Motorbike Mayhem by Hinds

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John Hinds delivers on his promise of ‘in extremis’ whilst exploring the unique patterns of injury seen in high speed motorcycle trauma.

John Hinds delivers on his promise of ‘in extremis’ whilst exploring the unique patterns of injury seen in high speed motorcycle trauma.

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  • TRISS Score = 2.1%

Transcript

  • 1. “Cases from the Races” John Hinds
  • 2. Conflict of interest Dainese leathers Arai helmets Daytona boots Bridgestone Motul oil
  • 3. Road racing = “Furniture”
  • 4. Scene safety: Beware of fire • Immediate • Delayed • Missed – Fast burn, under pressure • Quickshifter
  • 5. • **
  • 6. Reading the scene • Treat the injuries you find • Treat the injuries you expect
  • 7. Types of crashes
  • 8. Commonest mechanism Single Vehicle Accident -Rider misjudges corner severity -Typically left-hand bend
  • 9. “Low-side”
  • 10. “High-side”
  • 11. “Hit-by-the-bike”
  • 12. 4 Mechanisms of concern • “He hit the Kerb” • Broken Feet, reduced LOC • Boot lying in the middle of the road • Head on collision, apparently isolated femur
  • 13. “Hit the kerb”
  • 14. “Hit the kerb” • Either a dead stop… • …or a big launch pad
  • 15. “Hit the kerb”
  • 16. “His helmet came off”
  • 17. Examining the helmet • Careful with your assumptions
  • 18. “Broken Feet, Reduced LOC” • Examining the helmet can over or underestimate mechanism Broken feet = Slid feet first = Fall from height – Think neck – Think Base of Skull
  • 19. Clinical: Helmet removal
  • 20. Helmet removal is safe! • 200 per year • No secondary neurological sequelae
  • 21. Plan B.. ? “Failure to remove” = 1 : 2,000 ?
  • 22. Surgical airway? • Conditions are poor - • Head flexed • Chinstrap in the way • Lots of bleeding • May be trapped under another vehicle
  • 23. Failure to remove: Plan • Provide oxygen • Prevent hypercarbia • Access to the airway • Destabilise helmets structural integrity • Prevent harm
  • 24. Careful!
  • 25. Speed Humps
  • 26. • With a speed hump in place the spine is not in-line in the neutral position • Intubation by direct laryngoscopy is impossible with a speed hump in place
  • 27. “Head-on collision, apparently isolated Femur”
  • 28. “Beware the boot lying in the road”
  • 29. 4 Mechanisms of concern • “He hit the Kerb” • Broken Feet, reduced LOC • Boot lying in the middle of the road • Head on collision, apparently isolated femur
  • 30. SPECTATORS
  • 31. “BLOODY SPECTATORS”
  • 32. “I’d like to thank all the staff at the Royal Victoria Hospital who helped me – in Intensive Care, the Surgeons, the nursing staff…”
  • 33. “I’d like to thank all the staff at the Royal Victoria Hospital who helped me – in Intensive Care, the Surgeons, the nursing staff…” NIAS Paramedic: “That’s gratitude for you. How does he think he got there? On Santa’s F**ing Sleigh?”
  • 34. Questions…?