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.

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  • TRISS Score = 2.1%
  • Motorbike Mayhem by Hinds

    1. 1. “Cases from the Races” John Hinds
    2. 2. Conflict of interest Dainese leathers Arai helmets Daytona boots Bridgestone Motul oil
    3. 3. Road racing = “Furniture”
    4. 4. Scene safety: Beware of fire • Immediate • Delayed • Missed – Fast burn, under pressure • Quickshifter
    5. 5. • **
    6. 6. Reading the scene • Treat the injuries you find • Treat the injuries you expect
    7. 7. Types of crashes
    8. 8. Commonest mechanism Single Vehicle Accident -Rider misjudges corner severity -Typically left-hand bend
    9. 9. “Low-side”
    10. 10. “High-side”
    11. 11. “Hit-by-the-bike”
    12. 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. 13. “Hit the kerb”
    14. 14. “Hit the kerb” • Either a dead stop… • …or a big launch pad
    15. 15. “Hit the kerb”
    16. 16. “His helmet came off”
    17. 17. Examining the helmet • Careful with your assumptions
    18. 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. 19. Clinical: Helmet removal
    20. 20. Helmet removal is safe! • 200 per year • No secondary neurological sequelae
    21. 21. Plan B.. ? “Failure to remove” = 1 : 2,000 ?
    22. 22. Surgical airway? • Conditions are poor - • Head flexed • Chinstrap in the way • Lots of bleeding • May be trapped under another vehicle
    23. 23. Failure to remove: Plan • Provide oxygen • Prevent hypercarbia • Access to the airway • Destabilise helmets structural integrity • Prevent harm
    24. 24. Careful!
    25. 25. Speed Humps
    26. 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. 27. “Head-on collision, apparently isolated Femur”
    28. 28. “Beware the boot lying in the road”
    29. 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. 30. SPECTATORS
    31. 31. “BLOODY SPECTATORS”
    32. 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. 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. 34. Questions…?
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