Chapter 16: Accidents and First Aid

1. Accidents

If risk factors are reduced, more accidents can be avoided.

Who? Young and inexperienced drivers face particular risks; pedestrians, cyclists and motorcyclists are especially vulnerable in a collision.

Where? Higher collision speeds make inter-urban crashes particularly severe. On urban roads, pay special attention to pedestrians, cyclists and VMP users; no road is free of risk.

When? Be especially alert on holiday trips, at night and early in the morning, and in rush-hour traffic; fatigue, alcohol and distraction can increase the risk.

Accidents cause great human and economic costs (material, health and administrative).

Risk factors are: Human, the vehicle, the route and its surroundings.

• Human: Speed, psychophysical state, infractions... A pedestrian is considered as a human factor.
• Vehicle: This is usually due to poor vehicle maintenance.
• Route and environment: Bad weather, roadway or road signs bad maintenance.

Excessive or inappropriate speed is a major risk factor: it increases reaction and braking distances, reduces the useful visual field and makes injuries more severe. Distraction, alcohol and fatigue also increase risk.

In case of an accident:

• Do not routinely remove a helmet; removal may be necessary to open the airway or give CPR. Follow 112 instructions and minimise neck movement
• Do not give food or drink, including to burn victims
• Do not give medicine
• Do not move the injured unless there is immediate danger or movement is needed for airway care or CPR; minimise head, neck and back movement and follow 112 guidance
• Use gloves or a protective barrier if available; control serious bleeding with firm direct pressure through a dressing or clean cloth
• Do not move elements of the accident, unless there is danger to the injured or for traffic
• Do not put objects under their head
• Do not make the injured walk
• Keep the injured warm and reassure them, while protecting them from excessive heat
• Use PAS: Protect, Alert, Aid (the Spanish sequence Proteger, Avisar, Socorrer)
• Stop safely and assist when required, especially if help has not yet been organised; do not obstruct emergency teams or create another hazard.

Protect and alert: Switch on hazard lights and use a certified connected V-16 beacon for a Spanish-registered car immobilised by a breakdown or crash. Since 1 January 2026, triangles and non-connected beacons do not meet that requirement. Place it as high as practicable without exposing yourself to traffic. Leave the vehicle only if you can reach a safe place; otherwise remain inside with belts fastened. The driver must wear a reflective vest when occupying an interurban carriageway or shoulder.

Call 112, giving the road, kilometre point, direction, hazards and number and condition of casualties. The V-16 reports the vehicle’s location to traffic services; it does not call 112 or request medical assistance.

When a vehicle occupies all or part of your lane because of an accident, breakdown, emergency, roadside-assistance, maintenance or traffic-management work, pass with at least 1.5 metres of clearance and drive at least 20km/h below the road’s speed limit. On motorways and dual carriageways, stopped or walking-pace traffic must leave an emergency corridor for approaching priority vehicles: between the two lanes, or, with three or more, between the leftmost lane and the next. Vehicles in the leftmost lane move left; all others move right.

2. First aid

1. Ensure safety, call for help and control any life-threatening bleeding immediately:

• Check responsiveness by speaking loudly and gently touching the shoulders, without shaking the neck. If unresponsive, call 112 immediately, use speakerphone and follow the dispatcher’s instructions

2. While the call connects, assess the airway and normal breathing:

• A) Open the airway, following 112 guidance. Suspect a neck injury after a road crash and minimise movement; a trained rescuer may use a jaw thrust. Keeping the airway open takes priority
• B) Check for normal breathing for no more than 10 seconds
• C) If unresponsive and not breathing normally, start CPR immediately. Agonal gasps, slow laboured breathing or occasional panting are not normal breathing

If they are breathing normally, keep monitoring their breathing and responsiveness while awaiting help. If unsure, follow the emergency dispatcher’s guidance.

Adult cardiopulmonary resuscitation (CPR): compress the centre of the chest at 100-120 compressions per minute, 5-6cm deep, allowing full recoil. If trained and able, give 30 compressions and 2 rescue breaths; otherwise give continuous chest compressions. Use an AED as soon as available and follow its prompts. Continue until professionals take over, the person shows signs of life and breathes normally, you cannot continue, or the scene becomes unsafe.

The recovery position helps protect the airway of an unresponsive person who is breathing normally after a non-traumatic event. Do not routinely roll a road-crash casualty into it; avoid movement unless needed to keep the airway open, following 112 guidance.

SHOCK: A rapid weak pulse, pale clammy skin or worsening responsiveness may indicate serious blood loss. Call 112, control external bleeding, keep the person still and warm, and do not routinely raise the legs after trauma.

UNCONSCIOUS: Call 112 and keep the airway open. Normal breathing requires close monitoring; absent or abnormal breathing requires CPR, not the recovery position.

CONSCIOUS AND DIFFICULTY BREATHING: Call 112. If injuries allow, help the person remain in a comfortable position for breathing; do not force a position or unnecessary movement.

INJURIES: Do not remove embedded objects. Cover wounds with a clean dressing; if bleeding around an object, press around it, not on it. Minor superficial wounds can be rinsed with clean water:

• Head, neck, back and limb injuries may be serious even without an obvious external wound
• Report reduced consciousness, severe bleeding, breathing difficulty or suspected spinal injury to 112 immediately

BURNS: Cool a thermal burn with cool running water for 20 minutes, while keeping the rest of the person warm. Do not use ice or creams, burst blisters, remove stuck clothing, or give food or drink. After cooling, loosely cover with a clean non-stick dressing. Serious, large, deep, facial, chemical or electrical burns need urgent medical help.

BLEEDING: to stop the bleeding:

• Apply firm, continuous direct pressure to the wound with a dressing or clean cloth
• Call 112 for severe bleeding and continue pressure; do not replace it with pressure on distant arteries
• For life-threatening limb bleeding not controlled by direct pressure, use a suitable tourniquet if trained or instructed by 112; record the time and do not loosen it

Blood or clear fluid from an ear after a crash may indicate serious head injury: call 112, do not plug the ear, and avoid unnecessary head or neck movement.

For a simple nosebleed, if injuries allow, sit leaning forward and pinch the soft part of the nose for 10-15 minutes. Do not tilt the head back. After a head injury, seek urgent medical help.

If an unconscious person has blood or vomit in the mouth, keeping the airway clear takes priority. Follow 112 guidance, minimise neck movement and reassess breathing.

FRACTURES: May be closed or open. Do not straighten a deformed limb or push exposed bone back in. Avoid movement of a suspected spinal injury unless essential for immediate safety, airway care or CPR.

TRANSFERS: Await professional rescue and medical transport. An ambulance delay alone is not a reason to move an injured person into a van or truck; follow 112 instructions.