Medical Plan - Team Medical Australia
Transcription
Medical Plan - Team Medical Australia
2016 Medical Response Plan World Superbike Championship February 26 - 28, 2016 Phillip Island Grand Prix Circuit Dr Brent May Chief Medical Officer Contents Introduction 4 Execution 5 Medical Response 5 Trackpost 5 Alpha Vehicles 5 Medical Intervention Vehicles (MIV) 7 Track Medical Centre 8 Clinica Mobile 9 Spectator Medical Service 9 Evacuation 9 Receiving Hospitals 11 Operation 12 Fallen Riders 12 Management of a Serious Injury - CODE 3 RIDER 12 Traumatic Cardiac Arrest 13 Critical Incident 14 Concussion 14 Major Incident or Mass Casualty Incident 15 Flat Track 15 Education and Training 16 Professional Conduct 16 Command 17 Command Structure 17 Chief Medical Officer 17 Deputy Chief Medical Officer 18 Medical Centre Director 18 Medical Centre Manager 18 Medical Seniors 19 Communication 20 Communication Guidelines 20 Incident Communication 20 Examples of Communication 21 Personal Communication 22 Dr Brent May - Chief Medical Officer Page 2 Safety Appendice 22 23 Appendix 1: Track Medical Team Position 23 Appendix 2: Medical Team Equipment 24 Appendix 3: Helicopter Notification 25 Appendix 4: Officials Health Document 25 Introduction This Medical Response plan describes the medical service for the 2016 World Superbike event to be held at the Phillip Island Grand Prix Circuit, Phillip Island, Australia on February 26 - 28, 2016. The event is round 1 in the international World Superbike competition and comprises Superbike and Supersport classes and will be supported by the Australian Superbikes, Supersport and Historics Classes. The medical service will operate from 0700 -1900 daily from Friday through to Sunday. A limited medical service will be available from 0900 - 1800 on Thursday during “Bump In”. The Track Medical Response is comprised of: • Trackposts • Pit lane post • Patient Transport Vehicles - Alpha Vehicles • Medical Rapid Intervention Vehicles - Medical Car 1 and 2 • Medical Intervention Vehicles • Track Medical Centre • Medical Helicopter • Ambulance Vehicles • Race Control Medical personnel will be located on trackposts, in vehicles, in the medical centre and in Race Control. This Medical Response Plan meets the requirements of the 2015 FIM Medical Code Updated (http://www.fim-live.com/fileadmin/alfresco/6572001_ang_MEDICAL_CODE.pdf). It provides details of the Track Medical Response for the event and demonstrates all phases of the incident and medical response involved to a fallen/injured rider. The medical code also describes the assessment process for injured riders as well as guidelines for specific injuries. Dr Brent May - Chief Medical Officer Page 4 Execution Medical Response The medical response to a fallen rider occurs with four ‘Roles’ being completed by teams and utilising various resources. Role One: Immediate assessment and initial management of the rider at the scene Role Two: Transport to the Medical Centre with ongoing treatment Role Three: Assessment and management at the track medical centre Role Four: Transport to hospital for definitive care Trackpost There are 16 trackposts located around the track in positions most likely to be able to respond to a fallen rider (See appendix 1). Each trackpost is staffed by two to three medical officials (Paramedical, Nurses, First Aider or Doctor). Each post will be equipped with a spineboard, cervical collar, foam head block and an Initial Management Box. The trackposts are to immediately respond to a fallen rider and aim to reach the rider in a time of 30 seconds. They are to assess and provide initial trauma management to the rider. Safety of all officials is paramount. The trackpost should make their way to the closest point behind the tyre wall to the injured rider before crossing over the tyre wall to the rider. They should not enter onto the track surface until it is safe to do so AND have been instructed by Race Control. Pit Lane Trackpost There will be a Trackpost located in Pit Lane. Their function is to provide rapid assessment and initial management to any pit lane incident. They will be located in an appropriate, safe position in Pit Lane for all sessions. During Race starts, they will be located near Pit Exit to provide rapid response to any major start line incident. This will only occur under the direction of Race Control and will only occur under a Red Flag situation. Alpha Vehicles Alpha Vehicles are Patient Transport Vehicles and will be staffed by a full time driver and other medical personnel. They will have dual functions: to act as a trackpost (Role 1) and to transport injured riders from the scene to the Track Medical Centre (Role 2). They will be of two