CADWELL PARK GUIDE
Working
Day
0830-1800
< Please don't be
late, racing can't start until all doctors are there
>
How to Get
There
Cadwell is the little oval
on the (red) A153, halfway between Horncastle & Louth.
www.multmap.com and use "LN11 9SE" Postcode for
map
- Arrive at the circuit
entrance
- Tell security at the gate that you're the doctor
- Follow the road and head towards the paddock
- In the paddock is a gate that lets you onto the track. If
not open get a marshal (orange overalls) to open it for
you.
- Hazards on and drive slowly - there may be marshals on
track
- Drive through gate and left onto the track (Hall bends)
- Go along Hall bends, down through the Hairpin (right
hander), through Barn corner (right hander) and onto the
start finish straight.
- Along straight, past Race control ( 3 storeys) & pit
lane
- Medical centre is single storey red brick building on
right. (Ambulances & paramedics outside are a clue)
- Hazards off and indicate right into medical centre.
- Drive in front of med centre front door and park by the
helipad (not on it!)
What To Bring
Clothing
Emphasis is
warm, dry and practical. Boots, jeans, warm waterproof
jacket and gloves to protect from the highly variable
“Cadwell microclimate”. It is not unknown to have snow,
sunshine, rain and fog on the same day. The track will
provide high visibility tabards or jackets.
(Top
Tip: never trust the
weather forecast. )
Equipment and drugs
Medical
equipment is provided but bring stethoscope, mobile phone
and some money (for transfers, getting lost, etc.)
Entertainment
Bring lap
top, book or magazine in case you get bored.
Food
Lunch,
chocolate and other snacks are available from the Clubhouse
but is very expensive. Good idea to bring a days worth of
sandwiches and snacks of your own (tax deductible too!)
Miscellaneous
Earplugs if
you’ve got them. (Not a joke – race bikes are very loud)
What Do I
Do?
Before racing starts
• Sign on (this insures
you against injury at the track)
• Put on high visibility doctors coat or tabard
• Check equipment in Resus bays and in the Medical Car
e.g. Defib, O2,
laryngoscopes, ETT, suction, etc.
Top Tip: Check the
equipment is present & working. It’s not like a
hospital where replacement stuff is easily
available.
Your Duties
Although fun, motorsport medicine is a
real job for which you are paid real money. Your duties
include:
1) Avoiding
getting yourself injured (most important)
2) Diagnosis and treatment of minor injuries
3)
Resuscitation & transfer of severe injuries (thankfully
rare!)
4) Certifying
injured riders fit/unfit to race
5) Deciding if riders need hospital review (and at which
facility)
The workload varies from virtually nil to resembling an
A&E shift. There must be 2 doctors present before
racing starts although racing may continue if only one
doctor remains whilst the other is on a hospital transfer.
During racing
Stay within
earshot of the medical centre. If you wander further away
let Matt the Paramedic know where you are.
If there is a crash, race control will inform Matt by
radio. Race control will then....
1) ...inform
that rider is “kilo one nine” (unhurt) or
2) ...request “Medical car stand by” or
3) ...request “Medical car attend incident”
1) “Rider is kilo one nine” / “rider is
unhurt”
We do nothing. The rider waits trackside
until the race/practice is over and may be sent to the
medical centre later for a check up
2) “Medical car stand
by”
Matt and at least one doctor get into the
car. Put your seatbelt on. Once in the car the flashing
lights are turned on and the engine is started. You will
then wait for further instructions from race control. In
practice you will be requested to either stand down (rider
thought to be okay) or attend the incident (possible rider
injury).
3) “Medical car attend
incident”
Matt will drive briskly to the incident.
On arrival at the incident, the car will park in a “fend
off” position to protect the casualty (and you) from moving
vehicles on the circuit. Don't leave the car
until you've checked it's safe to do so.
Marshals will also attempt to protect your position by
placing bales around you and waving flags to inform the
riders to stop racing or slow down. This is not a foolproof
system and you need to be careful. Act under the direction
of the marshals at all times when on the circuit.
Top tip: Your
fluorescent jacket does not make you motorcycle proof!
At the incident
Stick to the basics!
(1) Assess the
scene
Don’t dive straight out of the car. Take time to look at
the scene to make sure it’s safe
and to get an idea of
mechanism of injury and number of casualties.
(2) Assess the
casualty
Ensure manual c-spine immobilisation and rapidly assess
A(c-spine)BCD. You need to rapidly categorize the rider
into:
• Time critical injuries:
Life or limb threatening
• Non time critical
injuries: Everything else
Time Critical Injuries
Aim to
treat Airway, Cspine, Breathing, Exanguinating extremity
bleeding only at trackside. Then decide whether or not to
go to the medical centre for further treatment or packaging
or to run straight for hospital. For time critical injuries
that you can’t handle at the track you should aim to be
heading for hospital ASAP. Continually ask yourself “Why
are we still here?”
Non Time
Critical Injuries
Usually
taken back to the medical centre for further evaluation and
treatment before being discharged from the medical centre
(either to hospital in circuit ambulance, GP, home or
paddock if race fit)
An ambulance will always attend each incident in case any
transfer is necessary.
Top tip: Don’t worry!
Severe injuries are thankfully rare.
