News and reviews

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Cases from the races at SMACC GOLD

August 7, 2014
Back in March I posted a podcast that I recorded at the smaccGOLD conference with Northern Irish anaesthetist and motorbike race doc, John Hinds, and Aussie anaesthetist and motorsport doc, Brent May. The talk that John had been invited to SMACC to give has been released on the other site that I'm involved with, the Intensive Care Network. The pro-con debate between John and Brent on the usefulness or not of cricoid pressure in airway management is also available on the ICN site.



John's "Cases from the Races" presentation is a great talk, at the same time entertaining and informative. John gave some great tips and lessons learned from his experience as a rapid response medic at road race events in Ireland. It's worth listening to for the approach that he and his team have developed to cut down to bare essential equipment and interventions in order to get the best outcomes as efficiently as possible.

This approach is illustrated in the first case he discussed when a rider hits a pit straight wall at full pelt resulting in a traumatic cardiac arrest:
  • No CPR
  • No clear fluids
  • No IV access
  • ETT
  • Bilateral thoracostomies
  • Pelvic binder
Result = Return of spontaneous output and circulation and ultimately, a good survival.

Impressive and rational.

He also outlines some key things to pay attention to:
  • when bikes catch fire
  • when there are more bikes than riders at an incident scene
  • what pattern of injuries to look for when key phrases are told to you
  • the importance of developing a high functioning team and keeping track of your activities and outcomes

For anyone who doesn't know,  road racing is the motorbike equivalent of tarmac rally with a long section of public road closed for the purpose of hosting a race. The best known motorbike road race is probably the Isle of Mann TT.

Here's John's Cases from the Races talk, which is accompanied by a slideshow
:



Here's the Cricoid Pro-Con debate:



Here's the podcast that John, Brent and I recorded at smaccGOLD:



SMACC will be held again next year in June. If you work in critical care, be that in ICU, ED, anaesthetics or prehospital, and you have not been to a SMACC event you absolutely must go. For a taste of what goes on, visit smacc.net.au. And if that is not enough, the 2015 conference will be hosted in Chicago, one of my favourite cities in the world. I'm certainly planning on being there.
 

Medical response at Formula 1: Insider

May 21, 2014


For anyone who doesn't already know, Dr Gary Hartstein, the previous FIA Medical Rescue Co-ordinator who rode shotgun with Alan van der Merwe in the Mercedes AMG C63 station wagon at the back of the grid for each F1 start, has moved on from mere tweeting and now writes his own blog, A Former F1 Doc Writes.


More recently, he has started a series of posts on how a medical response to a racing incident is articulated. The posts give an insight into how the process is managed at the very highest l...

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C-spine collar glory days

May 21, 2014


Sorry about this. I had planned to put up a post on the devolving role of the semi-rigid cervical spine collar two weeks ago. However, the more I read about it, the more I wrote and I ended up with a five page document. Waaay too long for a blog post!

So what I'm going to do instead is submit the original piece to a journal as an opinion piece and see if I can get it published. If that happens I'll put up a link to the article. In the meantime, as it may take some time to get through the edito...

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Concussion biomarkers - The new brain 'troponins'?

April 2, 2014


My thanks to Rik Hagen for the heads up on this article on a trial of brain injury biomarkers; specifically neuron-specific enolase (NSE), S100 calcium-binding protein (S100-B) nad total tau protein (T-tau).

Now, I can hear your eyelids closing already, but stick with me on this because it may be an indicator of future directions, both in terms of how we approach concussion in sport and perhaps for the level of expectation that is placed on the abilities of medics providing cover at sporting e...

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Podcast 7 released

April 2, 2014
Last week I put up a podcast recorded at the smaccGOLD conference with John Hinds (Irish Anesthetist, Intensivist, Prehospitalist and Road Racing doctor) and Brent May (Australian Anesthetist, Prehospitalist and Motorsport doctor). We discussed the hazards of providing medical cover at long distance events, the differences between circuit and closed public road motorbike events and some injury patterns to be aware of.

Podcast 7 - Irish road racing and Australian circuits with John Hinds and Br...
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Lessons learned at the Melbourne F1 GP for the 2014 season

March 24, 2014
  

Formula One has made some dramatic changes for the 2014 season, which are all well documented in the motorsport media, with some creating a fair bit of criticism. I thought we'd take a look at some of the elements that have a bearing on the provision of rescue and medical services. These may change during the year and more may come to light. Feel free to add to this post in the comments section below.



First up, the engine isn't an engine anymore. It's a powertrain or power unit. See this Rac...

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Rollcage Medic launches the Motorsport Medicine & Rescue Google community

January 19, 2014
Medical education, as with everything, is evolving and the progress of the online medical resources has been remarkable. Starting out as a hodge-podge of niche newsgroups and individual blogs, the FOAMed community has galvanised itself into a broad range of blog sites, content communities, journal clubs, podcasts and even conferences (think SMACC and Bedside Critical Care). Individuals and groups are finding ways to shape Web 2.0 resources to the benefit of promulgating medical education in n...
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The Rollcage Medic site gets an overhaul

January 19, 2014
The Rollcage Medic site has been in and out of the pit lane in something over 3.2 seconds and had a complete redesign to clean it up and streamline it. It's been a lot of hard work and I hope it will prove to be worth the effort.



The navigation should be quicker and the url at the top of the page should be more consistent. You'll notice the older blog posts have two sets of dates as a result of the reconfiguration; the older date is the original post date and the newer one is the date on whic...
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Formula 4 comes to Australia in 2014

January 19, 2014
Posted by Matthew Mac Partlin on Sunday, December 15, 2013 


Formula 4 has been confirmed as the new stepping stone in progression in open-wheel race car competition in Australia. So here is a summary of the key items of this new formula, with a focus on the elements that impact on medical and rescue provision.

The aim is to keep cost to a minimum, to encourage young talent to progress through the ranks to Formula 3 and on to Formula 1. That doesn't mean it will be particularly c...
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Time for a Registry

January 19, 2014
Posted by Matthew Mac Partlin on Friday, October 25, 2013



It’s hard to know that a problem exists if you don’t look for it.

Sometimes you’ll find it because the problem finds you, usually through an adverse outcome. But wouldn’t it be better to know of  a potential problem’s existence beforehand and, even better, put something in place to mitigate it. So it makes sense to look out for problems before they cause trouble; that’s just basic survival.

And it is not without ...

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