types located around the track (See Appendix 1) Alpha Vehicle (FIM Type B) There will be four Type B Alpha Vehicles used for medical response and will have a dual function. The Alpha crew will both act as a trackpost and as a transport vehicle. The vehicle may be required to move from its post to move to another incident. The vehicle should only move on the direction of Race Control. These Alphas will be staffed by a driver, a doctor and two paramedical staff. If the Alpha is required to transport a rider from its home position, or move from its position to another incident, the Driver and Doctor will remain in the vehicle while the two other staff remain at the trackpost to continue to respond to fallen riders. The Spineboard, Collar, one Radio and the Initial Management Box should remain at the trackpost. These Type B vehicles will carry: • Trauma Kit (Dressings, Burn Management, Thoracocentesis equipment) • Resuscitation Kit (Drugs, Fluids, Airway Equipment) • Medication for Resuscitation and Analgesia • Monitoring/Defibrillators • Oxygen • Suction • Spineboard • Cervical Collar • Patient trolley Alpha Vehicle (FIM Type C) There will be four Type C Alpha Vehicles used for medical response and will have a dual function. The Alpha crew will act as primarily as a trackpost but can also be utilised as a transport crew. The vehicle should only move from its position on direction from race control. These Alphas will be staffed by a Driver and two to three paramedical staff. If the Alpha is required to move from its position to another incident, the Driver will remain in the vehicle while the two other staff remain at the trackpost to continue to respond to fallen riders. The Spineboard, Collar, Radio and the Initial Management Box should remain at the trackpost. When the driver arrives at the scene of the incident, the trackpost crew will load the injured rider into the vehicle and will accompany the rider and vehicle to the medical centre. If there is an MIV at the incident, the trackpost will remain at their post after loading the rider and the staff from the MIV will accompany the rider to the medical centre. These Type C vehicles will carry: • Oxygen • Suction • Spineboard • Cervical Collar • Patient Trolley • First Aid Equipment Dr Brent May - Chief Medical Officer Page 6 Medical Intervention Vehicles (MIV) These are FIM Type A vehicles appropriately equipped and staffed to provide rapid response to any significant incident or rider injury and to provide initial resuscitation and management of significant injuries (Role 1) and may assist in transport of more critical patients (Role 2). MIVs will respond as directed by Race Control to an incident. When placed on Standby, the crew must be in their vehicles, belts on and ready to respond with the engine running. Beacons must ONLY be used when responding to an incident. All MIVs will be on Standby for the first 3 laps of every race and at anytime of a Red Flag intervention, or the stopping of a practice session. Once at the scene, the Doctor will act as the Team Leader and will institute and guide management. This Team Leader should remain with the injured rider until they arrive at the medical centre where a formal handover should take place. FIM Medical Rapid Intervention Vehicles - Medical Car 1 and 2 There will be two fully equipped high performance vehicles to provide rapid on-track response to a fallen rider to supplement the initial assessment and interventions provided by the initial responders. They will be located at Pit Exit and Turn 5. Each of these MIV’s will be staffed by: • A Doctor • A Paramedic/Nurse • A Driver experienced in motorsport These vehicles may respond at any time for a red flag situation, or if practice is stopped, due to a fallen rider after approval by the clerk of course and race director. These vehicles will be supplied fully equipped including: • Oxygen • Airway Equipment • Resuscitation Equipment • Monitoring/Defibrillators • Medications for Resuscitation and Analgesia • Trauma Equipment (Dressings, Burn Management, Thoracocentesis equipment) These vehicles will be used to chase all races. Chase procedures will be; Medical Car 1 will join the end of the field as they enter via Pit Exit or Turn 5. It will remain under the bridge on the main straight (rider’s left) as the field leaves for their Warm-Up lap. It will then pull behind the field for the Race Start. It will follow the field for the first lap and return to its position via Pit Entry. Medical Car 2 will join the field as they pass or enter via Turn 5. It will follow the field to the rear of the grid. It will follow the field on their Warm Up and exit at Pit Entry. It will then make its way to