First Aid Kit

I nearly always take a first aid kit on my bike. Any first aid kit is secondary to knowledge. Once you've taken a first aid course you might be thinking about what you need in your kit. This is my approach.

The purpose of the kit is not exclusively for use at the side of the road. It often happens that somebody goes down, carries on riding, and then realizes they are more injured than they initially thought once the ride has finished and the adrenaline wears off. Another thing to consider is that there is always a trade-off between size and utility. Kits that you buy off the shelf are often contained in a user friendly and compartmentalized case, which is good for home use, but takes up unnecessary space. So I just throw everything into a cell container I got from a backpacker store. Making your own kit also helps you think carefully about what to put in it. The contents of mine are as follows.

Large Items:
High Visibility Vest
Small Torch
Emergency Blanket
Instant Single Use Cold Pack
No 15 Wound Dressing
Triangular Bandage
Two Crepe Bandages (7.5cm and 10cm)

Flat Items:
Some Gauze Swabs (7.5cm x 7.5cm)
Non-Adhesive Dressing (10cm x 10cm)
Combine Dressing (20cm x 10cm)

Small Items and Instruments:
Some Plasters and Island Dressings
Antiseptic Wipes
Alcohol Wipes
Scissors, Forceps and Shears
Pins and Tape
CPR Mask and Gloves

For me this a good trade-off. The cell container is about 20cm x 15cm x 10cm and everything fits in it except for the high-viz vest. The cold pack is the biggest item, followed by the emergency blanket, triangular bandage and wound dressing. Having no cold pack would free up a lot of space but I think it is worthwhile. I don't have any eye dressings or saline solution steritubes, or any specialist burns items. For documentation I have a small pad and pencil in my jacket.

The use of most of these things is fairly self explanatory. The cold pack is useful for strains, sprains and bruising. The wound dressing (no 15 is the largest size) is a dressing attached to a bandage, and is the first thing I would use for most wounds. An exception would be if the wound was bleeding heavily, in which case I would use the combine dressing (a large pad designed to soak up blood) first. The alcohol wipes are for cleaning instruments. The non-adhesive dressing is useful for burns or road rash. Bandages can be used to secure dressings or directly to support or splint limbs. Shears are used to cut clothing; they are usually only included in large first aid kits.

State Versus State

Australian states are very competitive, even when it comes to road safety. As a justification for the Victorian motorcycle safety levy VMAC explains that

Trends in motorcycle and pillion fatalities since 2002 have been encouraging with an average 20 per cent reduction in Victoria compared to a 31 per cent increase in fatalities for the rest of Australia.

Apparently, Victoria is better than elsewhere. But this is the type of statistic that compares the current year to a selected previous year. You can bet your mortgage that the year 2002 was a bad one for Victoria in terms of motorcycle fatalities; if you want to appear better, simply compare yourself to a point in time when you performed badly.

So what state is best? The two figures below show the number of fatalities per 100,000 registered vehicles for Australia and its major states for the period 1995-2009. The states are plotted in order of population; the additional volatility for the smaller states is to be expected since there are lower numbers of fatalities in less populous regions. The first figure includes all fatalities (including passengers, pedestrians etc) and all registered vehicles. The second figure includes only motorbike rider fatalities and registered motorcycles. The points in red are based on estimated registration numbers as there was no vehicle census in the year 2000.




There will inevitably be differences in fatality rates between different states due to differences in climatology and demographics. Fatality rates are very useful as measure of risk, but they do not provide a means to compare the effect of the states' traffic policies on road safety. For this we need a measure of improvement. One way to construct a measure is to fit a smooth curve to each individual plot, and to calculate the negative of the slope of the curve at any given time point. The measure will be negative if fatality rates are getting worse (increasing), and positive if they are getting better (decreasing).

This measure of improvement is shown for 2000-2009 in the figures below, for all vehicles and for motorbikes respectively (for motorbikes the measure has been divided by the ratio of the fatality rates so that it is roughly comparable between the figures). The most important measures of improvement are those for the current year, as they give an indication of the direction that the states are heading. The states of SA, VIC and NSW are not only improving but appear to be doing so at a faster rate than previously. Unfortunately, the states of QLD and WA have been less than successful. WA has the unenviable distinction of being the only (populous) state that has a negative improvement value for 2009, for both motorcyclists and all road users. In WA, fatality rates are not improving.

