If you have a BVM (Bag Valve Mask resuscitator), you should not need naloxone. The problem is inadequate respiration, not inadequate naloxonation.

- Rogue Medic

Should The Driver Of This Car Be Strapped To A Back Board?

 

according to data obtained and reported by SPEED channel (165 mph to zero mph in one foot, as reported by SPEED’s Bob Dillner, before reaccelerating the other direction). The car spun around once while tipping onto its roof, and then barrel-rolled eight times with fire coming out of the engine compartment, shedding debris in all directions, until coming to a stop back onto its tires.[6] [1]

 

Michael McDowell is in the car during one of eight barrel rolls that came after he hit the wall at 165 MPH.

Is “spinal immobilization” indicated?

Here is video of the crash.
 


Download YouTube Video | YouTube to MP3: Vixy | Replay Media Catcher
 

The video lists his speed at 185 MPH, but 165 MPH is more likely correct.

He is out of the car and walking about, so NASCAR medical command (an emergency physician on scene at the races I have worked) will not request/demand/suggest “spinal immobilization.”

What happened?
 

The safety features of the barrier, the HANS device and the Car of Tomorrow racecar protected him.[6] Because of this, he walked away from the crash without injury, and waved to the stunned crowd.[6] [1]

 

OK. He walked away, but that kind of impact has to cause some serious damage –
 

Look at the mechanism of injury!
 

 

Since his old car was destroyed, he had to switch to a backup, and ended up starting at the back of the pack in the race.[1]

 

Here is an interview with him after the crash and the video shows him being assisted from the wrecked car and walking away without any board, collar, straps, or blocks.
 


Download YouTube Video | YouTube to MP3: Vixy | Replay Media Catcher
 

How about another crash at similar speed.
 


Download YouTube Video | YouTube to MP3: Vixy | Replay Media Catcher
 

As you can see, he did not have “spinal immobilization” on scene.

Another example. Perhaps the hardest NASCAR crash.
 

The video cannot be shown at the moment. Please try again later.


 

The wreck was so horrific it threw the engine away from the car and caused the race to be red flagged for 25 minutes to clean up the wreck. There were several reports by fans that his car flew through the air. With a grimace on his face, he climbed out of the car and laid down on the track. He was taken to the medical facility where he later emerged and gave an interview to on hand media personnel. He said he was fine & was a little sore, but had the breath knocked out of him and had taken “the hardest hit of his career” at Pocono.[2]

 

There is also an excellent review of the impact forces from the Sadler crash from someone who understands science.
 

Just goes to show you what a challenge it is to try to figure out what happened without the evidence. So despite how much it looked like a straight-on hit, it wasn’t. It’s amazing to me that the camera provides such a distorted picture of reality. I may never look at a NASCAR race the same way again unless I’m actually there. So I’m wrong about the angle, but I think (unless I get data otherwise), I’m probably right about the time. This is exactly why scientists have peer review.[3]

 

These cars are much safer in a crash, even at several times highway speeds, than what is available to drive on the street. Due to the lack of mirrors, inability to turn one’s head, and other limitations that are not relevant on a closed course, they would not be safer on the street.

What would happen if EMS, in the places not already eliminating “spinal immobilization,” did not immediately whip out collars, boards, blocks, and other implements of “immobilization”?

Somebody would be screaming about lawyers.

Somebody else would be screaming that he will be paralyzed.

The reality is that EMS extrication causes more manipulation of the neck than would occur by allowing the driver to get out of the car by himself.[4],[5]

When will we learn to stop causing iatrogenic harm?
 

 
Click on image to make it much larger, then scroll from right to left to see the composite photo of the crash in the order it happened.

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Footnotes:

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[1] Crash at Texas Motor Speedway
Michael McDowell
Wikipedia
Article

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[2] Elliott Sadler
Wikipedia
Article

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[3] Why the Sadler Pocono Crash Should Be the “Worst Ever”. Ever.
Aug. 8, 2010
Building Speed
Article

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[4] Cervical Spine Motion during Extrication.
Engsberg JR, Standeven JW, Shurtleff TL, Eggars JL, Shafer JS, Naunheim RS.
J Emerg Med. 2013 Jan;44(1):122-7. doi: 10.1016/j.jemermed.2012.02.082. Epub 2012 Oct 15.
PMID: 23079144 [PubMed - in process]

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[5] In order to protect the c-spine, should we stop helping?
Mill Hill Ave Command
Saturday, December 15, 2012
Article

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Comments

  1. I probably would not have even considered boarding any of these with the possible exception of Elliott Sadle for several reasons. Even not knowing about the various devices used by NASCAR in their vehicles, when you see someone climb out of the vehicle, talk to people, and in the case of Jeff Gordon, start studying the vehicle for damage, there has been so much movement of the c-spine already that essentially, it has been clinically cleared. Obviously if upon inquiry the racer was complaining of severe neck pain or parasthesias, that would change, but given an n/c/o status other than, as Elliott said, “breath knocked out,” there is no s/sx reason to board them.

    But with the SAFER barrier and the HANS devices and the other modifications to the cars that came about as a result of the (instant) death of Dale Earnhardt (Sr) – the Intimidator – these cars are designed so that the driver is as protected as possible. When you see someone drop the net, wave, and climb out, indications are they’re in pretty good shape. And, as we see, this is all supported by the evidence – none of them were, in fact, seriously injured.

    I saw all of these incidents live at the time they happened, and yes, I held my breath with some of them.

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