position at Turn 5. Medical Intervention Vehicles There will be three other Medical Intervention Vehicles (MIV 2, 8 and 12) located around the track. (See Appendix 1). These will be four door vehicles appropriate for their purpose. The MIV’s will be able to provide both on track and off track response to supplement the initial response. Each of these vehicles will be staffed by: • A Doctor • A Paramedic or Critical Care Nurse • A Driver These vehicles will carry: • Oxygen • Airway Equipment • Resuscitation Equipment • Cervical Collars • Monitoring/Defibrillators • Medications for Resuscitation and Analgesia • Trauma Equipment (Dressings, Burn Management, Thoracocentesis equipment) MIV 8 and 12 will also support the medical response via logistic, educational and administrative roles. This is an important function of these vehicles and will occur throughout the event. Track Medical Centre The Track Medical Centre function is to provide further assessment, resuscitation and management of rider’s injuries (Role 3). It may also be used to treat other personnel (Teams, Officials, Staff) as required. It is not intended to treat spectators and will only do so after PRIOR approval by the Chief Medical Officer. The medical centre is a secure permanent facility located at the northern end of the paddock area with an attached helicopter pad (See Appendix 1). It will have the ability to treat two time critical and four stable patients at any one time. It has 2 fully equipped resuscitation areas and four treatment areas. It has radiology facilities including Digital Xray and ultrasound. The medical centre also has reception facilities, toilets and comfort areas. The medical staff will include (at a minimum): • The Medical Centre Director (Assistant CMO) • Two additional specialist doctors with training in Anaesthesia, Emergency Medicine, Intensive Care or Surgery • Medical Centre Manager (Nurse) • Six Nurses with experience and training in critical care nursing • One Radiographer • One Medical Equipment Officer who will ensure all equipment is functional and appropriate for use • Two Administration Staff Dr Brent May - Chief Medical Officer Page 8 Clinica Mobile For many years the CLINICA MOBILE, or its personnel, under the direction of Dr Claudio Costa, has attended GP and SBK events and has gained a considerable reputation among riders and support personnel. The CLINICA MOBILE personnel will treat those riders who wish to be treated by them only after they have been seen by the CMO or track medical personnel. The CMO should declare riders medically fit or unfit as normal, after which they may go to the CLINICA MOBILE if they wish. The CLINICA MOBILE personnel will give a medical report to the CMO after assessment and treatment. A rider who has been declared medically unfit to compete, who after treatment by the CLINICA MOBILE personnel then wishes to race, must present himself back to the CMO for re-examination. The final decision on fitness to compete remains with the CMO. Spectator Medical Service The medical service for the public will be provided by a combination of St John and Ambulance Victoria. Any member of the public that requests assistance from the Track Medical Service will be referred to one of the First Aid posts. In an emergency, the track medical personnel may treat a member of the public until further resources arrive. Members of the public will only be referred to the Track Medical Centre after agreement between the Event Command and the Chief Medical Officer. Evacuation Patients that require further investigation or treatment will be transferred to one of the receiving hospitals (Role 4). This decision will be made by the medical centre staff in discussion with the CMO and the Ambulance service. The method of transport and destination will be based on the clinical need of the patient. The two main methods of transportation will be via Ambulance Victoria road vehicle or via the Medical Evacuation Helicopter. Ambulance Victoria Road Vehicles There will be two Ambulance Victoria vehicles based at the medical centre. These vehicles are dedicated to the track medical service and will be used for the transport of patients as required by the medical centre staff. These vehicles may also be required to transport patients from trackside to the track medical centre. The paramedics should have a working knowledge of the access points and turn numbers around the track. These vehicles will be fully equipped as per Ambulance Victoria standards and will be staffed by two ALS paramedics. In exceptional circumstances, the vehicle may also have the addition of a doctor for transport. This would occur only after discussion between the Ambulance service