“Cases from the Races” John Hinds

Conflict of interest

Dainese leathers

Arai helmets

Daytona boots

Bridgestone

Motul oil

Road racing = “Furniture”

Scene safety: Beware of fire

• Immediate• Delayed • Missed

– Fast burn, under pressure

• Quickshifter

• **

Reading the scene

• Treat the injuries you find• Treat the injuries you expect

Types of crashes

Commonest mechanism

Single Vehicle Accident

-Rider misjudges corner severity

-Typically left-hand bend

“Low-side”

“High-side”

“Hit-by-the-bike”

4 Mechanisms of concern

• “He hit the Kerb”

• Broken Feet, reduced LOC

• Boot lying in the middle of the road

• Head on collision, apparently isolated femur

“Hit the kerb”

“Hit the kerb”

• Either a dead stop…

• …or a big launch pad

“Hit the kerb”

“His helmet came off”

Examining the helmet

• Careful with your assumptions

“Broken Feet, Reduced LOC”

• Examining the helmet can over or underestimate mechanism

Broken feet = Slid feet first = Fall from height– Think neck– Think Base of Skull

Clinical: Helmet removal

Helmet removal is safe!

• 200 per year• No secondary neurological sequelae

Plan B.. ?

“Failure to remove” = 1 : 2,000 ?

Surgical airway?

• Conditions are poor -

• Head flexed• Chinstrap in the way• Lots of bleeding• May be trapped under another vehicle

Failure to remove: Plan

• Provide oxygen• Prevent hypercarbia

• Access to the airway• Destabilise helmets structural integrity

• Prevent harm

Careful!

Speed Humps

• With a speed hump in place the spine is not in-line in the neutral position

• Intubation by direct laryngoscopy is impossible with a speed hump in place

“Head-on collision, apparently isolated Femur”

“Beware the boot lying in the road”

4 Mechanisms of concern

• “He hit the Kerb”

• Broken Feet, reduced LOC

• Boot lying in the middle of the road

• Head on collision, apparently isolated femur

SPECTATORS

“BLOODY SPECTATORS”

“I’d like to thank all the staff at the Royal Victoria Hospital who helped me – in Intensive Care, the Surgeons, the nursing staff…”

“I’d like to thank all the staff at the Royal Victoria Hospital who helped me – in Intensive Care, the Surgeons, the nursing staff…”

NIAS Paramedic:“That’s gratitude for you. How does he think he got there? On Santa’s F**ing Sleigh?”

Questions…?