MOTORCYCLE RELATED BYSTANDER ASSISTANCE TRAINING

Vicki Roberts-Sanfelipo, RN – Director Accident Scene Management (ASM)

Survey Coordinator

ABSTRACT

October 1, 2022, a one-year grant project was initiated with the NV OTS to train 200 Nevada Motorcycle Riders how to help if a crash were to occur. These students completed eight hours of Motorcycle Specific Bystander training; a class called “A Crash Course for the Motorcyclist taught by Accident Scene Management. Those who completed the class were given a $50 Sport Trauma Pack so that they can would be able to implement their training if the opportunity arose.

The project was focused on the two areas of the state with the highest rate of crashes and fatalities. Six classes were taught in the Las Vegas area (150 students) and two classes were taught in the Reno area (50 students). The training was completed in a Six-month period at which time we started doing follow-up surveys to determine if any skills had been put into use. Though that is a short period of time, the project was for one year so follow-up needed to begin at that point to determine what, if any benefit was being realized from motorcycle crash specific first response training.

Reasoning for motorcycle trauma specific training: Though CPR & 1^st aid skills can be helpful at a crash scene, neither address specific issues related to motorcycle trauma response such as Helmet Removal, Jaw Thrust Rescue Breathing (a technique used to protect the neck in the event breathing must be supported), how to handle the crash scene, how to remove the bike from someone if they were still under it, and how to best move someone to safety if deemed necessary. Some bleeding control is addressed but thorough training with Spinal Stabilization and the ability to assess the situation and determine priorities takes a longer class taught by medical professionals.

It is also thought that motorcyclists are unique roadway users. Because motorcyclists often travel in groups, the most likely person to be at the scene of a crash is another motorcyclist. Training and equipping motorcyclists to help each other is the most powerful way to make a difference at the scene while waiting 5-20 minutes (sometimes longer) for professional help to arrive.

Though motorcyclists represent a small number of overall motor vehicle crashes it is disturbing to note that they are 14 percent of all traffic fatalities. Per vehicle miles traveled in 2021, the fatality rate for motorcyclists (30.20) was almost 24 times the passenger car occupant fatality rate (1.26). ¹

According to the National Safety Council, responsible for implementing the Road to Zero initiative, the number of nonfatal injuries increased by 5%, while the injury rate decreased by 4% from 2020 to 2021.2

INTRODUCTION

One of the items identified as an agenda item in the DOT’s Safe Systems Approach is Pre-Hospital (Post Crash) Care. Accident Scene Management (ASM), a 501(c)3 organization was founded in 1996 in order to teach motorcyclists what to do at the scene of a crash until professional help arrives (First Response Training). While there are several individuals addressing motorcycle trauma in educational settings, ASM is the only organization that has established a structured program that had been taught to over 40,000 motorcyclists as of 2023. The program has instructors in 32 states, four countries and is growing. ASM’s goal is to have instructors in all 50 of the United States.

ASM believes that the weakest link in the Emergency Medical System’s “Chain of Survival” is First Response. Although CPR & First Aid are important skills, they do not address critical aspects of motorcycle trauma. ASM began teaching “A Crash Course for the Motorcyclist” as a pilot project in the State of Wisconsin in 1997 in order to fill that gap. After a successful two years in Wisconsin, ASM began to teach in other states with materials organized in a way that they could be taught by other instructors. Lead instructors must be EMT or higher in medical training and are vetted and trained. All instructors (Lead and assisting) must complete training in order to teach our program.

MATERIALS AND METHODS

ASM conducted eight classes of an average of 25 students. Students completed a Pre-class survey to determine their knowledge before the class and then completed that same survey immediately after the class in order to determine if their answers had changed or if they had learned anything different. The goal was to show an improved response and to achieve 80% or better correct answer after the class. Pre-Test surveys were sent to students one week before the class. Anyone who did not complete the survey online prior to class was given the survey manually at the beginning of the class. Surveys were collected and placed in an envelope. At the end of the class, a post-class surveys were done in person, again, collected and placed in an envelope to send to ASM for manual input to ensure data was collected. Some issues occurred when people completed two pre-class surveys or did not turn the post class survey in and made corrections when correct answers were reviewed. Those surveys were not included in the results.

The goal of data collection was primarily to determine if students learned anything when taking the class and to determine if they had used any of the information and skills since taking the training. Secondarily we were interested in if they felt this information was useful, felt it changed their riding habits, or stimulated them to seek further safety and education training.

Students who completed the training earned a Certificate of Completion, an embroidered patch for their riding apparel, and Sport Trauma Kit with items that would be useful in the event they needed to respond to a crash.

See Addendum C

RESULTS

199 students were ultimately trained and equipped with trauma kits. 150 in the Las Vegas area and 49 in the Reno area. Evaluations were collected from each class and are available upon request but not included in this report.

One of the goals of the project was to reduce motorcycle fatalities in NV by 10% in 2023. The current crash data suggests that there will be a reduction of motorcyclist fatalities in Nevada for the calendar year 2023 but without crash specific details, it is unknown if ASM training contributed to the decrease.  If we were to repeat any future grant activities related to ASM training, we would want to utilize a different measure to determine if training contributed to a decrease in fatalities. We would also need to evaluate for a longer period of time since this was just a one-year project.