and the CMO. These vehicles will return to the medical centre after completing their transport to the appropriate receiving hospital. Medical Evacuation Helicopter There will be a dedicated medical helicopter for the transport of appropriate patients, as decided by the CMO or his delegate, to the Primary Receiving Hospital. The helicopter will be based at the helipad immediately adjacent to the medical centre. This area will be reserved for the medical helicopter and the will be kept clear of obstruction or other vehicles that may pose safety concerns. Patients will be accompanied by a doctor familiar with aeromedical medicine and safety. In complex or unstable patients, a second doctor or nurse may accompany the transport. Safety briefings and loading practice will occur each morning on the helicopter pad. Dr Brent May - Chief Medical Officer Page 10 Receiving Hospitals The Primary Receiving Hospital will be the Alfred Hospital. This hospital is a designated state Major Trauma Service including a full range of medical and surgical specialties, 24 Hour operating suite with a full time Emergency Theatre and a 48 bed Intensive Care unit. The emergency department also has a CT scanner and MRI. The hospital can receive both air and road transported patients. The alternative Major Trauma Service is based at the Royal Melbourne Hospital. The Secondary Receiving Hospital is Dandenong Hospital. This hospital can provide care for non-urgent and minor injuries including orthopaedic services. Several private hospitals will be utilised for non-urgent management of patients. A number of specialist surgeons are available for the management of these patients and will be consulted as required. Notification of a helicopter transfer will occur using the flowchart in Appendix 3. Alfred Hospital - Commercial Rd, Prahran Epworth Hospital - Bridge Rd, Richmond Operation Fallen Riders When a rider falls, the nearest Trackpost or Alpha should immediately communicate the incident and ‘code’ to Race control (see section on Communication). If the rider appears uninjured, the Trackpost or Alpha should not proceed over the tyre wall. The trackpost should remain behind the tyre wall motioning towards the rider to meet them at the nearest access point. The medical personnel should then further assess the rider for any injuries. If the rider is uninjured, the rider may return to the pits on a “Boundary Rider”. If injured, the rider should wait for an appropriate vehicle to transport the rider to the Medical Centre for further assessment. Medical personnel should respond to any rider that appears injured. They should carry their Spineboard and Cervical Collar with them to the injured rider. The Initial Management Box should be left in position and should only be used to manage a rider once they are back behind the tyre wall. If the rider has minor injuries and is able to walk, the Trackpost should assist the rider to behind the tyre wall where further assessment can occur. If the rider is unable to walk, or has suffered significant injuries, the Trackpost should place the rider on the spine board and carry the rider to behind the tyre wall. The trackpost will require the help of other track marshals to carry the board. They should instruct track marshals on all phases of the removal of the rider from the incident. Track marshals may also place “Medical Bales” near the scene to warn other riders of the medical response. Safety of all officials is paramount. Medical personnel should make their way to the closest point behind the tyre wall to the injured rider before crossing over the tyre wall to the rider. Management of a Serious Injury - CODE 3 RIDER The indication(s) that an injury is immediately life threatening includes any of: · Unconsciousness (i.e. unresponsive or responsive to painful stimuli only) · Absent, minimal respirations, abnormal breathing or a threatened airway requiring immediate definitive airway management · Absent carotid or radial pulse in the presence of abnormal consciousness · Significant injury likely to threaten life (e.g. traumatic amputation, penetrating injury, severe back or neck pain) All management of injured riders should follow established Advanced Trauma Life Support (ATLS) and Early Management of Severe Trauma (EMST) guidelines. Initial responders should institute Basic Life Support (BLS) protocols until advanced care personnel arrive. In the event of a patient arrest, Australian Resuscitation Council protocols should be followed. On advice to the CMO and the Clerk of the Course, from the medical crew at the scene, the following guidelines should apply: Dr Brent May - Chief Medical Officer Page 12 Race Control · Race Modification - Yellow or Red Flags as appropriate · Notification and mobilisation of nearest MIV +/- Medical Car to the scene · Notification and mobilisation of an Alpha to the scene · Notification of the Medical Centre · Notification of Event Control, Medical Director, Dorna, Race Secretary and Circuit Representative · Designation by the CMO of the incident as a “Medical Alert” or “Critical Incident” as appropriate At the Scene The patient should remain at the scene until safe to transport · Helmet removal · Immobilisation of the spine · Immediate airway management (assisted ventilation +/- intubation as required) · Cardiopulmonary resuscitation (as required) · Treatment of any Catastrophic Bleeding/Exsanguination · Attendance at the scene by the Clerk of the Course, CMO and Medical Director as required Transport · Continued resuscitation and stabilisation of patient · Loading in the vehicle once appropriate · Transfer to the medical centre with the appropriate crew At the Medical Centre · Continued resuscitation and stabilisation of patient · Notification of the external receiving hospital · Transfer to the external receiving hospital by Medical Evacuation Helicopter Traumatic Cardiac Arrest A rider that is unconscious and not breathing should be assumed to be in cardiac arrest. In addition to the procedures detailed above, management of the rider should include the following management should occur in parallel; • Control of External Haemorrhage • Use of pressure and Combat Arterial Tourniquets • Pelvic Splint application • Exposure of chest, arms and legs • Airway/Breathing management • Initially by Bag-Valve-Mask until equipment and experienced personnel are on site and ready for endotracheal intubation. 100% Oxygen. • Cervical Collar Application • ETCO2 monitor/detector preparation and attachment • Endotracheal intubation by an experienced doctor • Ongoing Ventilation maintaining ETCO2 30-35mmHg • Circulation • Commence CPR - Rate 100/min, Ratio 30:2 compressions:breaths • Check for pulse - Femoral (carotid if femoral unavailable) • Apply defibrillator - assess for shockable rhythm • Decompress the chest if tension pneumothorax suspected - Finger thoracostomy (5th ICS AAL) or needle thoracostomy (14g Long cannula 2nd ICS MCL) whichever you are trained in • IV or IO access - 2000ml crystalloid as a bolus • Adrenaline - 1mg IV, every 4 mins/2 cycles if the above has been unsuccessful. Adrenaline is unlikely to be of benefit in traumatic arrest so other treatments should take precedence Prompt, safe transport to the Medical Centre should occur with ongoing CPR. Critical Incident If an incident is of appropriate severity or is potentially/actually life threatening, the Chief Medical Officer will declare a “Medical Alert”. This allows for all personnel to be aware that an incident of a serious nature has occurred and the focus of the organisation is on that incident. It will also alert other parties including Victoria Police and Motorcycling Australia. If the incident progresses to the loss of life or remains of significant concern, the Chief Medical Officer will declare a “Critical Incident”. This will institute a multi-agency response as detailed in the Critical Incident Protocol. Please refer to the Critical Incident Protocol and associated documents for detailed information of the roles and procedures. Concussion Concussion, or mild traumatic brain injury, is a potentially serious injury and should be treated as such. It is defined in the Consensus Statement1 as a complex pathophysiological process affecting the brain, induced by biomechanical forces. 80-90% will have resolution in 10 days but most will not in the first 72 hours including postural instability and inattention. A rider does not have to lose consciousness to suffer concussion. As per the FIM medical code, all concussion should be managed as per Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport. Management for this event will include; • Assessment by SCAT3 documentation available at the medical centre • Re-evaluation, if necessary, by the same documentation and a formal Return-To-Play process • No rider will be allowed to return to riding on the same day as a concussion 1 McCrory P, Meeuwisse WH, Aubry M, et al. Consensus Statement on Concussion in Sport. Br J Sports Med 2013;47:250–258 Dr Brent May - Chief Medical Officer Page 14 Alternative to the Maddock’s Questions - Part 2 of SCAT 3 Assessment “I am going to ask you a few questions, please listen carefully and give your best effort.” 