Following Brook Macdonald's crash in Mont Sainte Anne that left him with a spinal injury, a lot of questions have been raised about the medical procedures around serious injuries put in place by the UCI. Brook was on the hill for a number of hours in pain before his evacutation was carried out. In a recent
interview with Pinkbike he described the evacuation effort as "not very good at all" and said:
| I spent 5 hours on the mountain waiting for a helicopter. I felt like they had no organisation in place for an event like this which is very bad on their behalf. They tried to take me down the hill in a quad. Come on! I had spinal injury, isn’t your first thought a helicopter? It was the worst day of my life spent there. I didn’t get any painkillers for an hour so I was in so much agony. People were arguing and fighting over what should be done about me, they were lying to me on when the heli was going to be there, it was really bad. The only thing that got me through was Peaty, Blinky, Wyn and our physio Dennis. If I didn’t have the guys there supporting me I don’t know how I would have handled the situation.—Brook Macdonald |
To understand more about the situation and how it might be handled in future, we reached out to the UCI and received the following statement from Xavier Bigard, the UCI's Medical Director, who was on the ground at the time of the incident. Their response is posted in full below:
| We understand the anxiety and concern caused by the accident Brook suffered during Downhill training at the UCI World Championships in Mont Saint Anne last Saturday. After being evacuated by helicopter, he underwent surgery at Quebec City Hospital the very same day and has since been regaining sensation in his legs and learning to walk again.
The time it took to evacuate Brook has led to many legitimate questions being asked, not least by the rider himself. Being myself on site during the event, I want to clarify some points and put the accident into context. It should be pointed out that the place where the accident occurred was very difficult to reach. Even so, first aiders were on the scene within four minutes to stabilise Brook’s spinal column, place him in a secure position, and carry out an initial assessment that determined he was suffering severe pain in the lower back and pelvic regions, hyperesthesia in one lower extremity and altered motor function in the other.
The first doctor was on the scene within 30 minutes with all the necessary heart monitoring equipment and sedatives. From that point on, the victim’s spinal column was perfectly stabilised, his vital signs and blood oxygen levels monitored, and morphine administered. The doctor at the scene decided to request an airlift, at which point discussions began on the best way to evacuate Brook.
Such is the legislation in Quebec that the fastest services (the military) can only intervene in life-threatening situations. Important to note that only military helicopters are able to carry out air lifting rescue operations. In all other cases, evacuation is carried out by a private operator. Given that the rider’s life was not in danger, the medical regulatory authorities deemed that the evacuation should be carried out by a private operator, which was alerted by the medical service at 13.00, the accident having occurred at 12.10.
Given that it would take the crew 50 minutes to arrive at the helicopter take-off pad and the helicopter a further 50 minutes to reach the scene, it was estimated that the victim would be evacuated at around 14.55. Owing to the blustery conditions at the summit, however, and the difficulties posed by trees and cables in accessing the area, the helicopter eventually landed at a location close to the victim at 15.20.
The helicopter then flew Brook to Quebec City Airport (the hospital’s heliport having been closed for maintenance work), where he was transferred by ambulance to the hospital. In response to the reaction to the time it had taken and we all regret to evacuate him, we held a crisis meeting attended by team managers, riders, two emergency physicians, the event organisers, and myself as UCI’s Medical Director.
It goes without saying that we would have liked a speedier evacuation. It is worth repeating, however, that the victim’s life was not in danger and that he was being monitored and his pain managed by a qualified doctor. It is clear that the bone lesions and neurological injuries he suffered were caused by the accident itself. In no way did the evacuation time aggravate the victim’s injuries or condition. In general terms, the arrangements put in place by the organisers complied with UCI Regulations, taking into account local legislation.—Xavier Bigard, UCI Medical Director |
We followed up with some further questions regarding their statement, and they responded by pointing to Article 13.4.011. "The organizer shall be responsible for the medical services to the exclusion of the UCI. Checks that may be carried out by or on behalf of the UCI are limited to checks of compliance with the UCI rules and do not shift responsibility for the medical services from the organizer to the UCI. The organizer remains exclusively responsible for the safety at his event."
It appears that they're saying that the Mont-Sainte-Anne organizers should take final responsibility for Brook's ordeal on the hillside. However, they did also say they were "open to considering an update of distances and duration for helicopter rescue operations," which will hopefully be a fruitful avenue of investigation for improving managing a situation like this in the future.
We also tried to get a comment on the situation from the organizers at Mont-Sainte-Anne but they declined to add to the UCI statement.
We wish Brook all the best in his continued recovery.
Additional reporting by Si Paton.
Always had them down as feeling like they are a cut above MTB anyways but this just further underlines it. Of course it’s highly likely the injury was as a result of the crash, but that doesn’t hide the fact the incident threw the spot light on how shoddy the risk assessments and planning for the race was. Why the hell does one nicest guys in the sport have to go throu this ordeal to reveal this?!
Being on scene within five or so minutes from first call is reasonable enough, though at races with sufficient on course patrol, a responder should probably be there within three. Getting a doctor to the patient on hill is actually quite uncommon, however given the severity of Brook's injury including loss of sensation in an extremity, seems an appropriate if uncommon course of action. In any case, getting a doc on hill or trail with all of the appropriate gear can take some time, but shouldn't be any longer than another 20 or so minutes from first contact with the patient (this estimate assumes the most difficult entrance and exit corridors for doc plus a huge amount of gear at which point fast transportation to the base takes precedence over waiting for a doc). During doctor wait time, the patient should have been sufficiently stabilized minus pain management by the first-on-scene and additional rapid response patrol and gear, including at minimum a quality backboard or vacuum mattress spinal stabilization, oxygen, several sets of vitals for data, and cleanup or treatment of other minor injuries. During this time, a dispatcher should be coordinating potential evac routes based on preliminary information of the patient's condition including on ground transport off hill, on ground transport from the base location, and potential air transport from both the base, or from prescribed landing zones on the hill.
Heli evacs are notoriously dangerous in the mountains where I worked in CO, so I'll assume the worst for Mont St. Anne as well in the interests of reduced bias. Its worth mentioning now that any first responder on hill should have a good understanding of landing zones and should relay important incident local info to a dispatcher in preparation for a possible on-mountain helicopter evac. IT IS NOT UNCOMMON TO BE DENIED A HELI EVAC if it is deemed too dangerous for the crew. In my seasons, we had several denied, and there were two incidents with loss of life of pilots and crew in poor conditions including one of the most experienced evac-heli pilots in the western US. There are contingency ground plans for severe injuries for this reason, so even if it was impossible to ever get a heli there, Brook should never have been on the hill for longer than an hour, much less five, just to wait for a helicopter. Per google maps, its a 30 minute drive from St. Anne to Quebec City, seems like a no brainer to have ground transport ready with such difficult heli legislation.
