Running targeted workshops has become a bit of a favourite activity of the FIA Institute. This is a good thing, as they have amassed a wealth of information from the variety of motorsport categories that they sanction and there are some very bright and keen people working with them.

At the beginning of the year there was the Extrication Workshop held at the 24 Heures Du Mans circuit. The Serious Accident Study Group was held in October in Singapore and only a few weeks later there was the Pan-American Conference in Mexico. Last week the Institute hosted the two day biennial Medicine in Motorsport Summit in Qatar.

Hopefully this is a signal of intent to share information and experience amongst those of us who provide medical and rescue cover to motorsport events and to boost the profile of this specialty, rather than simply a means of consolidating a silo. Time will tell.

I won't go through the whole program as a lot of it was fairly straight forward. I've attached my summary notes from the meeting to this post as a pdf file, which you are welcome to download. There were a few items worth highlighting.

Apparently there were 19 ASNs (National Sporting Authorities) invited, of which 15 were represented at the meeting, which is a pretty strong showing. It became clear that a number of ASNs are trying to build service support at home with varying levels of success. So attending the meeting was their way of finding out what others were up to and what strategies had worked to improve medical and rescue cover at events.

And this was probably the biggest gain from the meeting. During the last session of the second day, it was obvious that what was needed was a way of facilitating communication between the ASNs of the Asia-Pacific region and so the Asia-Pacific Motorsport Medical Network was born. A private online platform has been set up to which all of the chief and deputy chief medical officers (CMOs and DCMOs) have been invited. I have the pleasure of helping this network get off the ground and it will be interesting to see where we go with it. If there is enough material generated then expect to see a website and a Twitter handle launched so that there is a public presence that anyone can interact with.


In terms of the meeting content, the interesting points were as follows.

General

The meeting had a strong rally focus rather than the usual circuit-centric agenda. Not entirely surprising given that two of the three conveynors have a strong rally background (Dr Jean Duby and Dr Rik Hagen), but good to see given the usual emphasis placed on circuit racing at most FIA events.

Reintegration of competitors after injury

This can be tricky, depending upon the injury. A fractured leg is fairly easy. Concussion is still throwing up difficulties and no one seems to have worked out a good solution yet. Of interest, the FIA have a couple of different approaches.

First off, the event's CMO (Chief Medical Officer) is expected to follow up any injured competitor, regardless of their need for intervention and surprisingly this doesn't always happen. Sometimes the competitor slips under the radar, sometimes the follow up simply isn't done.

The FIA state that any world championship competitor who is “incapacitated” through illness or injury at any time requires a medical examination before being allowed to compete. Anyone else can be incapacitated for up to 10 days before requiring a medical examination, which seems odd and is a duration with no real evidence behind it. It's also not entirely clear what the definition of “incapacitated” actually is.


This is different to the criterion for entering an injury report into the FIA's forthcoming Injury Database, which requires death or “not being able to return to work for at least 8 weeks”. This duration seems inordinately long and raises questions about the feasibility of following up an injured competitor and the likelihood of missing significant but short duration injuries. There have been a number of big crashes recently that would not be entered into this database using the current criterion, including Mark Webber's WEC crash in Brazil or Ott Tanak's WRC crash at Rally Australia, both of whom required a hospital admission and both of whom more than likely have had a period of concussion. Indeed, the definition of a serious accident that we use in Australia is “any competitor, official or spectator who requires an over night admission to hospital”.

Once cleared to compete again, further follow up appears a bit sketchy and seems to be left up to the team's physios and doctors.

Race Track Trauma and Life Support

Dr Michael Scholtz's talk on hospital and counter disaster planning raised some important considerations and allowed him to talk about the RTTLS course that he and his team run annually at the Nurburgring in Germany. It is essentially an ATLS course tailored to the motorsport environment and requirements, which is a really smart idea. For added smartness, they invite junior doctors and paramedics from the local hospitals to participate and issue certificates of completion to those who pass the end of course exam.

During the course, the candidates get to meet drivers and go on a tour of the Nurburgring medical facility. Some get to complete a chase car lap. Those who pass the exam are then invited to be part of the circuit's medical team on condition that they sign up for three years and front up for a set number of events, not just the high profile ones.

From talking to Michael afterwards, a decent proportion of candidates do sign up, which helps the recruitment and retention drive; another hot topic that generated quite a bit of debate. I hope to get Michael on to the Rollcage Medic Podcast to talk more about the RTTLS course and a few other topics before too long.

The role of the CMO (and DCMO)

Rik gave a good, concise presentation that brought out all of the different tasks that face a chief medical officer, including some that are not immediately obvious if you haven't thought about them. For more information on this, Dr Sean Petherbridge (@UAECMO) who is the chief medical officer for several motorsports in the U.A.E., has written “Managing the Motor Sport Medical Team: The Good CMO Guide

First on scene training

This is becoming a hot topic with the FIA and a number of ASNs. Given the rally focus of this meeting, it was made clear that the logistics of rescue are very different to circuit events due to the long, single direction, point to point stages spread out over a wide competition footprint with little or no direct vision in race control. The role of real time GPS tracking of competitor vehicle position and status and potentially that of key officials, including the medical response vehicles, was highlighted.

Also emphasized was the fact that the most likely person to be first on scene of a crash is the competitor immediately behind. This has led to moves to train competitors in basic life support and clear communication, which is now a pet project of Jean Duby's. He has started to set up a program whereby all WRC competitors must attend a tailored BLS course at the start of the season. Once passed, they revalidate every three years. The details of the course are in the pdf file attached to this post.

It's a good start and something ASNs should be doing at national level. If your ASN is already doing this, whether for rally or circuit events, I'd love to hear about it, so drop me a line or put something in the comments section below.

Workshops

It wasn't all didactic. There was a couple of workshops that went through extrication maneuvres, including the one and two person Rautek, and two multicasualty rescue scenarios that highlighted dynamic changes in clinical condition and the ability to rapidly triage, treat and co-ordinate resources.

In the end, while it's a pity that the FIA's Serious Injury Database was never properly explained or explored, the meeting was quite useful, mostly for facilitating discussion between the Asia-Pacific ASNs and bringing about the launch of the Asia-Pacific Motorsport Medical Network. Perhaps from that we will see a new era of co-operation between groups with a vested interest in evolving the growing area of motorsport medicine and rescue.

As always, leave your comments and opinions below.