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DR Rik Hagen CMO Rally Australia. Address by Dr Rik Hagen To FIA Medicine in Motor Sport Summit Valencia 19 th September 2010 . DRIVE.DR. A USEFUL EDUCATIONAL TOOL OR JUST ANOTHER ACRONYM. D R I V E . D R. DRIVE.DR. D = Discovery R = Response
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DR Rik Hagen CMO Rally Australia
Address by Dr Rik Hagen To FIA Medicine in Motor Sport Summit Valencia 19th September 2010 DRIVE.DR
A USEFUL EDUCATIONAL TOOL ORJUST ANOTHER ACRONYM D R I V E . D R
DRIVE.DR D = Discovery R = Response I = Initial Intervention – Extrication & Treatment V = Verification of injuries and Stabilisation for transport E = Evacuation D = Definitive Treatment R = Repatriation
DISCOVERY Who discovers the Incident/Accident How do they discover that it has occurred How do they communicate this to the Response Team
RESPONSE Who responds and what level of expertise and equipment should they have? How is the Course/Environment made SAFE for the Responders? How do they get to the site of the Incident/Accident What is an acceptable time frame for this to happen in How do they communicate their findings and requirements to the Event Organisers
INITIAL INTERVENTIONExtrication & Treatment What Equipment and Expertise is required for Fire Suppression and Extrication Who does the initial Medical Treatment and what level of Equipment and Expertise is required ATLS Principles
VERIFICATION&Stabilisation of Injuries for Transport Where does this occur (“Stay & Play” or “Scoop & Run”) Who does this and what level of Equipment and Expertise do they require How do they communicate their findings & requirements to the Event Organisers What Documentation is required
EVACUATIONTo Definitive Care Where should the casualty go How do they get there Who does the Evacuation and what level of Expertise and Equipment should they have What is an acceptable time frame for this to occur in What documentation is required and Who Pays
DEFINITIVE CARE Where and what level of Medical Facility should this be at (i.e. Tertiary Hospital or Trauma Centre) Who pays
REPATRIATION Will there be a period of Convalescence or Rehabilitation required before Repatriation How is Repatriation achieved and is an Escort required What level of Expertise and Equipment should the escort have Who pays
THE TWO PRINCIPLES OF INTERVENTION First and Overriding Principle To get Medical Assistance and Assessment, with good COMMUNICATIONS to the Incident/Accident site as quickly as possible Second but Subservient Principle Minimise the disruption to the smooth running of the Event
DRIVE.DR APPLIED TO EVENTS • Let us now look at how DRIVE.DR can be applied to various motor sport events • I would like to look at the • 2010 Australian Formula 1 Grand Prix • 2009 Rally Australia (WRC) • 2009 Australasian Safari (Off-Road)
2010 Australian Formula 1 Grand Prix 5.8 km circuit at Albert Park in Melbourne 6 Medical Intervention Vehicles 2 Extrication Vehicles 8 “Doctors on Foot”, 4 of these in Pit Lane 6 Ambulances, 4 on Circuit & 2 at Medical Centre Medical Centre has 2 Resuscitation areas & staffed by Trauma and Anaesthetic Specialists Major Tertiary Trauma Centre 5 minutes away by road
2009 RALLY AUSTRALIA Held in Northern Rivers area of New South Wales There were 35 Special Stages ranging from 2.55 kms to 22.41 kms in length Each Special Stage had a Medical Intervention Vehicle at the start, and midpoint for stages longer than 15 kms. The MIVs were dual use Medical and Technical (Rescue capable). 2 MIVs, designated Incident Control Vehicles. 2 “Eye-in-the-Sky” Helicopters plus Evacuation helicopter Transponders in Competing Cars
2009 AUSTRALASIAN SAFARI Off-Road event that involves Motos (Bikes), Autos (modified 4WDs) and Quads (4 wheel bikes). In 2009 it covered nearly 4000 kilometres through the “outback” of Western Australia, approximately 65% of which was competitive stages. (stages up to 250 kms) Joint medical and rescue FIVs, a roving ICV and a Medical Intervention Helicopter, staffed by 2 senior helicopter trained paramedics. Portable Radios carried by competitors (in 2010 these will have GPS locators). No Transponders. Radio coverage by fixed wing airborne repeaters
DRIVE.DR APPLIED TO THESE EVENTS
DISCOVERY AGP - CCTV, Marshals direct observation Communication by Radio or Phone Rally Aust. - Transponders, SOS points, Next competitor Communication by Radio Aust. Safari - Following Competitor/GPS Communication by Radio
RESPONSE AGP - “Docs on Foot”, MIV & Extrication Fire & Rescue Services as required SAFE by Yellow/Red flag + Safety Car Communication by Radio Rally Aust. - EITS Helicopter (observe) & MIV + ICV SAFE by Yellow flags at SOS points Communication by Radio Aust. Safari - Helicopter + MIV (slow response time) SAFE - Live intervention (beacons/radio) Communication by Radio
VERIFICATION AND STABILISATIONOF INJURIES “STAY AND PLAY” OR “SCOOP AND RUN” AGP - Taken to Medical Centre by Ambulance OR Direct to Trauma Centre (3 mins) (“Scoop & Run”) Rally Aust. - Road side by MIV & ICV (“Stay & Play”) Aust. Safari - Roadside by Helicopter crew +/- MIV +/- ICV (“Stay & Play”)
EVACUATION AGP - Land based Ambulance either direct from scene OR from Medical Centre to Alfred Trauma Centre Exempted from mandatory Helicopter Rally Aust. - Helicopter evacuation to Brisbane Trauma Centre (45 minutes) (? Brief land based transfer) Aust. Safari - Helicopter evacuation to nearest hospital (up to 1 hour) then RFDS to Perth Trauma Centre All these at no cost to the Patient
DEFINITIVE CARE AGP - Alfred Hospital Trauma Centre (Tertiary) Rally Aust. - Royal Brisbane Hospital (Tertiary) Aust. Safari - Royal Perth Hospital (Tertiary) after transport delays Payment may be by insurance or reciprocal international hospital agreement. May require cash payment
REPATRIATION (and Rehabilitation) AGP - Depends on injury. Rehabilitation Unit attached to Alfred Escorted International Repatriation is expensive. ? Insurance Rally Aust. - Depends on injury. Rehabilitation Unit attached to RBH Escorted International Repatriation is expensive. ? Insurance Aust. Safari - Depends on injury. Rehabilitation Unit attached to RPH Escorted International Repatriation is expensive. ? Insurance
USE OF DRIVE.DR Introductory courses to Medical Personnel with no Motor Sport experience (i.e. Korean F1 GP) Used to assist Event Organisers understand the requirements for emergency intervention in motor sports Has been used in analysis of a mine disaster
DRIVE.DR Useful Educational tool OR Just another Acronym THANK YOU