Mountain evac isn't pretty, but it is extremely efficient if you look at most larger resorts in the western US. If it took longer than 30 minutes to stabilize and transport a patient from pretty much anywhere on hill to the base of the mountain, our crew would have a pretty lengthy and unpleasant discussion with our patrol director, mountain ops director, and risk management specialists. Five hours is the type of evacuation that costs a bike park millions in lawsuits. Bike Patrol is a pretty relaxed gig most of the time, collarbones, wrists, and concussions become a normal and frankly inconsequential part of the job, not taken lightly but rarely of any major concern. Massive trauma or code worthy events are not taken lightly and are treated with extreme care and expediency with a host of options available concerning fast response and transport of life or limb threatening injuries. There isn't always a "right" way to quickly move a spinal injury on mountain, but following basic protocols WILL ensure quality stabilization and timely evacuation, two qualities that are missing in Brook's case. I've gotten lost in the point I was attempting to make, but if a bunch of dirt-bag mountain bikers with EMT basic training and the radio assistance of doctors can safely get hurt people including those with injuries of similar caliber and occasionally more severe that Brook's off a hill and to higher care without causing further pain or damage in under 30 or 40 minutes (at the very high end), what the hell is the UCI doing?
That response sounds like it was taken from UCI insurance company liability manual.
Jokes goes sideways: 5 hour?! Brook is lucky to be alive after that "service" (((
Irrespective of whether it's the UCI's fault or the "Organiser's", EVERYONE involved is 100% accountable and responsible. UCI is the governing body no? The buck stops with them! This simply highlights their standards are seriously lacking for the health and safety of the riders in an emergency situation, as well as the embarrassing management by the organisers. If any good is to come, I trust this incident highlights the need to seriously review and overhaul emergency proceeding at a World Cup level at EVERY venue that is raced in future.
On a side note, I'm an Aussie living near Melbourne in Victoria. The first State Downhill Reace I participated in back in 2006 odd was in country Victoria (Long Gully to be exact). Not overly remote, but any serious injury would require a Heli. As it so happened over the two days of practice and racing, a Heli was called both days for two injuries. Got there in under an hour from the call, already had a landing site organised and the injured riders were airlifted swiftly. If a bunch of guys running a State round can organise a Heli, you'd think the f3@king UCI or MSA Organisers could manage it. . . . .
Having said all that UCI and event organizers should have been aware and prepared for this. Having a private evac heli on standby should have been the approach for an event of this nature, no?
I have track walked this downhill course many times and there are access points everywhere to get people off of the mountain on boards. I watched them take a few down and out a few times that weekend.
What I also did see is the UCI and Velirium.com people drinking and smiling/laughing later that evening. I am sure they were cheering for what a poor job they had done to ensure Brook's and others riders safety. I thought it was on-sense then and it is even worse after this response. Of course Velirium.com won't respond as they feel like after time it will all just go away.
Should be simple to understand that for four days you take on the cost to have a helicopter near the sight to transport injured riders. The line about they are any trees and wires in the way was correct...on the mountain that it. There were several ATVs that were there to take injured riders off the mountain once stablized to areas where a helicopter can land. Your excused are non-sense. BROOK AND OTHER RIDERS DESERVE A BETTER ANSWER THEN WHAT HAS BEEN GIVEN UCI AND VELIRIUM. Without them...you have no show.
www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries
I have had multiple surgeries in both Canada and Australia, and I can tell you the service in Canada is much better. I waited nearly 6 weeks to get surgery on a severely broken clavicle in Australia and went to the hospital and put the gown on and got into bed on 2 occasions, then sent home before getting surgery the 3rd time. Contrast that with Canada where I had surgery less than 12 hours after a broken radius, and similar with a broken pinky. Wait times in emergency are less than 1/4 in Canada in my experience.
I just broke my neck last week, and the insane level of care in Whistler was impressive. They transferred me by ambulance to Vancouver to fit my brace, and since I was there they decided to add a second CT scan (this time with dye), just to be sure. Total cost = zero, including pain meds and I do not have an employer so I have no health plan other than the provincial basic one that everyone gets.
There isn’t a single part of the bike park that we can’t get any patient stabilized and moving downhill within 30-40mins, and I’m willing to bet we have much harder to access area’s than the St Anne DH course.
It is not free in anyway and Canadian's know that, but say we have free health care. I noticed we like to say it to people that don't live in Canada. I always wonder why we Canadian's lie to people from other countries about our "Free" health care.
Free means it is not paid for..
Free = 0 $, at all, by anyone.
I can only speak of two Provinces that I have actually spent time in, but I know that in Alberta the medical payments are taken off of annual Provincial taxes.
If you live in BC you actually have to pay a medical bill monthly, they are called premium rates.
and like a good socialist Province, they go on a sliding scale depending on your family income.
What Canada has is a subsidized medical system, and I am sure you are aware of this, being Canadian yourself. I will also point out that scores of other nations around the world also have public medical systems, so why do Canadian's cling to this statement of free medical, which is actually untrue, like we are some sort of unique super caring Nation due to the fact that medical services are available to the public?
So, why, may I ask do Canadian's keep repeating that they have "FREE" health care.
We Do Not.
And if you actually listen to people from certain Latin American countries, one will see that our system is rapidly becoming similar to the issues they have in their social medical systems.
If you want fast efficient service, you pay a private clinic out of your pocket. This is quickly becoming Canada's situation, but Canadian's seem oblivious because the CBC keeps telling them otherwise.
One only needs to talk to some people with injuries that they had to suffer with for years before they got to have their day with a surgeon.
I know this as a fact, as I have two friends in their early and late 20's that had their lives put on hold for almost 2 years in one case and over 2 years in the other, because of a shoulder injury that the Medical system took that long to finally get them in to repair.
I won't even get started on the other abysmal failures that I myself have seen by this "Free" system, that have caused premature death.
Mont Sainte Anne is in Canada, so you all got to see Canadian bureaucracy at it's finest. Can't get a heli without a red tape dance first..
Anyways. I am ranting now. Just wanted to give some balance to those reading that actually believe Canada has Free World Class Medical for everyone because they heard so many Canadian's claim that.
Really wish Canadian's would put down the "free medical" kool-aid..
Tell it like it is.
Canada has subsidized medical services for the general public, but if you have the money to pay, it has a much better and more efficient private system for your needs.
I live in BC (Squamish), and people regularly need heli-evacs from very difficult locations here. I've never heard of one taking 5 hours. It's usually 60-90 min to scramble the SAR crew, get them to the heliport and into the air.
Also, we spend much less per capita on health care than the USA and are about average in spending among industrialized countries.
On the other hand, the mountains in Quebec are no where near the size and scale of the Rockies or the Coast Mountains, and the types of activities practiced are not the same (ex. no alpinism as there is no alpine, other than in the Gaspe region, and I would argue it is mostly subalpine). People definitely cannot compare Europe and Western Canada/US with the Quebec City area where the tallest mountain in the Laurentian Mountains (local range) is about 1100 m high. There is simply not the need for nor the same level of expertise developed. Worth mentioning, I also worked on ski patrol in Quebec, and heli rescues are not part of the regular tools, while in BC, the team practiced heli rescues (identifying and securing LZs, long lining) in partnership with the local S&R teams multiple times a season.
My point is simply that helivac would likely not be part of the regular toolset for most sporting events (ERP) in the area. Should we question whether the response was appropriate? Absolutely. Should they revise their protocols? Absolutely.
But it is NOT comparable to most places mentioned in the comments where there is a rich history and culture of S&R and helivac. There are definitely challenges associated with having an ERP that offers timely helivac when it is not commonly used in the region. I believe this must addressed for all future sporting events in Quebec.
Money should be no object in a situation like this one.
Do you move them via quad or pickup truck in that condition down to the ambulance?
