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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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Scene safety: Beware of fire
• Immediate• Delayed • Missed
– Fast burn, under pressure
• Quickshifter
Commonest mechanism
Single Vehicle Accident
-Rider misjudges corner severity
-Typically left-hand bend
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
“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
Surgical airway?
• Conditions are poor -
• Head flexed• Chinstrap in the way• Lots of bleeding• May be trapped under another vehicle
Failure to remove: Plan
• Provide oxygen• Prevent hypercarbia
• Access to the airway• Destabilise helmets structural integrity
• Prevent harm
• 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
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
“I’d like to thank all the staff at the Royal Victoria Hospital who helped me – in Intensive Care, the Surgeons, the nursing staff…”
“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?”