The management of road traffic accident and The care of casualties  has undergone many changes in recent years. To provide an uniform and systematic approach the EMS, firefighters, red cross, red crescent and other rescuers must be updated to reduce entrapment times, and mortality rates, over better organisation and a methodical approach. The rescuers should not attempt to administer medical first aid unless trained to do so. Self-protection is the first step of rescue  management because casualty may carries a harmful blood borne virus or bacteria. The next step is casualty assessment, to assess the casualty knowing of kinematics of injury is important.

Kinematics of injury: Kinematics refers to a branch of mechanics dealing with the motion of a body without consideration given to its mass or the forces acting on it. It is important for rescuers to try to establish the kinematics of the injury in order to determine the extent and seriousness of the injury. How injury was caused, what type of injuries may have occurred. Knowing the type of impact injuries is important.

• A cracked windscreen or displaced rear mirror may indicate head or spinal injury.
•  Deformed steering wheel or column may indicate chest injuries.
•  Deformed dashboard may indicate lower limb injuries.
•  Deformed gear change lever may indicate lower limb damage.
•  Deployed airbag may indicate facial injuries.
•  Seat belt sign may indicate abdominal or chest injuries

Casualty assessment: Obey the rules of ATLS (Advanced Trauma Life Support) and ABCDE is mandatory. It consists of the assessment of Airway, Breathing, Circulation, Disability and Exposure and environmental control. Attempt should be done to obtain a clear airway, achieving a normal breathing and circulation. Knowing the need of oxygen therapy and applying it in a correct manner is important. The rescuer should know the signs and symptoms of the shock and the correct way to manage it. Disability and neurologic assessment as well as exposure and environmental control are the next steps to manage casualties.