I assume it's a necessary mode of transport, albeit painful being jostled (cause I've been evaced on a quad and it hurt like hell but I got off the mountain to the pain meds faster), Shouldn't they have immediately loaded him on a vehicle and got to the ambulance once they knew a pilot would take 50 minutes to get to the heli-pad?
Here in the south, EMT's regularly have to backboard people and walk them and or quad them out and it takes 1-2 hours to walk them out.
The first femur break, in December, was in the backcountry with no cell service. We were lucky enough to have a couple of guys pass by at the time, they rode like hell to the parking area, where there's an emergency phone. We had to roust the volunteer fire department to come evac him about 2 miles by Rokon motorcycle before we could get him into a suitable landing zone to be flown out. He was still in a hospital bed and in surgery in half the time it took them to get Brook off the hill at all. INSANE for an event like this. We were just 2 idiots out riding and managed to piece together a decent evac. Part luck, definitely, but we hadn't planned an international event around the area either.
I realize he didn't have a spinal injury, but we didn't want to wiggle him around too much and catch an artery or something. I have been nothing less than blown away by the crews here around Denver.
@endurocat - Private medical. Competition in the market. Options. You want it, you get it. No bureaucrats making determinations for YOUR medical care.
However, I do think that the UCI should have a private chopper on standby for praccy and race days, when local legislation prohibits speedier exit, whatever that means.
If this is the way things work over there, then races should not be held there.
Also, why the heck did the Dr. need 30 minutes to arrive on scene. Should have been locked and loaded all day ready to go.
I apologize if I got my facts wrong regarding GDP and healthcare costs. My research back around 2010 showed that it was. I'll have to look at the link you posted and dig into the data. Thanks for posting it.
There was plenty of it at the bottom of that track.
I’ve gone that long before getting pain meds with a dislocated and broken hip, it ain’t fun. I was evacuated from the bike park in timely manner but the experts at the hospital wouldn’t give me anything for the pain until surgeon could see me. I couldn’t imagine the panic of waiting that whole time trail side, I’m glad Brook had a doc on site who could give him pain meds on site, at least!
** I paid a decent amount of money for private Physio, massage etc to help speed up recovery***
Ya I’m sure I bumped a few fat old smokers off the wait list for their 2nd fake hip... so what! the emerge team has done an awesome job of keeping this guy mobile and pain free post surgery.
AGAIN, GENIUS, blame the venue, not the UCI. They OBVIOUSLY submitted a false or embellished plan. Again, Pinkbike commenters are AMAZING and you all never fail to provide endless entertainment. You must be a historian to have the will to look all that up. Let me ask you this: My days in the Army I had subordinates that presented to me a plan for whatever it is we were doing and I had to sign off on it, and do you think I called every respective unit or organization involved in that operation to prove what my subordinate was telling me was true? NO! It's called being a PROFESSIONAL and when you submit a required plan of action you are responsible for providing you ensure that it is legit because the higher command (or in this case, governing body) doesnt have the time or resources to contact everyone involved to make sure what is state dis legit. I know that if I submitted an operations order that was falsified I would have been held accountable for every injury or death that happened. No different here. Mont St Anne submits a report stating how they are meeting the requirements then that's on them.
To clear up potential confusion about on mountain ground transportation specifically with spinal injury, moving the patient once a quality stabilization is completed can come from any number of sources. It isn't uncommon to use an ATV with a litter trailer or a reasonably equipped side-by-side to move a patient for a short distance if the terrain requires it, but even with good stabilization movement is avoided where possible. The thing with resorts is there is usually a ton of access to most of the mountain via foot or vehicle through maintenance roads, so if an ATV was going to be an issue for movement to the nearest ambulance access, carrying by arm and hand, or in a one-wheeled litter would still not take very long. With sufficient staffing, you could easily rotate groups of five or so guys and gals to keep arms fresh when carrying a patient. It's also always an option to pull capable friends and bystanders of which there would be tons at a World Cup to aid in extrication.
The most confusing part about this whole Brook story is the attempt to fully treat the patient on the hill. In a very worst case scenario with no vehicle support, if you have adequate medical staff you should easily be able to carry a patient off the mountain within an hour, once everyone finds a rhythm for movement it can go quite fast, still hard as hell, but pretty much eliminates any jarring movements when done correctly. I feel as though the preparation and organization by the venue must have been abysmal and feel awful that a doctor was made to administer five hours of care with limited support on the hill, that sounds like a nightmare, especially with facilities so close.
As a non-expert, but someone with enough experience to make commentary, perhaps the new approach should follow a similar strategy to what was utilized in my time at Trestle. Our directors would stage worst case scenarios, especially in early season or in preparation for major races/events and make everything as hard as possible. Steepest part of the mountain, difficult vehicle access, the gnarliest injuries or medical episodes, limited personel, etc. Humans make mistakes, and we certainly struggled on some of those trainings, but those mistakes were addressed and never repeated in actual practice because we had dealt with an artificially impossible scenario in training. In any case all the best and much love to Pinkbike peeps and the Bulldog. Go tell your local patrol you love 'em and quit ducking ropes. Cheers.
Definitely an interesting situation though. It sounds like the first responders did a good job, if they were stabilizing in four minutes and monitoring and giving pain meds within 30, like the UCI says. I'm guessing at a certain point a decision had to be made: either move on foot or to wait for a heli. I wonder why they didn't just walk out, perhaps it was deemed too risky since they wouldn't have known how unstable the fracture was yet.
Hearing how long it took their private helicopter service to take off, I'm certainly grateful for the fast response times of the flight services in CO.
I understand your perspective and agree with you to a point, but you stop short of holding UCI accountable. Should the venue be held accountable? Absolutely. By whom? At the very least, UCI. But you're acting as if UCI is blameless and needs to take no action. UCI's charter is to ensure the safety of its riders, not simply to ensure a "plan" is in place. UCI needs to pull out of MSA until they get their shit together and reevaluate how it vets venue safety plans at other venues. Short of that, UCI is failing.
In my eyes this failure comes down to an overly complex set of guidelines for the situation and blame falls equally in multiple directions. UCI being one of them. The contingency for who to call and when depending on the patients condition will naturally lead to unacceptably long wait times.
These rules were written and enforced by some Canadian government entity, implemented by MSA and then approved by UCI.
That being said, I half way agree with the above that the UCI is not directly to blame for this incident as it was not their system that failed. They should however, hold the systems they endorse to a higher standard, even if that means not holding a race in a particular country because their emergency management laws suck so bad.
What's that supposed to mean,?
Our special unit of “Burros “ name is would have pulled Brook out of the woods in less than 15 min.
No seriously, we are no careless people and we make things right and fast.
They seem to think that the further you live from shiny, square concrete mirrors stacked on each other, the less competent you are.
You elude to the same thing I did. In the middle of nowhere here, they don't worry about trying to get a heli-evac. They backboard and get to working carrying the person out of whatever terrain they are in.
If anyone reads this wrong (and they will), what the hell entitles us to think the UCI and the mountain owe any of us the greatest of Cadillac rides in the sky and they should deliver us like pizzas to the hospital..."hot and now".
A freaking helicopter is a monster luxury and none of us are owed it and if one doesn't show up for us when we willingly adventured out of our bubbles, then it's up to us and the hard working and caring folk who can respond in the due time they have. Nobody forced us out into the wild places of this world. We choose to go of our own.