See Addendum A for a list of classes taught

Pre and Post course surveys (Aka tests) were collected in order to determine if students learned anything new when taking the class. The goal was that after the class, they would answer with 80% or better accuracy. This was done with 100% participation

What we (ASM) learned: Students left the class with an overall better score on the surveys showing that they learned something new! While proud of this, we (ASM), also learned that our educational materials and prompts need to be more specific to prompt the instructors to give answers that are most correct, in a way that the students understand why that is the most correct statement. Many of our instructors from other states have picked up the survey as a great review for students and it has been approved by CAPCE (our new accrediting body) as an appropriately written test for Continuing Education qualification.

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The 6-month surveys started in April. While six months is not a lot of time to elapse before surveying students, there are positive results that are already showing up. We ended the Grant Program period with 58 replies out of 199 students that were surveyed (34%). We added a drawing for a Tactical Backpack as a reward for completion of the survey and that seemed to help us get more responses. That drawing will take place later this month.

1-2: 92% said they carry their trauma Packs when they ride and 92% said that they have recommended ASM to anther rider

3-5: 8.34% students responded to a motorcycle crash, 6.25 had personally been in a crash since taking the class, and 18.01% had used their training to help someone in a situation other than a motorcycle crash.

7-8: Over 80% of the rider said they rode with slightly or more caution after taking the class and 28% went on to seek further education

Narratives responses were all positive though one group of riders was not able to save their friend

DISCUSSION

Bystander Assistance refers to community based First Response training for traumatic emergency events that require quick response. Like CPR (which has its foundation in responding to Cardiac Events and Choking) and First Aid (that concentrates its efforts on common everyday injuries that might occur), Bystander Assistance has a focused role to play in preparing our communities to respond to traumatic events. A person’s chance in their lifetime of coming upon a crash is more likely than their chance of coming upon someone who has just had a cardiac event or is choking. First Aid begins to prepare the student for trauma but stops short of training them for high-speed roadside user events. In a motorcycle crash this type of information is imperative for all riders so that emergency care can be started immediately.

The Haddon Matrix is a Paradigm that is commonly used to show reduction of catastrophic events and the disaster plan that minimizes the effects when, despite our best efforts, a disaster occurs. Having a plan to reduce crashes is paramount to preventing a crash from ever occurring so the Matrix relies heavily on preventing a catastrophe from occurring. The Matrix takes things one step further by having a disaster (response) plan to reduce negative consequences should the disaster occur despite our best efforts to avoid it.

See Addendum B

EMS has done a great deal to improve its system with increased training of responders, improved structure and improved equipment, yet a gap exists between the time of the event and when the professional rescuers arrive. This gap must be filled with community training of individuals so that they not only know how to effectively respond and assist the EMS, but also know how to protect themselves so that they do not become injured in the process of trying to help. They also need to be properly equipped so that they can respond correctly with supplies that will help them effectively provide care. Personal protection, trauma shears, triangular bandage (tourniquet), gauze, and emergency blanket are essential items

CONCLUSIONS

Bystander Assistance Training is relevant and according to an earlier survey of 2000 students in 2005, 1/3 of the people who took the ASM class used the information to help someone (not always a motorcycle crash) within three years. Increased confidence, a focus on securing the scene and focusing on life threatening injuries have all helped to improve outcomes.

Though the timing for data collection was short, we were able to show that students learned something new and that some had used the information to help someone. We also learned that many of the students felt they rode with more caution after taking the class and that some were stimulated to seek additional training.

The challenge continues to be access to Bystander Assistance Programs (BAP) which must become more readily available. Certainly, discounted programs with incentive help to encourage training as we saw with this focused effort.

ASM’s vision is that BAP classes will be available nationwide someday, similar to how MSF programs are today.

ACKNOWLEDGEMENTS

ASM would like to that Pete Vanderaa for his belief in and support of our program through the years. We would like to thank Justin McDonald for the many hours he spent assisting us with the grant process and getting it right. We would like to thank the instructors: Pee Larr Handley, Heather Penachio, Shannon Venturo, Eileen Cunningham, Jess Leanos, and Steve Vick for teaching classes. We would like to especially recognize Full Throttle Law for providing space and lunches for the Las Vegas area classes and in particular, Shannon Venturo for the many, many hours she spent coordinating area classes. Jess and The American Legion in Reno provided space for classes end SOS provided discounted Trauma Packs. Vicki Sanfelipo from ASM spent many hours working on the project coordinating classes, entering data, writing reports, and managing financials.  Polly Marinova gathered data made it usable. This project would not have been successful without the 199 students who completed the training and participated in the surveys. We know the impact will be ongoing.

References

• ^{NHTSA Traffic Safety Facts, June 2023 – Bulletin 833466 – https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/813466.pdf}
• ^{National Safety Council Injury Facts 2021 – https://injuryfacts.nsc.org/motor-vehicle/road-users/motorcycles/}
• ^{S DOT Safe Systems approach 2022 – https://www.transportation.gov/NRSS/SafeSystem}
• ^{2023 NV Bystander Training survey results}