1 point for each correct answer. Which circuit/track/venue are we at today? Which session were you riding in when the incident occurred? Where on the track/which corner did the incident occur? Where was your last race or event? In which position did you finish your last race? Orientation Score of 5 Major Incident or Mass Casualty Incident In the event of a major internal or external incident, or a mass casualty incident, the State Health Emergency Response Plan (SHERP) and/or appropriate sub-plan will be activated. The Health Commander will coordinate the health and medical response to the incident. The Chief Medical Officer will act as in a role similar to a Field Emergency Medical Officer (FEMO) until such time as a FEMO arrives on-site. The main role will be to integrate the Track Medical service into the Health Incident Management Team. Track medical service doctors with appropriate knowledge, skills and training may be designated as Team Leaders. For further information, please refer to the Emergency Management Plan for the event. Flat Track The Troy Bayliss event will be held in the event precinct at the same time as the Superbike Event. The medical services required for the supercross track will be fully independent and will not utilise any of the Track Medical Service personnel, resources or facilities. In the event of a major incident at the flat track, the medical service provider must have a comprehensive plan that will not impact on any of the track operations or on the Track Medical Service. In the situation where the flat track resources are depleted, the event will be suspended until such time as there are sufficient resources onsite to meet the requirements of the event. Education and Training A comprehensive education and training will occur with respect to all aspects of the medical response. It will comprise both online and personal education components. The educational model will include: • Medical Training Night (Compulsory) • Published and distributed Medical Response Plan • Published and distributed Guidelines • Online learning package • Continuous Online Learning via Facebook and Twitter (Click on Links) • Track Briefing and Debriefing each day • Practical Training Session (Thursday Afternoon on-track) • Continuous On-Track education by the Medical Seniors The model will also include continuous Quality Assurance and Risk Management activities. Professional Conduct The medical team is group of professionals aiming towards the same goal. It should be a rewarding and enjoyable event for all involved. Professional and appropriate conduct must be maintained at all times. No information regarding riders, their injuries or “status” should be communicated by any members of the medical team. Social media use should be restricted to time between sessions and should not be unprofessional. The use of social media for personal comments should be appropriate and not negatively reflect the event. All behaviour should be appropriate and should not negatively impact on another team member’s enjoyment of the event. In particular, sexual harassment or misconduct will not be tolerated by any official or spectator. This can be obvious or indirect, physical or verbal, repeated or a one-off. Any such conduct, or if you feel uncomfortable at any time, should be reported to a senior medical official or the CMO immediately. Dr Brent May - Chief Medical Officer Page 16 Command Command Structure Ambulance Representative " Chief Medical Officer The Chief Medical Officer is responsible to the Clerk of the Course, and will: • Be responsible for the organisation and operation of the track medical service • Assess the fitness of competitors to take part in events • Arrange for the transport and treatment of all patients resulting from track incidents • Make decisions on the further treatment and transport to hospital of patients, as appropriate • Ensure that the documentation for each patient has been completed and passed on to the Secretary of the Meeting on the same day • Advise the Clerk of the Course on the placement of emergency vehicles and medical posts at the circuit • Advise the Clerk of the Course on the appropriate medical response to competitors who may be injured during practice and racing • Attend serious or potentially serious incidents, when required • • • • Remain in direct contact with Race Control at all times during the meeting Be in contact with the Medical Director prior to and during the event Liaise with the Health Commander and Emergency Services Attend Race Organising Committee meetings and advise the committee on medical requirements and resources for the Track Medical response Deputy Chief Medical Officer The Deputy CMO will: • Replace the CMO in the event of incapacity, absence, accident or illness. • Be an additional doctor for the medical centre including providing expert opinion and ensure the