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On-scene treatment of spinal injuries in motor sports

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Abstract

Because spinal cord injuries can have fatal consequences for injured race car drivers, prehospital treatment of spinal injuries is a major concern in motor sports. A structured procedure for assessing trauma patients and their treatment should follow established ABCDE principles. Only then, a stable patient could be further examined and appropriate measures can be undertaken. For patients in an acute life-threatening condition, rapid transport must be initiated and should not be delayed by measures that are not indicated. If a competitor must first be extricated from the racing vehicle, the correct method of extrication must be chosen. To avoid secondary injury to the spine after a racing accident, in-line extrication from the vehicle and immobilization of the patient are standard procedures in motor sports and have been used for decades. Since immobilization can be associated with disadvantages and complications, the need for immobilization of trauma patients outside of motor sports medicine has become the subject of an increasing number of reports in the scientific literature. Even in motor sports, where specific safety systems that offer spinal protection are present, the indications for spinal immobilization need to be carefully considered rather than being blindly adopted as a matter of course. The aim of this article is to use recent literature to present an overview about the treatment of spinal injuries in motor sports. Further, we present a new protocol for indications for immobilizing the spine in motor sports that is based on the ABCDE principles and takes into account the condition of the patient.

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Acknowledgements

The authors want to thank Sarah Goller for help with structural literature research, Paul Balbach for help with photography, Carola Lingner and Sabine Kreinest for help with graphic design. There was no funding of this study.

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Authors and Affiliations

  1. Department for Trauma Surgery, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany

    M. Kreinest

  2. Department for Orthopedics and Anesthesia, Specialty Hospital Vogelsang-Gommern, Sophie-v.-Boetticher-Straße 1, 39245, Gommern, Germany

    M. Scholz

  3. Department of Anesthesia, Arrowe Park Hospital, Arrowe Park Road, Upton, United Kingdom

    P. Trafford

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  1. M. Kreinest
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  2. M. Scholz
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Correspondence to M. Kreinest.

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Conflict of interest

MK is a Medical Director for RTTLS and received traveling costs from German Motor Sport Association (DMSB). MS is an Instructor for RTTLS, Medical Chairman and Chief Medical Officer for the German Motor Sport Association (DMSB). MS received traveling costs from German Motor Sport Association (DMSB) and from the FIA. PT is Medical Director for the British Touring Car Championship (BTCC), and honorary consultant to the UK Motor Sports Association’s Medical Advisory Panel.

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Kreinest, M., Scholz, M. & Trafford, P. On-scene treatment of spinal injuries in motor sports. Eur J Trauma Emerg Surg 43, 191–200 (2017). https://doi.org/10.1007/s00068-016-0749-3

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