Scramble to Turn 1

Incident safety and logistics - What is a First Response Vehicle?

So you and your crew are sitting in your intervention vehicle (radio call sign “Victor 1”) just off to the side of pit exit. The morning has gone well so far and everyone behaved themselves during qualifying. The race is a few laps in and things seem to be settling into a rythmn.

Over the radio comes a message from Race Control that ruins the peace:

“Victor 1, Victor 1, Standby!”


What is a first intervention vehicle?

We'll briefly go through first intervention vehicle setup as it can differ between regions and between event types.

The first intervention vehicle at a motorsport event is known by a number of names in different places and includes “first response vehicle”, “track response vehicle” and “medical intervention vehicle”. The different names reflect the different purposes and crewing of this vehicle for a given event. It may be a purely medical response or it may be a broader rescue, fire or safety response that has a medical component embedded within it.


Medical response vehicle terms

FIA 
  • MIV: Medical Intervention Vehicle. 
  • Crewing and equipment varies between circuit and rally events, with greater self sustaining medical and rescue capacity required for rally and off-road events.
  • The crewing and equipment configuration also varies between regions, reflecting local practice, though there is a minimum expected standard as prescribed by Appendix H regulations (https://www.fia.com/regulation/category/123)

CAMS (Australia)
  • MIV: Medical Intervention Vehicle. 
  • Radio call signs = Victor 1, 2, 3,... on circuits where the vehicles are usually purely medical with paramedics +/- a doctor and MIV 1, 2, 3,.. at rallies which have a more mixed medical and rescue skill role and often have the same crew configuration but may add a fire-rescue technician where the paramedic is not rescue trained. There is no particular reason for the call sign difference.
  • Minimum standards are prescribed by both the “Medical Services” and “Alternative Medical Services” documents (https://www.cams.com.au/regulations/manual/general-regulations)

Motorsport UK 

North America
  • IMSA – Wide variety. Medical 1, Emergency 1.
  • NASCAR – The medical car is referred to as “The 99”.
  • IndyCar – 
  • Sprint car series – The “Doc car”
  • Blancpain World Challenge – Medic 1, 2, etc.
(Editor's note: What terminology is used in your region? Comment below and let us know so we can share the language.)


The primary role of the first intervention vehicle and crew is to get to the scene of a racing incident as quickly as is safe, in order to remove the competitor or competitors from immediate danger, prevent further harm and initiate any critical interventions that are needed to effect a safe transfer of the competitor(s) to the definitive care destination (usually the event medical centre or the hospital).

 

 

First intervention vehicle types range from ambulances to dedicated fast response cars and custom kitted utility vehicles, from ATV buggies to road cars and 4-wheel drive vehicles to helicopters. The vehicle type is determined by its suitability for its purpose with regard to the distances and terrain it has to cross, the safety of its occupants, its ability to safely transport critical equipment and if needed, its ability to safely and securely transport or treat one or more patients.
At rallies, off-road or safari style events, for which the event footprint can be very large, the first response vehicle may need to provide a mix of clinical and rescue abilities. At circuit events a medical intervention vehicle (MIV) may have a predominantly clinical role with rescue being provided by a second or completely separate team; however this is not a universal model and many circuits also utilise mixed skill first intervention vehicles. Fire response from an MIV is usually basic and there is almost always a separate, dedicated fire response service at a motorsport event. Find out what the set up at your event is.

An MIV may be crewed a number of different ways, depending upon the needs of the event and location and may include between two to six crew members. For some events this is primarily a medical response and so the crew might be made up of paramedics with or without a doctor. At other events where the medical response is embedded within a broader first response, the crew might be composed of paramedics and maybe a doctor along with fire and rescue technicians. In some cases the driver might be an accredited motorsport competitor.
The crew make up should reflect the role of the intervention response and is influenced by the type of event (circuit, rally, off-road), the requirements of the event sanctioning body (e.g. FIA, IMSA, NASCAR, IndyCar, etc), the funding available to the event and regional legislation.