Unless we specifically pay for an insurance plan at the resort that guarantees specific response times for specific events, then nobody should be able to sue for us taking our own risks. Can we move on and just make sure Bulldog knows we love the hell out of his riding and his work ethic to recover??
kdvr.com/2015/07/03/flight-for-life-helicopter-catches-fire-in-summit-county
www.denverpost.com/2018/02/01/colorado-helicopter-crash-settlement
So I had a c6 burst fracture and c7 laminar fracture. resulted in 50% spinal cord reduction. went to ER took an hr to diagnose. was stabilized given fytanal for pain. ativan as a sedative and then a high strength anti-inflammatory and monitored. was told that once anti-inflammatory was administered and the spinal cord was stabilized that the risk of this getting worse was not a major concern and it was not a supper time sensitive issue. the controling concern was how to transport me to the hospital without further impacting the spinal cord. at this point it was determined that life flight was the best option. took 2 hrs to track down a heli and then 30 min to get to the ICU. was at the hospital 1 hr prior. so, this was a controlled environment and it still took around 4hr to get to the ICU from once I went to the ER. once at the ICU i was monitored and didn't go into surgery for another day. what I took away was that once I was given the drugs and stabilized time was not as much of a controlling factor. it sound like this was the same thought process as what was described above. also, with this incident you are having to transport the victim by hand to the nearest LZ. I have also work as a helitack crew member and been involvedin in 2 instances where people have to get helivaced out of fires with life threatening injuries. 3-4 hrs was atypical time from once the incident was called in to when they were evacuated. in regards to having a heli on standby my life flight cost 20k for a 1/2hr flight (granted this included two paramedics and the cost of drugs) so the cost associated with having a heli on stand by would be very expensive. more important you are removing access to valuable resource without knowing if it will even be used. what happens if there is a life critical accident 1 hr away but now you need to get a heli from 3 hrs away because the closet one is now reserved on standby? My take away is that they definitely need better procedures in place but peoples general overreaction to this is not completely accurate. Yes I know my spelling is the low hanging fruit on this response. cheers
UCI needs to just own this, apologize, support Brook, and show us that they aren’t scum by improving every aspect of their emergency response prep.
Also, side note... but where was Red Bull through this thing?? Really haven’t heard much on their end. Probably a lot I don’t know about sponsor rules etc... but don’t they have a lot of helicopters? Seems like keeping a Red Bull heli on site for these events would be amazing publicity and a nice gesture to the athletes that take insane risks to keep Red Bull associated with the gnarliest of gnarly. Just an idea to make things better, not intended to hype the blame game or start arguments about fault.
The timeline of events provided by the UCI official is not what was being asked for and come across as defensive or evasive. What's needed is acknowledgement of failures and solutions for the future.
Brook's injury at the time could have been severely life altering. Life as Brook knows it could be over but that isn't good enough for a reasonable evac time?
Assuming that the facts in UCI response are correct, how UCI/Velirium/Medics on site dealt with the situation: 5 mins for the first responders, 30mins for the doc to reach Brook and then 1h from the accident to call the heli is, in my opinion, acceptable. What I mean is that you have to take in account that the doc had to hike up the track, futher stabilize him, evaluate and then make the decision to evacuate him by air... I highly doubt that on any ski hill (Alps, Rockys, whatever), any mountain bike events or any high risk events where NO HELIS ARE ON SITE ON STANDBY, that the very same accident that Brook suffered would've been dealt more efficiently. Feel free to correct me if I'm wrong.
Brook's injury could have been - and may yet be - life altering. That is not the same as life threatening. A doctor on the scene determined the injury was not likely to cause loss of life, which appears to be the criterion to determine whether the most urgent solution - the military helicopter - was deployed. Death was considered unlikely, therefore the military helicopter was not used. On that issue, protocol was followed.
Some of the questions we might ask include:
• Were the protocols appropriate? For example, there could have been additional criteria for deploying the military helicopter, such as the timeliness / availability of other options.
• Were all protocols clear?
• Were the preparations for non-life-threatening situations adequate?
• Did all parties comply with preparedness standards or with the protocols?
• Did all parties promptly and accurately communicate their status?
"Were the preparations for non-life-threatening situations adequate?"
and possibly
"Did all parties comply with preparedness standards or with the protocols?"
The answer to the former is almost certainly "no" and it sounds like there may have been issues with the private helicopter operator that could result in "no" for the latter, too (the situation is less clear to me on that issue).
I can guarantee you, he would have been in the ER in 60 minutes if this had happened in Leogang. And i mean from the minute someone called in the accident, without prior assessment.
It took the heli about 10 minutes to reach us in Saalbach. Another 20-30 or so to lift in the doctor, stabilize the patient, carry them to the heli landing spot by winch, put him down again and then load him into the heli.
The whole thing was done in about 45 minutes with staggering efficiency.
It can definitely be done much much faster than what was showcased in Qebec. Especially with a heli on standby.
And we´re talking about a (albeit really really badly) injured foot here.
It was the race organizer's choice to rely on the heli evac procedures already in place, along with any local regulations that go along with them. If local procedures require you to get a doc up the mountain (30 min) to assess threat to life (30 min), then call in a private service located far from the resort (50 min), that's not even on standby at the helipad (50 min), then the race organizer should be making other heli arrangements. Seems like this was mostly forseeable, which is really disappointing. People on-site with Brook did their jobs, but the people behind the scenes apparently did not.
TBH, it just sounds like the race organizers were cheap/lazy in relying on existing procedures, and the fault pretty much lies with them. It can't have been much effort to give the private heli company a copy of the schedule and time slots when calls might be expected (practice, quali, race, etc). Would have been nice if the UCI understood Quebec's arcane heli procedures and stepped in beforehand but it's not really their job to understand how all the local laws might affect race operations. However if UCI fails to raise the bar after this fiasco then we can freak out at them. Their response here is.... not that inspiring. But then again I don't expect them to throw MSA under the bus publicly.
From the moment of the crash, your buddies called for rescue/help then it took "10 minutes (for the heli I guess) to reach (you) in Saalbach. Another 20-30 or so to lift in the doctor, stabilize the patient, carry them to the heli landing spot by winch, put him down again and then load him into the heli. The whole thing was done in about 45 minutes".
All of your experience correlate with Brook's accident in MSA : 5 mins for first responders, 30mins for doc to hike up, then another 30mins for him to get stabilized, evaluated and ready to be evacuated. Where it went wrong, and that was my point earlier, is that it took almost 2 hours (50mins prep + 50mins flight) for the heli to show up at MSA after the medics decided on an air evacuation. If it would've been possible to use an ambulance in Brook's case, all of that would have been taken care of in about 1h30 from the moment of his crash to his arrival at the hospital.
Again, my point was that Velirium (which organized the event, Not UCI or MSA which is the ski hill corporation), should'nt have have relied on the turn around time of the air evacuation (which must have been "sold" to them as way less of 1h40) instead of having them on site.
Yeah, i got that.
I was just making the point that there was a lot of stuff going on even before the heli was called.
In my case, i called in and literally told them to send a heli. Without many questions they complied and the heli was in the air (as i was told) while i was still on the phone telling them about the situation.
If, as you correctly stated, they have had a heli on standby they should have just called in the heli immediately once it became clear Brook was seriously injured. The fact they had a doctor hike up there first to assess the situation is pretty damn embarassing for an official event of international magnitude, if a regular guy like me in a bikepark can literally tell the phone operator to send the damn heli.
