“Medical car on scene”: first medical contact (2)

Before we consider the approach to the driver still in his (or her – my use of the masculine pronoun is purely for simplicity!) car, I wanted to briefly consider what we do when the driver is out of the car on arrival on-scene.

First, the relatively rare situation of a driver out of his car, but not feeling well. The best and most interesting example of our approach in this case would be Fernando Alonso’s accident in Brazil in 2003:

When we arrived on-scene, Fernando was half sitting, leaning back against the base of the grandstand wall. He was pale, sweaty, and clearly not in top form. I’d seen the accident on the screens in the Medical Car, and knew it had been huge. I told Fernando that we were going to place him on a gurney, load him onto the ambulance that had already arrived on-scene.

“I’m not going on a stretcher, I’m going to stand up” he said stubbornly. I was annoyed, but not surprised. This is how these guys are. I thought about it for a moment.

Happily, Dino, the Chief Medical Officer in Brazil has teamed us with Dr. Fernando Novo for years. Fernando is one of the pillars of the PHTLS (Prehospital Trauma Life Support) course in Brazil, and this brilliant skill set, as you’ll see in a moment, came in incredibly handy here. I told Dr. Fernando that we were going to do a “two man takedown”.

I told Fernando (the F1 version), still sitting against the wall, what was going to happen. I said we’d let him stand up and wave to the crowd. I insisted that if he felt unwell standing, he was to just whisper that to me, and we’d get him lying down pronto. I told him that before we let him stand up, we were going to place a rigid cervical collar before he stood up. And that as soon as he’d waved to the crowd and acknowledged their applause, he was to remain quite still as we prepared him to be put on the gurney and loaded onto the ambulance. I told him this was non-negociable.

Fernando (Novo, my colleague) stood on Fernando (Alonso)’s right, and I at his left. Standing up was uneventful. Good. Step one successful. Now picture this: Fernando Novo and I apply a long spine board (held vertically of course) to Alonso’s back (while he’s standing), holding it there with my right, and Fernando Novo’s left hands, placed under Alonso’s armpits on each side and grabbing the handles on each side of the board. We each place our free hands (my left hand and Dr. Fernando’s right) on either side of Alonso’s head, to provide additional stabilisation beyond that of the collar. My left (and Novo’s right) feet are blocking the bottom of the board. Ready? On the count of three, we tip Fernando back, the ambulance crew grab the bottom of the board, and waving to the crowd, Alonso is placed on a gurney and loaded onto an ambulance while the crowd cheers.

This is an excellent example of the complementarity between the local team (here represented by Fernando Novo in the medical car) and the FIA. It also eloquently speaks to how important it is to have everyone reading from the same page in terms of medical knowledge and technique. Here, Fernando Novo and I shared knowledge of the PHTLS course, with obviously highly satisfactory results. Now we need to hope the FIA actually does move ahead with worldwide implementation of a motorsport medicine course. Yeah, the one they’ve been talking about for ten years now.

When the driver is out of the car and not complaining, we’ll almost always take him in the medical car. I would use this time to check for any subtle complaints that only start to appear when the adrenaline of the accident starts to fade away. It’s also a great opportunity to look for subtle symptoms of concussion. So I’ll ask about who he was following when the accident happened, and other questions looking for anything . . . not right. If there are symptoms, complaints, or if the medical warning light of the car was triggered, we drop the driver off at the medical centre.

21 thoughts on ““Medical car on scene”: first medical contact (2)

  1. Thank you for sharing this very interesting article. I was not surprised to read the resistance of going on the gurney, this seems to be very common amongst all our elite sports personalities. Personally a foolish choice I feel but when there is so much adrenalin pumping through your system it is easy to overlook the fact that as a human being you are not immortal🙂 aaah the joys of adrenalin combines with status

  2. In case of an event where drivers and public are involved, where does the priority for the FIA medical team lies?
    Is the infrastructure and the medical manpower at a circuit sufficient to deal with a ‘Le Mans 1955’-type of accident?

    • In the invent of a “Le Mans” incident the local Police would take over. The circuit medical team would initially deal with it,until it is deemed a major incident. At this point the Major Incident plan would be started. The plan is practiced every year at Silverstone,using various scenarios. The people involed are Police,Ambalance and Fire. The circuit Managment are there plus CMO for the meeting and local Race Director. If any thing is need from the FIA it would be asked from the Gold Comanda. I know Silverstone is maned in case of this type of incident plus the use of the local emergencie services.

  3. Hi Gary
    Yesterday when I saw the medical car positionning itself in front of Massa’s car, in a protective position, I immediately tought of your former post on the subject !

