There has been a large amount of comment in recent weeks, indeed since pre-season, about the decision to dispense with the dedicated IMSA Safety Team for the 2014 TUSCC. Incidents, and the efficiency of dealing with them by local teams, from Daytona onwards have only added to those calls with a number of informed observers comprehensively ringing the alarm bells, and plenty of perhaps less informed observers simply saying that the decision to field the IMSA Safety Team needs to be reversed NOW, coupled with comment and criticism of some of the specifics from incidents this season and the way in which they were handled!

Once in a while though a voice of sense and reason emerges, in this case its a DSC reader, Paul Marquardt, himself a trained and certified Emergency Medical Technician, to explain in very clear terms the scale of the challenge, the roles and responsibilities of those involved trackside, and the difficulties involved in getting this fixed quickly.

This piece evolved from a debate on the Facebook pages of Radio Le Mans’ Midweek Motorsport Listeners Collective where Paul is a regular and enthusiastic contributor.

Read on dear reader, you may well learn something – I did!

GG

The safety of motor racing is being brought into question after the events that took place at Canadian Tire Motorsport Park this past weekend during round 8 of the Tudor United Sports Car Championship. Two racecars burnt to a crisp while on international TV. Viewers, race team owners, drivers and even trackside fans are outraged with the safety team’s apparent lack of response to the incidents. For years, the International Motor Sport Association (IMSA) has employed the services of the IMSA Safety Team, a group of emergency medical services personnel that receive highly specialized training in regards to medical and rescue response in motorsport. But, for the first time in over a decade, sports car racing in the USA is not using the best safety team in the game, and the consequences of this are beginning to be seen.

EMS is comprised of three different branches: Law Enforcement, Firefighters and Emergency Medicine. All three of these branches are utilized at every race meeting any of us ever attends. The law enforcement presence is usually handled by existing local police departments. A local department that is near a track will offer extra shifts that week to their officers to work the race, while at larger tracks, like the Indianapolis Motor Speedway, they have their own police department. The fire fighting structure is much the same as the previous law enforcement deployment. For smaller tracks, they will utilize local fire support services, and for the larger circuits/events, the circuit will either have their own fire department on site or they will have a standing contract to utilize a nearby cities department for the weekend.

Medical response is different however. Track marshals are trained to administer basic first aid, but aside of that; their job is to work the corner. Controlling traffic, ensuring the scene is safe for the medical crews and other drivers is where their responsibility lays. Also, at any major event, there is a medical helicopter, which is provided by a local medical flight service. For example, if you’re in the state of Minnesota in the United States of America and are racing at Brainerd International Raceway in Brainerd, MN, there will be a North Memorial Air Care trauma helicopter on scene.

They are in no way affiliated with the race meeting or race series governing body. The medical helicopter’s service has been paid to be on scene, and they are ready to respond to an emergent situation much like they’d respond to any other civilian emergency call. In addition to the flight team, there will usually be 1-2 (or more depending on the size of the track) ground ambulances deployed at different points around the circuit to ensure adequate response time to the scene of an accident.

Let’s now integrate the race organization. For an example, I’ll use the Federation Internationale de Automobile (FIA) Formula 1 World Championship. The race has started and on lap five, a car crashes and the driver is not getting out. First, police will come to the scene of the accident on the spectator side of the fence to ensure the crowd does not interfere with anything, such as throwing trash at the car/driver or hopping a fence onto the track. Next, the corner workers will neutralize the corner. Yellow flags will be flown, and racing will be mitigated at that area of the track.

But, for this example, let’s say it is a large accident and the race has been stopped and red flagged.

Now is when the medical car, with the race doctor and medical staff, is dispatched and sent to the scene of the accident. The race doctor is most commonly board certified in emergency medicine.

The most famous race doctor was essentially the individual that brought respect and credibility to the position, Dr. Sid Watkins, an emergency medicine physician as well as a board certified neurosurgeon from the UK.

During this crucial part in the timeline, after the incident and before the medical car has arrived, TV does a disservice to the apparent competence of a corner marshal.

The TV pictures we see in our living rooms show a crashed racecar and an unconscious driver sitting in it. We the viewers agonize over why nothing is being done during these critical moments by track marshals that are sometimes less than 10 feet from the accident.

Surprisingly, this is what they are trained to do.

In trauma medicine, if there is no way to effectively stabilize a patient’s cervical spine, you do not touch them, ever. If the driver has suffered a severe injury to his spine, and his neck is moved incorrectly, you could cause permanent damage to his spine, or in the worst case, cause paralysis.

The only instance of overriding this safeguard is when there is a life threat present, such as fire, and the driver needs to be extricated right away. The medical car will then arrive and the race doctor and medical staff will quickly attend to the driver.

Once the FIA medical team realizes this driver will need further emergency medical intervention, the ambulance is summoned. That ambulance will then respond to the scene from a nearby posting position.

This posting position is completely dependent upon access roads to and from the track; the important point to understand is that the ambulance is on the race circuit property. The ambulance will arrive on scene and assist the medical team and race doctor in extricating the driver from the wreckage, put him on a back-board to immobilize his spine and neck (some racecars will even have the entire seat removed with the driver seated in it, therefore completely preventing any change in the driver’s spinal position until he reaches a hospital), and then the ambulance will carry off to either the on-track hospital, or if a life-threatening injury has taken place, the driver will be put directly into the helicopter and flown to the nearest trauma hospital.

That is how EMS response, generally speaking, works at a race circuit.