First intervention vehicle crew skills

Paramedics / EMTs

  • Varying level of clinical ability depending upon their grade. Grading systems vary by region and usually differentiate ambulance officers with basic life support skills all the way up to those with advanced clinical knowledge and skills; e.g. intensive care paramedic.
  • Experience in pre-hospital environments and hazard identification and management.
  • Experience in scene control.
  • Experience in radio communications
  • Often aware of local government and private agency networks and practices 
  • Certifcation at state or national level – accountable professionals
Doctor
  • Often included for specialist knowledge and skills, particularly advanced airway, resuscitation and trauma management.
  • Skill and experience may vary widely depending upon the individual's level of training and their regular day job.
  • Often drawn from critical care specialties such as emergency medicine, intensive care, anaesthetics, pre-hospital and retrieval medicine, general practice and certain surgical craft groups.
  • Familiarity with trauma and acute medicine principles is important and particularly for those who do not work in a critical care specialty outlined above and are not regularly providing cover at motorsport events

Fire fighter
(May be combined fire and rescue trained)
  • Specialist knowledge and skills for managing fires and fuel types.
  • May have specialist knowledge for specific hazardous materials (HAZMAT)
  • Experience in pre-hospital environments and hazard identification and management.
  • Experience in scene control.
  • Experience in radio communications
  • Often have some level of basic life support training and sometimes more advanced.
Rescue technician
Often based in fire fighting or paramedicine rather than a specific role.
(May be combined fire and rescue trained)
  • Specialist knowledge and skills for managing entrapment. This includes specialist training in using rescue equipment such as hydraulic rescue tools.
  • May have specialist knowledge for specific hazardous materials (HAZMAT)
  • Experience in pre-hospital environments and hazard identification and management.
  • Experience in scene control.
  • Experience in radio communications
  • May have some level of basic life support training and sometimes more advanced.
Accredited motorsport driver
  • Experienced in race craft; e.g. where the racing line is, how competitors will likely react, category specific regulations.
Note: The skill sets outlined in this table represent general principles and are not guaranteed. There may be wide regional variation depending upon local regulations and practice. This table represents options that should be considered and should be matched to needs of the event.


FIV Equipment

Related to its crewing, a first response vehicle is stocked with equipment that pertains to its purpose. In general this is composed of clinical equipment, personal protective equipment, a basic fire response and potentially, depending upon the level of additionally available support, technical rescue equipment. How advanced and how much equipment this is will depend upon the needs of the event, the skill mix of the crew and the capacity of the vehicle being used. The objective is not to bring a hospital to the incident but to employ pre-hospital medicine or combat medicine principles and cater for the minimum necessary to achieve a meaningful outcome based on likely injury patterns.

 

Clinical equipment

  • Airway resuscitation – streamlined to needs
  • Trauma resuscitation – streamlined to needs
  • Oxygen cylinder
  • Resuscitation and analgesic pharmacology – streamlined to needs

Personal protective equipment

  • Gloves
  • Helmet
  • Eye protection
  • Weather appropriate clothing
  • High visibility clothing
  • Respiratory protection

Technical rescue equipment

  • Fire extinguisher (often powder + CO2 cylinders)
  • Basic rescue tools
  • Hydraulic rescue tools
  • Event specific equipment; e.g. FIA Lear seat tools.
  • Specialist access equipment

Note: This is neither a mandatory nor exhaustive list. The actual equipment stocked will depend upon the role that the MIV and crew are to play at the event and should be appropriate to the level of training and experience of the crew members.

Additional guidance on the crewing, equipment and vehicle type for your event can often be found through your regional motor sport regulator or the sanctioning agency (See Table below)

Medical and rescue service standards

At a race event, most communication is via two-way radio with call signs assigned to each responder or group. In the scenario at the start of this piece, the first intervention vehicle was put on alert with the call sign “Victor 1”, Victor being the internationally recognised radio designation for the letter “V”, as in first response Vehicle.

NATO phonetic alphabet, codes and signals - https://www.nato.int/cps/en/natohq/news_150391.htm

With attractive decals, emergency strobe lights, a cool call sign and a closed race track, it's often tempting to get sucked in to the adrenaline of an incident response and push the accelerator to the floor. That said, the primary role is to get to the scene, which is hard to do if you've overcooked it into a turn and ditched the car into a gravel trap or tyre wall.

So, watch for the next article and podcast when we'll go through entering a race track safely.

The Podcast

Scramble to turn 1 - What is a First Intervention Vehicle



The podcast is recorded using Skype videoconferencing so there is a bit of extraneous noise which we have tried our best to clean up. We hope this does not affect what you get out of listening to this podcast.


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