So, where i disagree with the timeline is anything that happened before the doctor´s assessment and call for a helicopter, because that´s basically almost another hour of delay that could have been avoided if proper response protocols had been implemented, which should have been the case given the rather obvious shortcomings in local emergency response procedures.
You stated that at other locations this wouldn´t have been dealt with any faster and that´s where my point is. In my case, it was dealt with one whole hour faster, because noone but me needed to assess the situation first in order to authorize a helicopter evac.
As first responders were on location within 5 minutes, their evalutation of the situation should have been enough to authorize helicopter dispatch, if actual emergency protocols were in place to circumvent the faulty local legislation.
So honestly i am of the opinion that this whole thing couldn´t have been handled any worse and that´s not even considering the f*ckups by the med evac company.
That's not to put any blame on the first responders, docs, etc - I'm sure they all did their jobs the best they could. This was a management/logistical failure 100%.
That being said, 50min prep for 50flight time is ridiculous, but the blame cannot be put on them exclusively. Most likely, they were not aware there was an event that might require their services and were called at the last minute. The issue lies with the organisation lack of preparation to evacuate a serious injury. The services in winter are easier on snow, but the mountain itself is not really equiped to handle major evac with a quad. And specially where the accident happened. I would definitely NOT be immobilized and towed behind a quad on those access trails!
"The organiser must submit an evacuation and medical plan to UCI prior to world championships, world cup and continental championships. The organisers medical coordinator must meet the technical delegate if applicable or the president of the commissaires’ panel before the first training."
Clearly states an evacuation plan is needed, and that it must be signed off before first training by the UCI representatives at the event. This clearly shows that UCI signed off on something that was not adequate. They were still the last signature signing off everything as OK, which it turned out not to be.
So if an air lift is not possible, what is the alternative... that is the first question that should have been asked when reviewing the plan. Apparently no one asked this as because if someone had then they would have had a plan in place before Brook crashed and would have known exactly what they were doing. Not dithering around on the side of the hill.
UCI can say that it is the organisers fault, but their own rules indicate that they sign off on it, therefore they are the organisation holding the can at the end of the day, just as much, if not more than the company that was the organiser of the World Champs.
The waffle in the press release is just backside covering before the poop hits the fan.
It was far longer than 30 minutes to get him sedatives, we know this from multiple sources present and Brook is not a liar.
You need to respond to the mental decision to put that man on a quad and the individuals who attempted to do so should not have employment any longer.
Talking to the team managers, everyone knew that the UCI would push off blame onto the organizers, who would in turn say this is how it is. But it should not be considered acceptable by anyone. Consider this: in world cup winter sports, an evacuation delay of 45 minutes led to multiple people losing their jobs.
Xavier Bigard you need to resign.
It is a whole sorry affair where everything that could have gone wrong did and Brook is the poor guy at the end of it.
What don't you understand about : "Important to note that only military helicopters are able to carry out air lifting rescue operations."
This is limited by the quebec legislation. In a life threatening situation the military heli would have been called.
The main issue to me is :
- the time it took for a doctor to come to the scene : 30 minutes. For instance in Irish motorbike road racings there are doctors on motorbikes whose job is to be at the scene of the crash as quickly as possible. We should have medics able to ride a DH bike or a dedicated motorbike with necessary equipment on a DH world course or access paths and reach to the scene of the crash in only a handful of minutes. See the lectures from late John Hinds (RIP), the flying doctor, about first emergency response at the scene of motorbike crashes:
smacc.net.au/2015/10/more-cases-from-the-races
- the time it took to get a private heli on site. This one should definitely be addressed by hiring a private heli. It wouldn't really change anything in a life threatening situation.
Also, how hard do you people expect the UCI to be on the event organisers in public? We don't know what is being said in private, but do you really expect people would want to hold World Cups if the UCI publicly crucifies them when something goes wrong?
The UCI deserves our contempt for pushing off the responsibility and this statement leaves a lot of questions unanswered which I find unacceptable.
Why did the UCI tell us they delivered sedatives to Brook within 30 minutes when people on site have claimed 60 minutes? Why was there an argument over whether or not Brook should be evacuated via quad? And why on earth were fellow racers the individuals making the medical call not to let him down via quad?
As I stated previously, in winter sports a similar situation led to resignations and this was caused by an evacuation delay of 45 minutes. If the UCI does not receive pressure from the athletes, teams, organizations and us the bike communities they will not take responsibility and we will not see adequate change.
The tone in the UCI statement is however irritating, at least, and i think a great chunk of commenter's rage lies there
If the riders don't feel adequately protected by their teams, the event organisers or the UCI then some sort of riders' union (along the lines of the Grand Prix Drivers Association) might be needed, if there isn't one already. This might be especially important for the privateers.
Is that too hard?
DH and MTB pro cyclists in general should apply for membership and get someone represented for their respective disciplines. Road riders managed to get some bad weather protocols tules applied among other things, women are fighting for more representation and equal prizes. DH riders should be able to benefit by pushing for measures towards safety.
The UCI will gladly take all the plaudits of having a great World Champs or a fantastic World Cup event, but ducks behind a passage in a rule book to say, "oh, it's not us at fault, but them...". If you have that rule, you should also have someone policing it to ensure that you are happy with their (the organisers) response to it.
If you want the plaudits, you also have to accept the negatives. And that is why they are (and quite rightly) in the firing line. The UCI Commissaries are supposed to check these sort of things, are they not? It is their name on the billboard, not Verilium (of whom I did not even know until the comments in this article); ergo and by perception, they are the organiser in the face of the public. If they don't want to seen as this, then they need to take their name off the headline.
It is their own systems that have let them down as they (the UCI) seem to not have had a system in place to check safety systems are to a high enough standard. And if they do, then their own system is lacking as well. Seems no matter which way you look at it, there is fault on their behalf.
Hate for UCI in this respect is fully warranted.
The organiser is ducking the fire at this point simply because no-one really knows who they are. But both organisations are equally culpable here.
But equally, Matt, what if NOTHING is being said in private? UCI hiding behind a clause, and the organiser hiding behind "it wasn't life threatening...". No need to even talk to each other if you're both taking that approach as they are trying to say they are the victim of circumstance. Each organisation are equally gutless.
Fail to prepare, prepare to fail...
The weird "life-threadening-rule" aside, there are so many crazy shortcomings in this short interview - I can't f***ing believe it.
1. Is it so hard to at least say "SORRY" or acknowledge failures once?! --> Xavier Retard would be a suitable name.
2. If the local regulations do not allow fast acting in such a situation, then you cannot hold such an event there.
(50 minutes to get the call for the heli out and another 50 minutes for the crew to get to the helicopter?!?! wtf) If the respons team already suspects that a spinal injury occured, what other options besides a helictoper do you have in a mountainous area? How can this be a 50 minute decision-making process?!
3. Why can't you get one of those private helicopter operators staying at the side? Maybe even one that can actually do an airlifting rescue?
4. At an event of this size, importance, coverage etc. 30 minutes for the first doctor to arrive?! If you know a (dangerous) part of the track is hard to reach, then you better have a full medical team waiting close by! And not somewhere down in the valley.
5. Severe injuries, not matter what type, can get life-threatening at almost any time. How can you tell, with an on-site assessment in the woods, that "the victim" was "not in danger"?