What brought this subject to light are the recent issues that the Tudor United Sports Car Championship (TUSCC) have endured in their inaugural season. A number of incidents have occurred, but what caused the most uproar are the recent incidents that have involved fire.

Fire response in EMS is a specialized process and it’s not something that can be undertaken by anyone that’s on the track near the accident. The police, the paramedics in the ambulance, the flight helicopter team, the track marshals, the race doctor and his team; none of those people are trained to control an active fire. I’m an Emergency Medical Technician and have zero training in fire fighting. I’d be just as good at fighting a fire as I would in assisting doing Paul Truswell’s job every June – it would be bedlam.

Fire is a very specialized job in EMS. First and foremost is understanding that firefighters do more than the obvious job of fighting fires. They also are the part of EMS that is trained in extrication and rescue. Pulling someone off a cliff, safely removing someone from a burning building, saving someone from drowning in a lake or being swept down a river, and in this case, removing a race car driver who is strapped into a moulded seat with a six point harness: that’s fire fighter job territory, and no one else’s.

The IMSA Safety team was comprised of a group of certified firefighters and rescue specialists in/around the southern United States, and also up along the Northeast coast. These men and women are trained and nationally certified firefighters. They work for their local fire departments, get up in the middle of the night when their pager goes off and go help stop a giant building fire or the elderly women who fell down in the kitchen.

In addition to their standard all-encompassing fire fighting training, IMSA contracted with numerous agencies and gave their safety team hours and hours of specialized training concerning the management of a motorsport accident. Items such as high-incendiary fires, working in the dark (endurance racing), MCI (multi-casualty incidents), and the specifics of how to safely neutralize a race car, whether it be from hybrid power, burning gasoline, a stuck throttle — they were given hundreds and hundreds of hours over the years in motorsport-specific rescue training.

TUSCC chose to not utilize the 10+ years of experience of the IMSA Safety team this season (pictured below at their final race together – the 2013 Petit Le Mans). Instead, they are using the local fire departments in the surrounding cities (as I mentioned previously) to handle their fire response.

Now, are these fire fighters capable? Yes.

Would I trust them to take care of my family if need be? Absolutely.

Do they understand how to proficiently and quickly remove a racecar driver who is in a six-point harness, wearing a HANS device from a burning carbon-fiber race car surrounded by gasoline and hot engine components? No.

And that gap, these countless displays of less-than-competent EMS response, is what we are seeing this year. It’s what we saw with the 24 Hours of Daytona when Memo Gidley had his horrific accident. It’s what we saw when the Dodge SRT Viper burnt to a crisp at this year’s 12 Hours of Sebring (below), and now most recently with the Deltawing burning two weeks ago at Mosport in Canada. That gap in specialized training is proving to be dangerously huge.

EMS personnel go through hundreds of hours over the years of our careers to maintain our proficiency and certification. I took an Emergency Medical Technician (EMT) course, then took my medical registry exam, and became a certified EMT. However, I don’t get to start saving lives forever now. Every two years I’m required to log continuing education hours to demonstrate that I’m actively working to remain proficient in my skills. That’s what IMSA provided for their Safety team. They would constantly train their safety team members. TUDOR is not providing that this year, IMSA did before.

These shortcomings have been highlighted rather quickly throughout the year. Much of this information isn’t coming to light just in the past few days. So now the question is: how fast can we fix this problem?

EMS has a very different way of handling a work schedule. Work for most of us is Monday-Friday 8-4 or 9-5. People get weekends off, holidays off, and a certain amount of vacation time built into every 12-month calendar.

But, a fire department or ambulance service is different. Fire departments and ambulance services are open 24/7, 365 days a year.

To accommodate a ‘we never close’ structure, schedules are done differently. In my experience a process called Bidding handles schedules in EMS. There are two bids a year: Fall/Winter and Spring/Summer. Each bid is broken down into a 2-week block and lasts for 6 months. What this means is that twice a year, I go into the office and pick my schedule for half a year. I specifically choose which shifts I want to work over a 14-day period, and then for 6 months those two weeks repeat themselves.

For example, I’m in the Spring/Summer 2014 bid as we speak, and every other Thursday I’m at work on the ambulance from 4am-4pm. IMSA’s Safety Team was comprised of firefighters, paramedics and EMT’s from all over the country. I’m not sure how all those EMS professionals individual departments handled scheduling, but rest assured, some type of 6-month bidding, or even monthly schedule process took place.

Summer, as it is for any job anywhere in the world, is when everybody wants time off. Time with families, kids are out of school and so on. It’s premium “off-time.” So not only are these specialist fire fighters and EMS personnel scattered across the USA, but they don’t have coordinated schedules anymore like they have the past 10 years. In short: IMSA can’t just say, “okay everyone, come back for the next race”, because they won’t have the people available to do it. Equipment and clinical practice also changes every year.

Methodology in treatment and procedure in medicine is constantly evolving. The IMSA Safety Team specialists, with only a year off from the job, will need remedial training with equipment and procedure to be as proficient as they were 12 months ago.

What IMSA needs to do right now is see who they can assemble from the disbanded traveling safety team as soon as possible, and have at least some of these people on site for the remainder of the season. Then, looking ahead, TUSCC needs to make a push to have training go on during the off-season and try to reinstate the IMSA Safety Team by the beginning of the 2015 season.

I took the time to write this because I don’t want EMS or the track marshals to be seen poorly in the public eye. Everyone is doing as they are trained. What needs to happen is in the hands of management not the trained clinicians on the ground.

Paul Marquardt