  4. Garry, thanks for the blog. I thoroughly enjoy reading.
    I have a small question… Albeit a morbid one…. What arrangements are in place for accidents that are obviously fatal? Do the medical centres have a mortuary? Are the medical teams told to go through the cpr motions regardless to lessen the impact for tv viewers?

  5. In general pre-hospital medicine the rapid takedown procedure has been totally discredited at “normal” RTCs (see the UK FHC position statement on C-Spine immobilisation). Do you consider this to be applicable to motorsport medicine, or do the increased magnitude of forces involved in collisions mean it is warranted?

    • Standing trackside, under a Safety Car, with a rather belligerent and “vagal” looking driver, one needs to improvise. This was, under the circumstances, an acceptable solution that minimised scene time and provided acceptable immobilisation relatively rapidly. As opposed to none at all.

  6. Wow! Just watched the race in Montreal live. Medical cars were there within seconds of the crash on the last lap. Massa was lucky he ran into a wall of tires and not a concrete wall. An Italian from Australia is the winner…winning his first F1 race but I’m sure you all already know that. ;))))))

    • Fantastic race, the season just gets better and better. VERY impressed with the speedy deployment of the medical cars and relieved that both drivers seem to be okay

      • Hi Sue …. Just wanted to agree with you. It certainly was a great race. I do feel sorry for Massa though; He’s had some very bad luck this season. Williams was smart to pick him up after Ferrari dumped him. I’m sure they are disappointed with Raiko. Word is they are going to drop him at the end of the year too. The engineers don’t like the way he’s been yelling at them when ever something goes wrong for him. I had to laugh when he did a donut on the same corner twice in Montreal. I’ve nothing against him, he’s just so rude, but he sure is funny (when you can make what he’s mumbling about). Do you have a favorite team and/or driver? I hope this doesn’t start another argument but what do think of the new sound ( or lack thereof )? Take care.
        Loads of Hugs🙂

      • Liza, hate the new sound, doesn’t it seem weird to hear the squeal of tires. My favourite team is any team where Michael was, but this season I am supporting Mercedes (Rosberg actually, Hamilton gets on my nerves).

        But deep down I am a Ferrari girl at heart, they will always be special to me

        Sue. X

    • Hi Mimi,
      Your posts are always right on the money . . however, first Massa ran into Perez and then into the wall. The Force India dampened the impact a bit.
      And hooray for the incredibly fabulous Daniel!
      lm

      • Lulu, I think you’ll find that it was Perez that was at fault. It was reported today that when Massa was talking to him from the hospital about his reckless driving, Perez laughed at him and walked away. I thought that was pretty ignorant. Massa is one of the nicest guys you could ever meet. I read that he experienced 27G force on impact. Its amazing he wasn’t hurt. See the accident looping on Bleacher Report at:

        https://mtc.cdn.vine.co/r/videos/CD325B600F1087509229075873792_2f21b16c9e9.0.3.1502343076091597382.mp4?versionId=ohXRTGjd5Sl2jRpES9XoS4oyMJrHmjOt

        Perez only got a P5 penalty for causing the crash. It was reported that in his short 4 years as an F1 driver, his first 3 year contract with McLaren was torn up & he was kicked out after the first year for having a bad attitude & since, he’s been with a different team each year, each year getting replaced.

        He’s more of an asshole then Kimi. I will admit Raiko is easy on the eyes ( when he was young anyway), but he says such ignorant stupid things, one just has to laugh. And when he does speak, its as if the corners of his mouth are glued together. The worst part is he thinks he’s so cool. I’ve seen him push people out of his way dozens of times & in Monaco one of the Red Bull guys pulled him out of harms way of an on coming F1 car, as he was stood in the middle of the pit lane doing who knows what. He didn’t even say thank you, just walk away.
        On a personal note, Kimi once called me a lesbian because I shunned his advances. He shamelessly flirts & cheats with any woman that will have him, mostly he hits on the pit girls. I feel sorry for his poor wife ….. although Michael had a good laugh when I told him what Raiko called me. I really don’t know if they were friends.

    • Hey Mimi……. Wasn’t that an exciting race? ……. I wish they were all like that. Correct me if I’m wrong but are you an F1 fan? I mean it’s great if you are, for some reason I thought you weren’t. I guess we both got a bump on the head, LOL. If you have been watching the F1 GPs, what are your favorite teams? drivers? If not, it’s nice that you are getting into it.
      Also, I didn’t get a chance to thank you for being so understanding & kind to me when you said the blog needed me. I got a warm fuzzy feeling inside when I read that. If you don’t mind me asking, what State do you live in? Do you have any siblings?
      Sending you lots of positive energy xo
      (a.k.a. Liza)

  7. As a former marshal, I follow your blogs with great delight. Unfortunately the video of Alonso’s problem in Brazil has been blocked by Formula One Management on copyright grounds. Is there another link?

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