appropriate clinical guidelines are followed • Advise the CMO of injured riders and complete the appropriate documentation • Confirm all appropriate documentation is complete on each patient seen • Guide decisions on appropriate transfer of patients from the medical centre to hospital • Remain in contact with the Medical Centre, CMO and Race Control at all times Medical Centre Director The Medical Centre Director will: • Be a senior leadership role • Be based in the medical centre providing expert opinion and ensure the appropriate clinical guidelines are followed • Assess riders for fitness to compete and inform the CMO of fitness as soon as it has been decided • Advise the CMO of injured riders and complete the appropriate documentation • Confirm all appropriate documentation is complete on each patient seen • Guide decisions on appropriate transfer of patients from the medical centre to hospital • Liaise with the CMO and the Ambulance service with regard to timing and urgency of patient transport • Remain in contact with the Medical Centre, CMO and Race Control at all times Medical Centre Manager The Medical Centre Manager is a senior critical care nurse who will: • Ensure the effective functioning of the Track Medical Centre • Roster and ensure effective staffing of the Medical Centre • Ensure effective triage of all ambulatory and non-ambulatory patients is performed upon arrival at the Medical Centre • Ensure the correct preparation and maintenance of all Medical Centre equipment. • Maintain both verbal and written communication flow with Race Control, by direct phone or radio, regarding all matters involving the Medical Centre • Ensure effective liaison with patients, their families, friends and team members when they are being treated by the Medical Centre staff • Liaise effectively with ambulance, helicopter and all staff regarding effective transfer of patients from the Medical Centre to secondary treatment facilities • Ensure effective communication and relationship management with referring health facilities • Maintain a direct liaison with the Chief Medical Officer Dr Brent May - Chief Medical Officer Page 18 Medical Seniors Medic 1 A paramedic with extensive experience in motorsports and trauma. Their role includes: • Medical response from MIV 8 as required • Ongoing education and training of medical staff • Logistic and welfare support of the medical team • Quality Assurance and Risk Management activities Medic 2 A paramedic with extensive experience in motorsports and trauma. Their role includes: • Medical response from MIV 12 as required • Ongoing education and training of medical staff • Logistic and welfare support of the medical team • Quality Assurance and Risk Management activities Medic 3 A senior medical official with extensive experience in motorsports and education. Their role includes: • Medical response from MIV 8 as required, based with Medic 1 • Ongoing education and training of medical staff • Logistic and welfare support of the medical team • Quality Assurance and Risk Management activities Communication There will be a dedicated medical radio channel in operation throughout the event. This will be the primary mode of communication. All communications will go through the Medical Communicator in Race Control. No communications should be point-to-point. A secondary radio system will be provided by Team Medical Australia and used for senior medical personnel. The primary use of this MedNet is for logistics and administrative functions. This will also provide an alternate channel in case of main channel failure. A direct phone system will operate between Race Control and the Medical Centre. This will include a ‘Hotline’ as well as a separate dialled line. Communication Guidelines All communications from points should begin with “Race Control this is . . . . . “ followed by your designated call-sign eg “Race Control this is Trackpost 2 A”. Call-signs will be designated as per the track position or vehicle you are located in (See Appendix 1). Communications of serious incidents should take priority over minor incidents or administration or logistic issues. Listening to the radio prior to initiating a communication is important. Incident Communication When a rider falls, there are several pieces of information that should be communicated: Call-sign, Location, Number of Riders Down and Medical Code. Location The location of the incident/fallen rider “Rider Down” by Turn Number and Side (Rider’s Left or Rider’s Right). Number of Riders Down and Bike Numbers The number of riders down should be reported if multiple riders have fallen. Prioritise the most serious incident first. If possible, Bike Numbers should also be