‘The Medical Supervision of Motorsport’
Dr Paul Trafford, Wirral University Hospitals
The meeting was introduced by the LMI President, Dr Roger Franks, who welcomed everyone to the meeting and invited the LSA President, Dr Janice Fazackerley, to take over proceedings. Dr Fazackerley introduced the speaker, Dr Paul Trafford who began by introducing the organisation for whom he worked, the FIA which is the governing body for world motor sport. In addition there is also the FIA Institute, an international not for profit organisation that develops and improves motor sports safety and sustainability and the FIA Foundation, an independent UK charity which supports the promotion of road safety internationally, the environment and sustainable mobility as well as funding motor sports safety research. Dr Trafford then paid tribute to Professor Sid Watkins who had recently died in November 2012. He was a Liverpool University graduate and had made a major contribution to the medical safety of Formula One drivers over the last 30 years,
Dr Trafford then showed a video of one of the first major accidents in motor racing at the Le Mans 24 hour race in 1955. This had resulted in 83 deaths, mainly among spectators with a further 122 with serious injuries. This tragedy highlighted the complete lack of medical response and facilities resulting in no help being available for injured drivers and spectators. He contrasted this with the race today where up to a quarter of a million spectators may be present with a medical service cover of over 60 doctors with a similar number of nurses and 25 ambulances being immediately available.
Dr Trafford then looked at motor racing fatalities worldwide between 1990 and 2008 and noted there were 55 deaths in total just in 2008. He commented that deaths on racing circuits were going down whereas those associated with rallying were increasing and this figure did not include deaths of spectators.
Dr Trafford then talked about biomechanics which is the study of the mechanism of injury and tries to quantify human tolerance levels and therefore the prediction of injury. He showed the effects of different types of crashes on the body with injuries to the neck being common to all sorts of impacts. In Formula One, all crashes are individually investigated and Dr Trafford demonstrated this by looking at two which happened in the same place at the Monaco Grand Prix. Both drivers survived principally due to the design of crash barriers and Dr Trafford revealed how these had been tested. Interestingly the best barriers seemed to be old tyres tied together except for head-on collisions when cars tend to go through them. He then looked at other types of crash investigation and simulation including the use of crash test dummies, cadaveric studies and digital models, the latter being one of the best but most expensive. The science of injury risk assessment has been developed because of the amount of data now available following accidents with their resultant type and severity of injury. It therefore becomes possible to establish which kinds of impact causes which types of injury. This provides engineers with sufficient data to design systems that can help to prevent these injuries in future.
Dr Trafford spoke about head injuries. The severity of a head injury can be predicted by the HIC (Head Injury Criterion) score which was derived from crash test dummy experiments. The use of crash helmets greatly reduces the incidence of head injury. Another piece of recently introduced equipment is the HANS Device which helps to stop the head whipping forward following an impact causing fractures to the base of the skull.
Next Dr Trafford showed the dangers of rallying with videos of the consequences of two accidents. This demonstrated the relatively isolated nature of rally driving and the difficulty of getting medical personnel to the scene of the accident rapidly. As a consequence, rally drivers are now taught basic first aid because often one of them is not actually injured and they can attend to their co-driver immediately. Indeed, the following rally cars usually arrive at one minute intervals as opposed to medics who often take, on average, upto 10 minutes to attend.
Dr Trafford discussed the dangers of fire; he demonstrated this with a video from 1973 showing a racing car on fire with the only rescuer being a fellow driver. The lack of fire fighting equipment was obvious and as a result the driver died. This danger has not gone away, as a recent fire in the pit area during defueling after a Formula One race demonstrated. As the race had finished, many of the fire appliances had already left the circuit. One of the major problems is the poisonous nature of the smoke because of the burning plastic and carbon fibre. His final video was of a touring car race in Suzuka, Japan. An accident between two cars had caused a massive fire and the only personnel available were fire fighters who started to extinguish the fire. They eventually dragged the driver out of the car who appeared dead but then started to move. The fire fighters continued to fight the fire until a minibus arrived and the injured driver was thrown in and driven off. This recent video demonstrated the continuing poor medical facilities at motor racing even in first world countries.
Dr Trafford then looked to the future which he said included education. This was absolutely vital because motor racing was now going to countries with no tradition of this sport and therefore no idea what to do when injuries occur on the track. Training was also important particularly for paramedics who he thought were often better at dealing with injured drivers than doctors. Research was also important particularly in extricating drivers. He commented that in the US, the protocol for any injured racing driver was to have a full body CT scan which was the equivalent of 700 chest x-rays and this could be done several times a year if drivers regularly crashed. He commented that a far more clinically based approach was needed where drivers were medically assessed. If they were conscious and had no pain they should be allowed to get out of their cars themselves if able to do so, without the use of collars and other traditional safety equipment. He commented that medics and paramedics were fearsome about putting intelligence before protocol because of the perceived threat of litigation. He thought that future safety developments such as new helmets, safety belts etc would further improve driver’s survival after crashes.
Dr Fazackerley thanked Dr Trafford for his talk and after a number of questions from the floor asked Dr Colin Hopkins to give the vote of thanks.
6th February 2013