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

1. “Cases from the Races” John Hinds

3. Conflict of interest
Dainese leathers
Arai helmets
Daytona boots
Bridgestone
Motul oil

14. Road racing
= “Furniture”

17. Scene safety: Beware of fire
• Immediate
• Delayed
• Missed
– Fast burn, under pressure
• Quickshifter

34. • **

38. Reading the scene
• Treat the injuries you find
• Treat the injuries you expect

47. Types of crashes

48. Commonest mechanism
Single Vehicle Accident
-Rider misjudges corner severity
-Typically left-hand bend

49. “Low-side”

50. “High-side”

51. “Hit-by-the-bike”

59. 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

60. “Hit the kerb”

61. “Hit the kerb”
• Either a dead stop…
• …or a big launch pad

62. “Hit the kerb”

76. “His helmet came off”

81. Examining the helmet
• Careful with your assumptions

84. “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

85. Clinical: Helmet removal

87. Helmet removal is safe!
• 200 per year
• No secondary neurological sequelae

88. Plan B.. ?
“Failure to remove” = 1 : 2,000 ?

90. Surgical airway?
• Conditions are poor -
• Head flexed
• Chinstrap in the way
• Lots of bleeding
• May be trapped under another vehicle

91. Failure to remove: Plan
• Provide oxygen
• Prevent hypercarbia
• Access to the airway
• Destabilise helmets structural integrity
• Prevent harm

99. Careful!

100. Speed Humps

104. • 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

106. “Head-on collision, apparently
isolated Femur”

118. “Beware the boot lying in the
road”

132. 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

133. SPECTATORS

134. “BLOODY SPECTATORS”

139. “I’d like to thank all the staff at the Royal Victoria Hospital who
helped me – in Intensive Care, the Surgeons, the nursing staff…”

140. “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?”

141. Questions…?