Clearly states an evacuation plan needed, and that it must be signed off before first training by the UCI representatives at the event. This clearly shows that UCI signed off on something that was not adequate, therefore they cannot say, sorry, not sorry, as sorry, but they were the last signature...
"The organizer remains exclusively responsible for the safety at his event."
Btw, at which point did MSA blame the UCI (since you mentioned "blame each other")?
I hope this serves as a wakeup call to UCI & any other organizers that these type of things should be planned for well before the event. Just because Brook is apparently doing well, it doesn't mean that things couldn't have been WAY WAY worse if a few variables went even slightly differently.
Doctor there in 30 mins - where the **** was he/she? Why was the doctor not stationed on or, at least, at the foot of the hill with access to uplift and/or a vehicle of some kind?
No extraction - fair enough i suppose as its local law, sucks if you're the patient of course.
Private airlift - jesus wept, cannot fathom why there wasn't a local crew on standby at the biggest race of the downhill calendar
0mins, call comes in and 1st responders start heading to scene
4mins, 1st responders on scene and starting their primary assessment
6mins, 1st responders notify dispatch of info and ask for doctor.
7mins, doctor gets call while he is on a shoulder disco at top of track.
10mins He finishes up, grabs his gear and leaves scene.
12mins, doctor hikes back to UTV
14mins, doctor is in UTV with gear ready to go.
25mins, doctor has been battling with crowds of spectators in his UTV heading down to accident site, he gets as far as he can in UTV
30mins, doctor has walked 5 mins into the course and found patient and called himself 10-7.
*no idea if this is what happened, just pointing out that 30mins is a possibility.
And I can only imagine the situation that the doctor said that it COULD be life-threatening (knowing that it's not true) to get a quicker evac. Meanwhile someone really is dying somewhere else and the Heli isn't available. Most likely a prison worthy situation for the doctor. I'm sure you're aware of doctors' professional code?
The management and the onsite doctors failed the participants TWICE.
.
Im sure Quebec Search and Rescue Volunteer organization could also step in with their own chopper.
The one in North Vancouver gets used daily by hikers and mountainbikers.
I only see a bunch of political roadbloack in this evac. operation.
But, what do i know...
But a doctor lying to emergency services to get quicker evacuation isn't one of them. This IS a criminal act according to the code of ethics of physicians in Canada, possibly punishable by imprisonment.
By the way, the criminal code is under federal authority. So ''especially Quebec Canada'' doesn't mean anything, it's the same in any province. Are you sure you have any idea of what you are talking about?
Also the code of ethics isn't the Criminal Code of Canada. I agree that a medical practitioner shouldn't lie however.
In Ontario Orng staffs full time pilots on location 24/7. its about time your province took some of those equalization payments and do the same. This is clearly an unacceptable result especially for this type of global participation event. A pilot should have been available 24/7 and not one hour away and a nonchalant attitude towards risk mitigation from a medivac company is unacceptable.
And negligence to any professional code (doctors, engineers, lawyer, etc) by a member really is subject to a criminal prosecution. That is the point of a professional code, so members are liable of their actions.
What blows my mind, is that in 2019 in -what I think of as- a modern Western country (Canada), local legislation & infrastructure leads to such a poor service to the people.
In this case Brook is the victim and because of it happend in a WC, we all know about it. But surely there must have been lots of 'victims' before him.
If I ever go MTB'ing in Quebecq (not gonna happen), I 'll remind myself not to crash. And if I do, it beter be life treatening.
I bet all the European country's beg to differ. Even here in Belgium (no mountains) we have choppers. In the Alps (French, Swiss, Italy) you'll find very very capable mountainrescue (probably the best in the world).
I call it LACK of 'socialist health care'. I also don't understand what the problem is with the word 'socialist'. In north americ you use it as a synonym for communist or some sort?
It's a hill located in proximity to a city of half a million inhabitants. It's not a remote mountain location
Last time (about 4 months ago) they actually flew a specialist out in a second heli, obviously the condition was life threatening but still the resources are there, its just how they're organised or not organised in this case.
It is the World Cup, the highest example of professionalism for both the drivers and the organizers. If you create a track for such an event don't you worry about creating places where you can evacuate someone who, given the high level of competition, will get seriously hurt if it falls?
My guess is that the likelihood of injury at World Champs is greater than World Cups and a more aggressive evac contingency plan may need to be in place.
I agree with you!
www.nytimes.com/2008/03/04/sports/04iht-alpine4.10693330.html
So as someone who was there with him I would like to make sure everyone knows the correct facts, as I don’t believe the ones published by the UCI doctor to be correct.
I arrived on site a little bit after the crash and was with him until the doctor arrived, I believe this to be a bit longer than 30mins, and also that doctor did not arrive with sedatives, these had to be brought up the mountain by someone else.
I myself was appalled by the fact prior to this the medics on site before the doctor considered to drive him down the mountain on a quad bike trailer, down a super rough 4wd track, and they actually began doing this, until the riders present requested them to stop.
Also apparently when they called the helicopter company they were told it will be 1hr40 if we had of known this then the group that was there would have carried him off the mountain ourselves.
I hope that no one ever has to go through such a situation again and wish Brook nothing but the best in his recovery.
If I heard a race was cancelled because the riders safety concerns were not addressed I would be 100% behind the riders, even if I had to watch a eMTB race instead of a DH race! (okay I would probably just go for a ride and not watch that crap)
As for the cost, the UCI should pay and they can split the bill between their DH and XC departments. If they can do this for events like the road tours then why should DH and XC be treated worse when the risk of injury is arguably greater? If the political will is here solutions can be found.
However, they did also say they were "open to considering an update of distances and duration for helicopter rescue operations," which will hopefully be a fruitful avenue of investigation for improving managing a situation like this in the future.
I think the anger with UCI seems pretty misplaced for the most part, as it was the MSA organizers who opted to use the shitty local heli procedures, and to not provide ingress/egress areas for injured riders and heli landing points along a dangerous track. But having said all that I found their response here to be wholly unimpressive.
But can we spare a thought on this:
"In no way did the evacuation time aggravate the victim’s injuries or condition." ?!?
How is this a statement form a qualified professional - Medical Director?!?
While time did not "aggravate the victim’s injuries or condition" spending 4/5h on a hill certainly increases the risk for anyone's life regardless of how well trained/qualified the doctors on site are because... [read on]
"...the victim’s life was not in danger and that he was being monitored and his pain managed by a qualified doctor."
Monitoring vitals after a crash as bad as Brook's does nothing against the possibility of internal damage/bleeding etc. that can place his life at risk... Dr...
"In general terms, the arrangements put in place by the organisers complied with..." the UCI's need for a chance to hide behind the paperwork instead of taking responsibility for their own lack of preparation and competence!!!
The only "victim" in this case are the athletes who will understandably be "aggravated" by the prospect of having to place their trust and possibly lives in the hands of the UCI!
#1 This is Quebec. It's a beautiful place to ride, but never have I met people so arrogant or unmotivated/lazy. Some of the local staff onsite proved that yet again this year. Their contempt for anyone who doesn't speak french is pretty vile. Not all Quebecois are this way, but a considerable proportion. It angers me.