Back to the original question: what state is best? Looking at the 2009 figures, the ordering of the states is the same whether we consider all vehicles or only motorcycles, and is as follows:

1. South Australia
2. New South Wales
3. Victoria
4. Queensland
5. Western Australia

Congratulations South Australia. The improvement shown by SA in motorbike fatality rates during the last few years is unique. In 2007 there were only 8 motorbike fatalities in SA; the first (and currently the only) single figure number they recorded in the online Australian Road Death Database. The volatility of the fatality rates in SA is naturally larger than the more populous states, so it will be interesting to see if they can remain at their currently low levels. I don't know what SA is doing, but for the moment it is working.

The Yangon Solution

Unlike other politically isolated nations, there is a surprising about of freedom with regard to conversing with the locals of Myanmar (Burma), many of whom speak good English and are happy to talk about the problems facing the country. This makes Myanmar a fascinating place to visit. The traffic in Myanmar's former capital city of Yangon (Rangoon) has an interesting feature. There are no two-wheeled vehicles of any kind other than police vehicles, which is unique for a populous South-East Asian city.

Suppose 500 soldiers go into battle and 5 are fatally wounded. That's 5 fatalities, with a fatality rate of 1 fatality per 100 soldiers. The total number of soldiers is a measure of exposure: 500 soldiers are exposed to risk. If the battle is smaller, with only 200 soldiers, but at the same level of risk, we might expect only 2 fatalities. So reducing exposure reduces fatalities. If the battle is less intense, but of the same size, then 500 soldiers would again go into battle but the risk (as measured by the fatality rate) would be smaller; perhaps 1 fatality per 250 soldiers, and the number of fatalities again reduces to 2.

Road fatalities work in the same way. There are only two ways to reduce the number of fatalities: you reduce the risk or reduce the exposure to that risk, and most traffic policies affect both to some degree. Increased driver training seeks to reduce risk, but may also deter people from obtaining a licence which reduces exposure. Exposure is typically measured using either the total number of registered vehicles, the total distance traveled by all registered vehicles (which unfortunately is often inaccurate), or the total number of licence holders. If the risk remains constant, a large increase in these will lead to an increase in road fatalities.

Reducing the number of road fatalities to zero is easy: ban all motor vehicles. This reduces exposure to zero. Reducing exposure is easy to do, but while it may reduce fatalities, it inevitably impinges on the freedom of the individual. There is a trade-off, and so policies that reduce exposure are applied to circumstances where the risk is deemed to be high, such as with night-time curfews for young drivers and the setting of minimum driving ages. The policy in Yangon is an example of this approach. Even the safest motorcyclist acknowledges the increased risk that is present compared to driving a car. Yangon has reduced the exposure to zero for motorbikes which, relatively speaking, are a high-risk vehicle.

MUARC (Monash University Accident Research Centre) is perhaps the highest profile research group for road safety in Victoria. They have a publicly available series of reports. Some of these focus on cycling (here here here here) including a number on the use on bicycle helmets which I haven't included in the links. Other focus on motorcycling: on younger, older and high-risk riders (here here here), on crash information and countermeasures (here here here here), on training, licensing and hazard perception (here here here here).

Of particular interest is this report which reviewed motorcycle licensing and suggested an 'optimal model' for its implementation. The primary recommendation was that car licences should be a pre-requisite for bike licences (not implemented). Other recommendations included restrictions for L/P plate riders (zero alcohol, no pillion, power-to-weight) and an increase in the teaching of cognitive skills such as road-craft and hazard perception (all implemented to some degree). The reasoning behind these recommendations was clearly stated. Quoting from two sections of the report:

Another general principle of the optimal model is that, given the high crash risks associated with motorcycling, the model should not encourage increased exposure (...). For this reason, the total costs of obtaining a motorcycle licence (...) should not be cheaper than for a car licence.

The research suggests that any safety benefits of motorcycle licensing and training probably result more from exposure reduction (a reduction in the total amount of riding) than from crash risk reduction.

The aim of the proposed 'optimal model' is to contain exposure (i.e. to discourage the use of motorbikes) rather than to reduce risk. Surely then, it is the policy of Yangon that is the true optimum. But is it a bad one: should bikes be banned? Or perhaps we should ask the opposite question: should the use of bikes be encouraged, even if the increasing exposure leads to additional fatalities? What do you think?

I think motorcycling should be made freely available to all those who desire it. The freedom of the individual to take his or her own risk is a right that should not be taken away by the state in the pursuit of lowering the road toll. In Melbourne, banning motorbikes would rightly lead to protests. In Yangon protests are met with force, and as demonstrated in 2007, dead protesters are soon forgotten. Yangon is not an example that should be followed.