
- Swelling and bruising.
- Visible deformity or a limb that appears bent, shortened or rotated.
- Inability to use the limb normally.
Common causes
- Direct impact.
- Twisting or shearing forces.
- A fall from a vehicle or height.
- Relatively minor trauma in someone with weak bones.
What it could be
- A closed fracture.
- An open fracture where a wound communicates with the broken bone.
- A dislocation, sometimes associated with a fracture.
- A significant soft-tissue injury that can resemble a fracture.
What to do immediately
- Do not attempt to straighten or realign a deformed limb yourself.
- Support and immobilise the limb in the position found.
- Cover an open wound with a clean dressing.
- Do not push exposed bone back into the wound.
- Arrange appropriate emergency transport.
When to seek help urgently
- Any suspected fracture.
- Any wound over or near a suspected fracture.
- A cold, pale, blue or numb limb below the injury.
- Severe increasing pain with a tense swollen limb.
When to see a doctor
There is no routine tier for a suspected fracture. Suspected fractures require prompt assessment.
Wounds, Road Rash and Open Injuries
What you'll notice or feel
- Grazes and abrasions after sliding across a road surface.
- Cuts containing grit, glass or other debris.
- Bleeding.
- Apparently superficial but heavily contaminated wounds.
Common causes
- Sliding contact with the road, particularly in motorcyclists and cyclists.
- Glass, metal or debris.
- Impact against vehicle components.
What it could be
- A superficial abrasion requiring thorough cleaning.
- A deeper injury involving a tendon, nerve or blood vessel.
- A wound communicating with a fracture or joint.
- A contaminated wound requiring assessment of tetanus protection.
What to do immediately
- Control bleeding using sustained direct pressure with a clean cloth or dressing.
- Cover the wound.
- Do not remove deeply embedded objects yourself.
- Do not apply turmeric, ash, oils or other substances to open wounds.
- Check your tetanus vaccination history if known.
When to seek help urgently
- Bleeding that does not stop with sustained direct pressure.
- Embedded material or extensive road rash.
- A wound over a joint or one exposing deeper structures.
- Loss of movement or sensation beyond the wound.
- Uncertain tetanus protection.
- Spreading redness, increasing pain, discharge or fever.
When to see a doctor
- A wound that is not improving normally over the following days.
- Any uncertainty about depth, contamination or underlying injury.
Head Injury Alongside Other Injuries
What you'll notice or feel
- A blow to the head, with or without loss of consciousness.
- Headache, nausea or vomiting.
- Confusion or memory gaps around the accident.
- Drowsiness, dizziness or visual disturbance.
- Sometimes no symptoms initially.
Why this matters
- A dramatic limb injury can distract attention from an accompanying head injury.
- Symptoms of significant head injury can occasionally appear later.
- Blood-thinning medication increases concern after head trauma.
What it could be
- Concussion.
- Bleeding within or around the brain.
- A skull fracture.
- An associated neck injury.
What to do immediately
- Arrange appropriate assessment after a significant head injury.
- Avoid alcohol and driving.
- Avoid returning to sport or strenuous activity until appropriately assessed.
- Tell the assessing doctor about any blood-thinning medication.
When to seek help urgently
- Loss of consciousness.
- Worsening headache, repeated vomiting or increasing drowsiness.
- Confusion, unusual behaviour, slurred speech or difficulty waking.
- Seizure, weakness on one side or visual disturbance.
- Clear fluid or blood from the nose or ears.
- Head injury in someone taking blood-thinning medication.
When to see a doctor
- Persistent headache, poor concentration, irritability or sleep disturbance following a head injury.
Ongoing Pain After Being Discharged From Casualty
What you'll notice or feel
- Persistent pain despite an initial X-ray being reported as normal.
- Pain becoming apparent after more obvious injuries begin to settle.
- Difficulty using a limb weeks after the accident.
- Persistent neck or back stiffness.
Why this matters
- Emergency assessment appropriately prioritises immediate life- and limb-threatening injuries.
- Some fractures are difficult to see on the first X-ray.
- Ligament and tendon injuries are not visible on ordinary X-rays.
- A less painful injury may be overlooked when another injury dominates the initial assessment.
What it could be
- A fracture not visible on the original X-ray.
- A ligament, tendon or cartilage injury.
- An injury to a region that was not initially imaged.
- A soft-tissue injury following its normal recovery course.
What to do
- Do not assume that an initially normal X-ray means persistent symptoms should be ignored.
- Keep a record of which areas were examined and imaged.
- Bring discharge records and previous imaging reports to follow-up when available.
When to seek help urgently
- New or worsening numbness, weakness or loss of function.
- Pain that is increasing rather than improving.
- Signs of infection in a wound.
- Any bladder or bowel changes following a back injury.
When to see a doctor
- Pain persisting for several weeks after an accident.
- Failure to return to normal use of a limb.
- Persistent neck or back symptoms following a vehicle accident.
- Persistent pain in an area that was never specifically examined or imaged.
YOUR CONSULTATION
What to Expect at Your Visit
- The doctor will ask about the mechanism of the accident — including speed, direction of impact, helmet or seatbelt use, loss of consciousness and whether you could walk afterwards.
- After significant trauma, examination may deliberately include areas beyond the part that hurts most because one injury can distract from another.
- Imaging is selected according to the injury: X-rays for many suspected fractures, with CT or MRI used where the clinical situation requires more detailed assessment.
- In delayed presentations, repeat imaging may occasionally be useful because some injuries are more apparent later.
- Treatment may include wound care, immobilisation, rehabilitation or surgical treatment depending on the injuries identified. Significant trauma may require several specialties to work together.
- Keep copies of discharge records, reports and imaging following a road traffic accident, as documentation may also be important for insurance or other administrative purposes.
* IMPORTANT: A Note Before You Go
This page is primarily intended to help people understand what may need attention after an accident. It is not designed to replace emergency assessment at the scene of significant trauma.
If an accident has just occurred and you are uncertain whether an injury may be serious, seek appropriate emergency medical assessment rather than waiting for symptoms to become more obvious.