fred27

Thank you for sharing.

hf1

I thought that the high heat (caused by a poorly ventillated Nomex-clad body) would be a major contributor to higher bpm's. Like in a sauna, for example.

Is there any other procedure with comparable or superior ratio of diagnostic power to inconvenience (cost) ratio?

Sterling Doc

Interesting thought on the Nomex, and the answer is probably not known in numbers. That said, the fact that fewer people are succumbing to burn injuries does not mean that fires, and injuries aren't happening (somewhat frequently) in a club race setting. Better Nomex, better emergency response, egress drills, and better medical treatment of burns may prevent death, but not fires and some degree of injuries themselves.

Tage Evason is a good example of all this. His transmission bolts were not tight enough, backed out, the trans shifted over and pulled apart a 10-AN oil line, spraying it onto the headers. He had the back window out, causing a blow torch of flames reverting back into the cabin. In the rush to finish a repair before going out, he did not put his head sock on. He spent about 6 weeks in the hospital getting terrible burns on his neck treated. He survived due to modern, excellent medical care, and is back racing (he will be in a 944 at NASA Nationals).

Many of these issues would not have (or have been much less likely) to happen at a pro level, but the level of prep is not the same, and many fires I see are due (to some degree, at least) to user/builder error.

His video of the event is below. I think you'll want your Nomex after seeing it:

kurt M

I have been saying this for a few years. Lot of folks think more is better without looking at what each safety system pro and con list has on it. Heat causses far more than just heart issues, it lowers your ability to think clearly and drive the car. you are more likely to get in a wreck when you are heat bonking.

150 bpm is not much for someone that is active even for those of us that are "on the older side" of standard. What is bad is eating poorly, smoking, living a sedentary life and then expecting your body to be able to work well under what to some is a normal amount of stress. I see a lot of racers that take far better care of the car than they do the body. A race car is a system and the system includes the driver. Many a hot lick car and a red faced, puffing out of shape driver in the grids cool suit or not.

Sterling Doc

As far as the cardiac screening, it's tough to do a better job without some unintended collateral damage.

Stress tests would definitely pick up more problems, but at the cost of many more false positives. Stress testing of asymptomatic persons is recommended against these days due to this issue. The risks of the procedure, and the unnecessary angiograms that follow these false positives, end up being greater than the benefits of those found to have "silent" disease and treated [in an asymptomatic population]. Racers would not seem to be have higher baseline cardiovascular risk than the general population, so this would seem to hold true for us as well, as a blanket recommendation. This is independent of the cost (which is also significant).

Probably the best tool is is a thorough history, and individualized risk assessment to see what testing, if any, is indicated. It will never be perfect, and we will always have to balance the benefits of what we do with the risks.

hf1

Thanks for the valuable responses Doc.

Sterling Doc

I agree with the fitness part, and it is something I bring up in racing physicals in similar terms. You don't want racing to be your only fitness activity (or stress test!)

As far as the Nomex, the answer is better cooling and fitness, not giving up on Nomex. From a "public health" perspective, maybe a certain level of driver cooling should be mandated when racing above a given temperature. Some pro series require this.

Martin S.

First of all, I am NOT a medical professional, but I'd play one on TV if they ever asked me Here is my approach:

We read above, "Anyway, I am curious about the relationship between EKG as a "screening tool,"....an EKG is static. My doc makes me do a stress EKG with accompanying echo cardiography. You get hooked up with the standard EKG leads, tech does a echo (ultrasound) cardiogram of your heart resting.

Next, you are up on to the tread mill and increase your speed and the pitch of the treadmill with a goal of reaching 220 bpm minus your age...or higher if you can. All the while the cardiologist is running EKG strips and checking BP. When you max out, you lie down and they do another echocardiogram. They look at the initial static echo test VS the condition of your heart fresh off the tread mill. They can easily detect areas of your heart that are not receiving an adequate blood supply. My sanctioning body requires a static EKG every 2 years...I do the above procedure annually. In addition my doc tells me to:

1. Keep my BMI to normal ranges, for height and age..I need some work here.
2. Watch your cholesterol and have a lipid screen panel done checking for HDL and LDL levels
3. Get routine exercise 3 to 4X a week, do interval training if possible. Need a little more focus here as well.

As far as physics activity, look what routines some of the NASCAR racers "endure", guys like Jimmy Johnson. These racers are fit.

Heat, as Doc Sterling writes, you can certainly get overheated in the cockpit. I use a cool shirt with the large Cool Shirt cooler that has the ability to also supply cool air to ones helmet. I love my Cool Shirt. With the large Cool Shirt cooler mounted in the trunk, the ice lasts for quite some time, not the case with the smaller cooler which needs to be refreshed after ever practice session. Cool Shirt also has a "hoodie" shirt that will keep you head cool...they ain't cheap. One could conclude that it is very important to keep your head cool, not just your trunk...cooling the blood supply to the brain can't be a bad thing.

And in concluding, there are some things in life that one does not want to skimp on:
1. Parachutes,
2. SCUBA gear
3. Bungee jumping cords
4. Safety gear for car racing and motorcycle riding, racing and otherwise
5. (You fill in the blank)

GT3 Techno

Thanks for sharing.

A big tree like this right behind the guard rail should raise questions for such a big event.

hf1

Martin, great post. I've always wondered and keep forgetting to ask: How do you get the Cool Shirt hose to go inside/through the racing suit?

jdistefa

I agree with Eric re. spec racing. The inherently slower speeds give one an extra margin of safety. And often the racing is better

Also agree with Eric that the best screening tool is a very thorough history. Americans do too many damn tests, many of which, as applied, have low pre-test probability, significant rates of false positives/negatives, and both direct and indirect potential for harm. Ok, rant off.

The screening ECG/EKG is not to risk stratify or identify who may have a heart attack. As Circuit mentioned it is virtually a useless test in that regard. There are rare exceptions that can be lifesaving to recognize (look up Wellen's syndrome), but those cases don't statistically support the costs and inconvenience of a screening program. Yes, the intersection of economics and public health

The purpose of the screening ECG is fourfold:

1) To identify those who have already had a heart attack.

2) To identify those who have clinically significant conduction blocks and/or may have an arrhythmia syndrome (Brugada, WPW, etc.).

3) To identify those who may have structural problems, i.e. significant left ventricular wall thickening from unrecognized/untreated high blood pressure, or an outflow obstruction due to septal wall mass (HOCUM).

4) Perhaps most importantly to provoke people to reflect about their cardiac risk factors, fitness, and have an appropriate discussion with their doc.

Italy has a well published series on their ECG sport screening program and there is good evidence to support it in terms of cost:benefit ratios. I think it's a good idea for us, especially since most of us have some degree of grey hair and therefore increased inherent risks from too-many-birthdays syndrome.

jdistefa

Martin, fixed it for ya.

ProCoach

Article has been updated. Linky here: http://blog.parathyroid.com/race-car...racing-deaths/

gums

Interesting update, and as is usually the case, it's the combination of multiple factors adding up to an unfortunate conclusion

cgomez

In addition to all comments, the most important safety feature is the track itself.
It is just a shame that the trees are just lined-up against the armco. A simple (not necessarily F1 type tire wall) could have saved Allan.

We take big risks when we go to race/drive in tracks that are not adequately prepped to today's safety standards. That's why I never go to places like Summit Point where it is very easy to flip (banked dirt everywhere) and/or hit a tree (and object with infinite rigidity relative to a race car)