communicated. Dr Brent May - Chief Medical Officer Page 20 Medical Code Medical Codes are used to quickly communicated the seriousness of the incident and the likely time taken to clear the rider. Code 0 No medical intervention required Rider gets up unassisted Code 1 Short Rescue Rider able to walk with assistance Rider will be cleared from track in less than 1 minute Code 2 Long Rescue Rider requires stretcher Rider will be cleared from track in less than 2 minutes Code 3 Prolonged Rescue Rider(s) seriously injured Rider(s) requires stretcher Rescue will take longer than 3 minutes Medical intervention required on track In addition, you may be asked for a “status” or “condition” update for Code 3 riders. The following information should be provided: Conscious Level Conscious or Unconscious. A formal GCS is NOT required. Breathing Breathing Normally or Abnormal Breathing or Not Breathing Significant Injuries A very brief summary of major injuries sustained. e.g Head Injury and Arm Injury, Shoulder Pain. Examples of Communication Example 1: Fallen rider at Turn 4 who gets up and walks normally TP8 “Race Control this is Track 4” RC “Go Ahead Track 4” TP8 “Rider Down Turn 4, Rider’s Left, Bike #1, Code 0” All Code 0 calls are low priority and should only be done if the radio is clear and no other incident is being dealt with. Remember, you should not cross over the tyre wall for Code 0/ uninjured riders. Example 2: Two Fallen Riders at Turn 2, one who is unable to walk with an injured leg TP2A “Race Control this is Track 2A” RC “Go Ahead Track 2A” TP2A “Two Riders Down Turn 2, Riders Right, one Code 2 and one Code 0” You should respond immediately to the Code 2 rider with your spineboard and collar. Example 3: Fallen Rider at Turn 9, not moving in the gravel trap Alpha 9 “Race Control this is Alpha 9” RC “Go Ahead Alpha 9” Alpha 9 “Rider Down Turn 9, Riders Right, Code 3” You should immediately respond to the rider with your spineboard and collar. Once at the rider you should give further information. Alpha 9 “Race Control this is Alpha 9” RC “Go Ahead Alpha 9” Alpha 9 “Rider Unconscious but Breathing” This will trigger further resources to be sent to the scene including a MIV if required. Personal Communication No medical team personnel should release any information regarding a rider’s status or injuries sustained or any other person being treated. This includes taking photos in and around the medical centre and includes all forms of communication including social media. Medical Team personnel should also be aware not to infringe on copyright laws. Safety Any unsafe conditions, actions or areas should be immediately reported to a senior medical team member. All personnel should provide themselves with appropriate environmental protection including wet weather gear, sunglasses and sturdy footwear. Your green overalls and tabard should be your outermost layer whenever possible. Safety is everyone’s responsibility. Dr Brent May - Chief Medical Officer Page 22 Appendice Appendix 1: Track Medical Team Position MIV12 TP12 TP12A TP12B A2 " A2 Appendix 2: Medical Team Equipment Supplied By The Event Organiser AGPC Equipment • Initial Management Boxes x18 • Trauma Boxes x7 • Resuscitation Boxes x7 • Folding Scoop Stretchers x7 Medical Vehicles • FIM Medical Cars x2 • MIVs x4 - 4 door vehicles with beacons and signage • Track Ambulances x7 with Driver and Equipment Track Medical Centre • Televisions x2 with direct circuit feed • Refrigerator • Photocopier, Fax, Telephone and Internet • Outdoor Heaters x2 • Trestle Tables x3 • Uninterruptible Power Supply (UPS Battery Units) Supplied By Phillip Island Operations • Spineboards x 18 Supplied By Team Medical Australia Medical Centre Equipment • Sonosite Turbo Ultrasound Machine • Zoll EMS Transport Monitor • Glidescope Ranger Video Laryngoscope • Philips MRX Monitors • Lifepak 12 Defib/Monitor • Mindray Patient Monitor • Laerdal Suction Units x3 • Agfa CR Digital Xray Equipment • Portable Xray Machine • Oxygen Vehicles • Track Ambulance with equipment Medical Equipment • Portable Defibrillators x3 • Initial Response Kits x3 Medical Evacuation Helicopter • Helicopter and Pilot provided by RotorLift with appropriate internal fit-out for medical services Ambulance Victoria Vehicles • AV Vehicles x2 with ALS Paramedic staff Communications • Appropriate Communications equipment for all trackposts, medical vehicles, senior medical personnel and the track medical centre Dr Brent May - Chief Medical Officer Page 24 Appendix 3: Helicopter Notification See separate document Appendix 4: Officials Health Document See separately distributed document or Marshall’s Book Dr Brent May - Chief Medical Officer Page 25