#2 The place where Brook, and a number of others crashed is pretty gnarly to get up to. Being a little over half way down the mountain it's a good hike in and not far from the gondola, making for piss poor HLS sites with all the cables and hillside. Doctor was onsite, at the bottom of the hill, with access via quad/atv, not sure what took 30 minutes to get them there. The helo circled for quite a bit trying to find a spot to land, I watched it from the gondola.
That being said, I've medevac'd enough guys out of inhospitable places to know that it is not impossible to 'man-pack' a guy out of an area like that, just bloody hard work, and likely beyond the abilities or motivations of a bunch of lazy, arrogant local volunteers with a contempt for anything not french. So why not use the mountain rescue team or fire department? Quebec is a beautiful place, with some amazing riding, but don't ever get hurt there, because you will see a side of it that is impossible to like.
Points to take away:
1. Find better staff/volunteers who are more motivated and less contemptible.
2. Have a pre-incident plan, with outlined HLS and evac points.
3. Where the F*** is your mountain rescue team, and why are they not on standby for incidents like this?
4. While the UCI are merely enablers, and they offload the responsibility for everything else onto the organizers, perhaps they would support/insist upon a specialist mountain rescue team at each event for incidents like this.
Someone somewhere f*cked up and overlooked a sufficient pre-incident plan. A simple apology would go a long way to making things right, but between the arrogance of the largely French UCI, and the incompetence of the local staff (putting him on a quad??) an apology is unlikely to be forthcoming. With the amount of people onsite, there would have been sufficient physical support to get Brook safely and comfortably down that mountain to an awaiting ambulance, and I would have been more than willing to muck in, why did they not call the local fire dept for medical assist? So many questions.
Pre-incident planning should be a bigger priority than what is clearly was at this event. Heal up quickly Bulldog.
I think that at least the helicopter should be stand-by and ready to lift in a few minutes during the event and not have to wait on the staff to come in. I also think that MSA should make a statement of some sort, gives a really bad image of Quebec right now. We know our emergency system can suck, totally agree this should have been sorted out before the event.
I'm sorry of what you think of us... I assure you that what you think most of us are, it is the contrary, it is just that bad personality tends to show more... or maybe Quebec City is worst for that kind of attitude. But I also agree that when you volunteer, you should take that job seriously and put your heart to it.
Some of the volunteers were just appalling in their attitude towards visitors, it saddens me to see them representing their beautiful province that way.
@ta4645: You can say the same about every single area in the world, probably including yours. Actually the kind of post you published earlier full of "french hate" is an example of that: bad attitude and ignorance (as if québecois and french were the same people and had the same culture).
Which is the reason they should update the rules to mandate as well as a mean for a doctor to be on site of the crash much quicker so that everything is clear to everybody : the riders, the organizers, the uci, the public.
Given the extended wait, I do wonder what the objections to using the quad/stokes basket are? If you are a regular joe at the park and you crash, you will be getting a stokes and not a helicopter.
30 minutes for Doctor to reach the scene.
20 minutes for Doctor to call for a chopper.
50 minutes for crew to reach chopper.
50 minutes for chopper to get to the scene.
40 minutes for chopper to find somewhere to land.
Reports are 4-5 hours from accident to evac, so there is extra time missing. Note how UCI does not state the time Brook was actually evacuated. The last time is "when the chopper landed". I am inclined to believe there is a further hour or more of stuffing around.
"and the event organizers will be paying to have a helicopter pilot available at the heli base off-site."
I am very surprised that UCI or event organizer did not say in the statement about anything about the above , as in "yes it was longer than we of liked, but we learned from it and have put X and Y in place"
Hopefully other events organizer's can learn from this, but I have a feeling if UCI don't help with costs like this to safe guard riders health etc, that not many organizer's will step forward as I am sure having a Helicopter and crew on stand by is going to cost a bit!
Full paragraph
"As a result of this event, for tomorrow’s race, the emergency response team is reviewing all the places that a helicopter can land, debriefing first responders on how to secure the scene for the helicopter to land, and the event organizers will be paying to have a helicopter pilot available at the heli base off-site. The response time for a non-life-threatening injury should be reduced to 50 minutes. For a life-threatening situation, it was explained that the army will be on site with their helicopter within 20 minutes."
From
www.pinkbike.com/news/brook-macdonald-sustains-spinal-injury-in-training-crash-mont-sainte-anne-dh-world-champs-2019.html?trk=rss
I was the DH track coordinator for our Aussie National Champs a few years ago and it cost our local club tens of thousands to put on the event in the end. We had to pay the Aussie version of the UCI (MTBA) to be able to host the event.
My thoughts and prayers go out to Brooke and Claire for speedy recoveries and I hope this is a stark reality check that ensures safer event structures and procedures in the future.
UCI events should be sponsored by Enve Composites. Both are happy to place blame on others.
Enve stated in Mike Levy's Enve test article "our wheels are expensive because we use King hubs which are made in house in the USA" and ignored the fact that their rims cost twice what a King hub set does and accounts for most of the cost of the wheels.
UCI... Well guys, it's an unfortunate event but we stabilized his spine and then twiddled our thumbs while we waited for the guys we are going to blame to show up. Check out our rules; they even say it's not our job to be responsible for rider safety..
Furthermore, UCI's statement of "only military helicopters are able to carry out air lifting rescue operations. In all other cases, evacuation is carried out by a private operator" is not true. Sure the only time that the military can interfere or assist is in life threatening situations, but any private helicopter response team can complete an extraction. Even here in the USA our emergency response crew are run by private contractors. Sure the police and fire department can arrive and assist in stabilizing but when you get loaded up in an AMR ambulance that's a private contracted company. In fact Life Flight in America is operated as a non-profit private entity.
UCI is shifting the blame and it's not entirely on them but they certainly aren't willing to accept any responsibility.
Potential spinal cord injuries with loss of motor function and sensation should be put in the most rapid response category, as should injuries with compromised vascular supply (e.g. no blood flow to leg). Time to intervention may matter in these cases, as opposed to a simple fracture.
I think "life threatening" is the wrong dividing line for the allocation of appropriate resources.
Thoughts and prayers to Brook.
"Bulldog and the Pups" is one of my kid's favorite videos.
www.sombriocartel.com/en-US/files/bulldog-and-pups
I hope he makes a full recovery.
How can anybody on the mountain rule out a life-threatening condition after a crash like that?
Yes, there might not have been obvious life-threatening injuries but I doubt that they did an ultrasound-exam to rule out internal bleeding and to my knowledge internal bleeding is a serious risk... How can anybody determine that he is not going to bleed to death internally while still on the mountain...
Quebec is indeed very technocratic... Somehow there is a law that prevent the winch equiped army helicopter to intervene in non life threatening injuries AND there are people to abide by that even in those circumstances!
That is as facinating as it's concerning.
That being said... I really hope that internally the UCI is asking alot questions internally and working to resolve this problem. If you are going to leave it up to the race promoters to handle the medical services, the UCI should perform a very detailed safety audit prior to the racers/teams arriving. This audit would include medical evacuation methods on this hill, pathways for transport, etc. Staffing and equipment on the hill and at the staging area, evacuation from the venue via roads and airlift as well as touching base with the local hospitals to ensure they are set up to handle a various array of injuries. Maybe they already have something like this in place.. if so.. it was poorly executed.
From the sounds of it, the delay here was due to a lack of planning and weather. One of which can be fixed.