Assessing For Race
Fitness
Injured riders will be sent to the
medical centre for assessment of their fitness to race. A
rider must be capable both mentally and physically of
controlling his motorcycle at racing speeds. The assessment
is to protect
other riders as
much as the rider himself. Riders may attempt to ride with
significant injuries to try to get points in their
championship. Riders tend to have high pain thresholds and
tend to be extremely fit, young men. Be aware that they
will often be carrying old fractures/injuries. Some clubs
will send in ALL fallers for medical assessment, no matter
how minor the crash.
There is no standard test
or series of tests (as far as I know). Experienced doctors
tend to invent their own based on experience. I tend to use
physical tests that simulate upper limb braking /
accelerating forces (press ups, squats) and check that
lower limb mobility is sufficient for the rider to move
about on his bike in order to control it. The rider must
have hand and foot function adequate to operate brake,
clutch, gears.
Riders must also be mentally unimpaired and have no central
or peripheral neurological impairment or period of LOC
within the last week.
Above all use common sense. Unless you happen to have a CT
scanner or X-ray machine in your car it is wise to err on
the side of caution and send riders to hospital if you are
in any doubt as to the diagnosis or appropriate treatment
of injuries. That will keep you, the rider (long term) and
the GMC happy!
You may be occasionally put under pressure by team
managers, parents of racers and riders themselves pass an
injured racer as fit. Just do what you think is medically
correct and you will be able to sleep that night with a
clear conscience.
Tricks of the Trade
Watch
out for the following:
“The
pumped rider” – riders
who fall but are uninjured are often pissed off and don’t
appreciate being pestered by well meaning medics. If they
get up and are moving around, give them a second or two to
calm down before approaching. Try not to grab them - they
hate being manhandled!
“The
possum”
rarely
an unscrupulous rider may
stay down in the hope that the race is stopped so that it
will be re-run – with them back in!
NB: obviously you must consider fallers injured until
proven otherwise
“Post crash
vasovagal” The guy
looks okay, you’ve brought him in for a check up and he
goes grey and feels faint. Usually occurs about 10 mins
post crash.
NB: exclude life threatening injury before oxygen and legs up
“The
stoic” suspected limb
fracture but needs the points and wants to race again.
Usually sorted by failure to complete assorted pressups and
or bunny hops.
The concussed
rider – You may not
have encountered concussion before. The rider will keep
asking the same questions every 10 mins. Amusing at first
but a real heart sink after 30 mins. Definitely not fit to
race & hospital review is mandatory (small percentage
can deteriorate from intracranial bleed)
Leathers
– if they must be cut off,
unpick down the seams with a stitch cutter (nurses are good
at this)
NSAIDS
– kind to load with
paracetamol / brufen combo if not contraindicated.
Entonox
– can be useful for removing
leathers from injured riders and splinting bent limbs
Morphine
– titrate i.v dose as usual.
Oxygen and pulse ox. mandatory. There is no place for im in
trauma!
Ring the receiving
hospital – if sending
rider to hospital for review it is courteous to ring ahead
and prime the hospital first. They appreciate it. The
numbers are in the medical centre office
Grumpy A&E Junior
doctors – Try to be
patient with post ATLS juniors at the hospital who want to
know why you haven’t PR’d the patient and put up 2 litres
of warmed Ringers lactate etc. They don’t know you are
fresh back from Iraq where you worked with Special Forces
as a trauma medic!
Surrounding
Hospitals
Louth
#clavicle or less (<20
mins travel)
Grimsby
Large DGH (no neuro) (<30
mins travel)
Hull
Teaching hosp
(neuro/thoracics) (>30 mins travel)
Radio
Protocols
• Never mention a riders name or injuries on the
radio (confidentiality)
• Use riders race number and a “kilo code”
• Locations are by name of corner or designated callsign
i.e “doctor to
race control, rider six appears kilo one nine.”
kilo one dead, not certified
kilo two dead, certified
kilo nine unconscious
kilo one four
abrasions, bruising
kilo one five limb fractures
kilo one seven head
injury
kilo one eight
back injury
kilo one nine no
apparent injury
kilo two zero ambulance pickup after race i.e minor
(You will probably never use the radio yourself but it’s
useful to know what’s going on if you’re listening in!)
Pay
Pay
is
£260
per day 0845 to 1800. Collect
from the Paddock Office after racing (next to the canteen –
ask Matt).
Medical Insurance
Read the website for detailed
information. You should ring them to check they are happy
about racetrack work before you start (it has never been a
problem before)
Important Points
LISTEN:
To advice from Matt the paramedic
NEVER:
Cross or go onto the track unless directed by a marshal
NEVER: Drive
“WD” (wrong direction) around the circuit
ALWAYS: Keep an eye on the bikes even when behind a barrier
ALWAYS: Wear high visibility doctors coat or tabard
AVOID: Cutting off racing leathers unnecessarily
(>£1000)
CHECK: Helmets after crash. can give useful clue to impact
severity
LEARN: How to safely remove riders helmet
(2 person skill)
AVOID: Getting the helicopter in unless absolutely
necessary
The riders should be treated in the same
way and to the same standard (or better!) they would
receive in A&E. It is essential to appropriately
document assessment, treatment and disposal in the usual
way. Do not discuss casualty details with non-medical
personnel.
Contacts
Dr Tim Moll (Chief
Medical Officer)
email:
cadwellcmo@mac.com
For more information about racetrack work:
www.motorcycleracedoctor.co.uk