Medicine … in the fast lane

By DRª MARIA ALICE PESTANA SERRANO E SILVA features@algarveresident.com

Drª Maria Alice is a consultant in General and Family Medicine, and is Director of Luzdoc International Medical Service in Praia da Luz, near Lagos.

It was a big racing Easter weekend at the Portimão Autodrome and Luzdoc doctors were there…. Dr Jo reports…

I must admit, I have this rather morbid fascination with car and bike crashes, the more ‘acrobatically’ spectacular and deserving of numerous slow-motion replays on sports and news channels the better.

So it was not surprising that I jumped at the chance to work with the Medical Emergency Team at the A1GP held at the new Park Algarve, this Easter weekend. But, as I quickly found out, it was not all fun and games and being able to wear flashy red suits and driving the (totally awesome!) Medical Car, which, by the way, is always driven not by a medic but by a qualified track driver! I had the privilege of seeing first hand the detailed preparations and planning it takes to have a medical support team standing by and ready to deal with any incident on the track and off it.

Motor sport safety has come a long way. The 1994 loss of one of motor racing’s greatest drivers, Ayrton Senna, was a wake up call for the motor racing community. The subsequent drive to ensure that nothing like his fatal accident would ever happen in Formula One again culminated in the creation of the FIA Institute for Motor Sport Safety. According to Professor Sid Watkins (one of the world’s top neurosurgeons and the F1 Championship Chief Medical officer): “There is an unbelievable difference between motor sports now and when I first entered. In the 1960s and 1970s, for every ten accidents there was either a death or a serious injury. Now the ratio is around one in 300.” In fact in the last 10 years there has not been a serious or mortal incident in Formula One.

This is due in part to the constant effort of the ruling motor sport bodies to standardise the medical training programmes and strictly comply with and implement uniform safety policies and procedures for all medical teams around the world. And the medical team, Emerg-Saude, based in Lisbon, contracted by Park Algarve is no different. They are FIA accredited and their team of doctors and nurses/paramedics are clearly well rehearsed in their roles. Luzdoc is happy to cooperate as their Algarve based associated company and our doctors have been integrated into their work force since January.

The team is loosely divided into two, the mobile units scattered around strategic points on the track, and the static unit who stays behind in the Medical Centre and just waits until something happens.

The Medical Centre is actually more like a mini clinic, with a separate resuscitation room, mini theatre, burns room, x/ray room and a couple of consulting and recovery rooms… as well as the all important doctors’ lounge… our ‘waiting’ room. This unit provides medical support for not only any injured drivers but to any team or staff member as well as any member of the public with serious injuries or sudden medical condition. During active training/racing, this unit is always staffed by at least two doctors with good resuscitation training and experience, and two Accident and Emergency trained nurses, who then rotate to give 24-hour cover over the crucial race days.

The mobile units comprise of the official Medical Car (with a representative doctor from the particular motor sport body, in this case the A1GP), at least two fast response vehicles with a doctor and nurse on board, and the Extrication Team car (aka the ‘slicks’). And they really do have to live up to their nickname as the A1GP Medical Procedure stipulates that an extrication team should be able to extract a driver from a crashed car in under four minutes… and the really good ones can do it in under one minute and 30 seconds! Their sole function is to get the driver out safely and quickly so that the rest of the medical team can provide the necessary care.

In case of serious injury, the team also has a helicopter at its disposal for quick transfers to either the Barlavento Hospital (which is on alert during race dates) or even to Lisbon to any specialised facility if the clinical situation requires it.

All this is co-ordinated by the Tower.  The all-seeing, all-knowing Tower Medic decides if, when and where the medical car, the fast response unit or the extrication car must be despatched, when the team goes on high alert, when we can stand down, and most importantly when we can get lunch!

A recent study that assessed the Health and Safety features of one regional motor racing circuit in the UK over a five year period, showed that each competitor had a four per cent chance of requiring on-circuit medical attention, 0.6 per cent chance of hospital referral and 0.17 per cent chance of admission per race. There were three deaths from a total of 9000 competitors (mortality rate 0.033 per cent), confirming that despite the nature of the sport, the mortality rate remains low with prompt skilled medical intervention

These improvements in motor sport safety have guaranteed less chance of injury for the drivers but it has meant that for Accident and Emergency junkies like me, there is now more action training for the event than actually during the event! Ah well, I guess there is always the Paris-Dakkar…

Best health wishes,

Dr Joanna Karamon Goldman