Here's also hoping that greater emphasis and responsibility is placed on "event organizers" for having these types of contingencies covered before the first athlete drops in for a practice run, let alone racing.
More to the point why was there no alternative evac plans already in place?
I worked world cups in 2006/7/8 And distinctly remember that Champery had a Helo on site for the entire weekend, it was parked almost next to the pits, in fact i think there is footage on a Sprung?? video of a rider getting winched for evac in the middle of practice, we are talking minutes from accident to evacuation, not hours. I also recall there was low cloud at Valnord in 2007 and because the Helo couldn't fly, practice (or maybe qualies) was postponed until it was safe to fly again. I've been up and down MSA a few times, alpine/euro pilots evac from WAY more inaccessable places on a regular basis. Even if this is not possible, a spine board and stretcher could have had Brook of that mountain in 30 mins or at most an hour. Then it is a short drive to the nearest hospital. This all should be in a pre-race plan. We are talking World level sport here, not a sunday kick-about in the park
This was over 10 years ago???? have we regressed in rider safety? It is an utter disgrace, and as for the none-life threatening aspect, go sit a UCI commisaire on a mountain with a broken spine and see how long he's prepared to sit it out for. UCI/MSA whoever is actually at fault, you should be ashamed.
Team managers should be joining forces and laying the law down on where they will/wont race.
Am I wrong to think the private helicopter could be hired for the entirety of the event?
—
I was part of a DH orga team back in 94-98 for only national races. It was without saying and clear rules, to have full equipped doctors at the race. And to get to the place can’t take 30 min! This is unbelievable, to state that all went correct.
f*ck MSA and f*ck the UCI and their political answer that are worth shit!
The Bulldog must bite some heads off! Speedy recovery DH brother!
Well you know that in advance, don't you?
"... and the difficulties posed by trees and cables in accessing the area, the helicopter eventually landed"
Those trees and cables have been there before as well, isn't it?
"arrangements put in place by the organisers complied with UCI Regulations,"
Should that not read "UCI Regulations will need to be revised in order to ensure organisers have a solid plan in place for an (emergency) evacuation at each section of the track, to be executed in the unfortunate case of an accident"
Self-reflection has never been the UCIs (or any of these sanctioning bodies) strongest points...
We all saw in Andorra a very bad crash few years ago an it took only minutes for the rescue team to be in the place and working. With all the money they spend,they could grab a professional rescue team and let them to plan any emergency.
MSA needs to see this as a wakeup call. It needs to cut in heli landing zones and clear these of FOD daily during the racing. They should have individuals on the hill trained in heli marshalling and who understand how to mark out surface wind strength for pilots to assess. The need to practice their response periodically and religiously before an event and they need to be advocating to the authorities to change the rules of military heli response for the weekend based on the risk involved. If military evac isnt possible MSA should pay for the requisite event insurance to ensure a helicopter is on standby. They need all marshalls to be better trained in patient handling and evacuation.
Teams need to come together (as happened in F1) and insist on minimum standards and they need to be prepared to refuse to race, putting riders first.
The list goes on and on, but top of the pile sits UCI with the most ability to influence all of these layers through their regulation of the event. It would be easy to do. I will be interested to watch to see if they do this.
Good luck and good healing, Brook! We can’t wait to see you flying like a bulldog soon!!
That being said, from a medical standpoint the timeline that they are presenting seems “adequate”. Emergency medicine operates using standards that may sound outrageous for the regular citizen. The main premise being, “is the patient at risk of dying?”, if the patient is stable and without life threatening injuries, the priority then switches to making sure that the extraction is the safest for both the patient and the crew.
It absolutely sucks for Brooke, and PR wise it absolutely sucks for the UCI...
It's a god'damn downhill race where riders go at insane speeds - get the frigging Heli on site ready to evacuate ANY crash like that - no waiting to check only if life threatening bullshit waiting and then we'll sorta decide..........- EVACUATE STAT !
But now, what is the mountain bike community going to do about this? Because if the organizers don't give a crap about safety, then it's time for a boycott and/or strike.
You have to ashame deepl, most for the latter phrase in which you drop any responsabilities because the rider injury came from an accident.
You mr Xavier, could be a medical director, but you are not a good person.
Shame on all of you UCI and MSA, the only words you were to say were " Sorry we f*ckd up, never evaluate all the difficulties in medical emergency extraction at a site of many years word level competition of a life-treatening sport. We are just a*sholes, sorry Brook and sorry everyone."
I was riding with mates in the middle of the forest 10 miles from the nearest town, 40 miles from the nearest major hospital. Not at an organised race, just a casual ride.
I had a local first responder next to me within 30 minutes, and a helicopter landed within another 10. Testimony to this speed is the fact that I didn’t feel any pain until the helicopter took off by which time they were starting to IV me the good stuff.
Out helicopters in the UK are charities and not paid for centrally like our NHS but they all work together effectively to create a relatively efficient response system.
Within 4 hours I’d had the wounds cleaned, and the bones reset (and vomited on a nurse :-/ ).
Pretty scary to think I’d have been waiting for 4 hours at an organised race just to get evac’ed. Thank goodness for the NHS and free healthcare.
If you bike on the Surrey Hills then the Ambulance helicopter is a regular visitor to Box Hill...
UCI: "From that point on, the victim’s spinal column was perfectly stabilised, his vital signs and blood oxygen levels monitored, and morphine administered. The doctor at the scene decided to request an airlift, at which point discussions began on the best way to evacuate Brook."
'AT WHICH POINT DISCUSSIONS BEGAN' on an evac plan??? Shouldn't every section of track have a dialed in evac strategy, before the race?? Lame.
UCI should not have any right to be exempt from responsibility; nor, the organizing of assistance for evacuation protocol.
This is what corporations do to screw anyone under them, in order to benefit themselves only and not having to pay anything for failure to follow through.
Where i live, the hospital has a helicopter ready for an evacuation as such.
I remember when I was a kid playing rec soccer league, what I now call "amoeba ball" when all the kids just run around the ball in a group , where you were either "blue" team or "red" team. There was always a rescue team on site...for 30 middleschoolers...playing amoeba ball.
So the hospital didn’t have a back up plan for when the helipad was closed for maintenance?
Perhaps after Mr. Bigard's tender and heartfelt correspondence to the mountain bike community we should respond?
Everyone who's reading this as a customer satisfaction document is missing its intention.
I hope this man's child never gets hurt in a similar way.
Every bad situation must lead to an improvement. Period.
www.vojomag.com/news/worlds-2019-brook-macdonald-blesse-a-la-colonne-les-secours-en-question
And a new addition to the photographer shot list: helicopter landing zone + Heli + pilot.
So, no, this "entire situation" would not have been "avoided".
To think a little piece of plastic will stop a broken bone...lol....
Heal up Brook \,,/
However, the UCI Medical Director should have said "sorry" for sure, and "we've learned and will do better next time", but he won't because it implies culpability and therefore responsibility.
Airbus H145 helicopters, Cost Can$12,500,000.
Random guess operating Cost per min $60 plus crew ?? $4000/hr
Fly back to base each night
Unfortunately/ fortunately mtb isn’t F1
Get well soon Brook
And a evacuation plan for each area of the track along with transportation plan to get the Dr to the patient for each part of the track
Sounds like a good use of an ebike
A mtb first aid supplies company could even sponsor it.
@opignonlibre: