On track Alpinestar medical crew does nothing, spinal chord injury is serious

LungButter
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5/1/2023 11:09am

So he didn't have any spinal or back injuries at all right?  Just checking.....

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Tyler D
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5/1/2023 11:17am
LungButter wrote:

So he didn't have any spinal or back injuries at all right?  Just checking.....

dude.jpg?VersionId=E9egxyEIJ 8sXZ

 

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OR Racer46
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5/1/2023 11:25am
LungButter wrote:

So he didn't have any spinal or back injuries at all right?  Just checking.....

Per Cooper No  .  Per Vital he broke his clavicle,  his  spinel cord was damaged ,. his head was ripped off , Medics suck , everyone should be carted off in a air mattress 

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mersk331
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5/1/2023 11:30am

If the whole Alpinestars medical unit is ran by such morons then the OP can volunteer just like the rest of the people on the team. Not saying people don't make mistakes and that what happened with Brian was good at all. Things can always be made better, and they should be. So go right on ahead and sign yourself up. Don't come on here just to bitch. Every person on that team cares about the riders and does the best they can. There have been plenty of crashes where riders are taken out on the stretcher just not always on TV. You're trying to use a microscope while ignoring the rest of the table. 

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The Shop

RichieW13
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5/1/2023 11:37am
LoudLove wrote:
“ providers can’t force medical treatment on a sober and competent adult.”  I’m curious if that applies to individuals participating in a professional sporting event?  And...

“ providers can’t force medical treatment on a sober and competent adult.”  I’m curious if that applies to individuals participating in a professional sporting event?  And what are the protocols when treating a participant suspected of suffering a concussion?  It’s a fascinating discussion.  

spimx
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5/1/2023 11:58am
Splat03 wrote:
We don’t immobilize or treat based on mechanism. That’s old medicine and no longer taught in EMS. We evaluate the pt based on their complaint and...

We don’t immobilize or treat based on mechanism. That’s old medicine and no longer taught in EMS. We evaluate the pt based on their complaint and take mechanism into account. If they don’t have a current CTLS complaint AND are able to make sound medical decisions AND refuse immobilization then guess what, no collar and or board. I was not privy to the conversation held between Webb and the Asterisk crew members but if Webb refused then no immobilization. 
Adults are allowed to make their own decisions regarding their own medical treatment. They are even allowed to make poor decisions that medical providers disagree with that are later documented as an AMA refusal (against medical advice refusal).

I watched the same race and saw the same thing everyone else did. I also thought a collar and board would be appropriate as a precaution but providers can’t force medical treatment on a sober and competent adult. 

The long spine board actually has worse outcomes in some research. The benefit of the cervical collar is inconclusive. Also we're talking about a very specific demographic of patients here that are elite level athletes. Most of the detriment to the long spine board and cervical collar was patients with things like obesity lordosis kyphosis history of respiratory disease. The infield of a supercross track is probably not the place to evaluate and inform the patient, that's just my idea. If it was up to me they would be aware ahead of time that they are going to be removed from the track with spinal motion precaution which would be the scoop stretcher, because vacuum mattresses take a long time to apply. Anything is better than making them stand up and walk when they are clearly disoriented and then bouncing them off the track on the back of a mule and absolutely nothing supporting their spine. 

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spimx
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5/1/2023 12:01pm

If they have a high forces event and the medical crew can see that it was like a shoulder or an extremity or something that took the brunt of the impact, the racer can determine how they want to be taken off the track. If you can see that they got nailed directly in the head or back of the neck like Cooper Webb did the racers need to be aware ahead of time that there will be repercussions if they refuse being immobilized to be removed from the track. 

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Question
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5/1/2023 12:03pm Edited Date/Time 5/1/2023 12:39pm
LungButter wrote:

So he didn't have any spinal or back injuries at all right?  Just checking.....

OR Racer46 wrote:
Per Cooper No  .  Per Vital he broke his clavicle,  his  spinel cord was damaged ,. his head was ripped off , Medics suck , everyone...

Per Cooper No  .  Per Vital he broke his clavicle,  his  spinel cord was damaged ,. his head was ripped off , Medics suck , everyone should be carted off in a air mattress 

This is not directly addresed to your post but would you say that if Webb had woken up unable to walk or with partial paralysis ? When that will happen to you, or your friends, maybe you will change your mind.

Safety is no joke. We can try to brag and makes ourselves look like rednecks because only tough guys ride motocross, but for me anything regarding safety is important and have to be discussed regularly. Indeed quite a percentage of people are not riding anymore because of injuries, sometimes life changing injuries, or overall safety issues (rocks next to the track, lanes on tracks that are too close - death of my nephew's friend a couple of years ago like that - , lack of flaggers, lack of paramedics (or skilled ones...), lack of helmet communication from the racing direction, 4 stroke grenading, lack of collarbone protection, etc etc). Maybe 20 to 50% of the people have exited or are simply not entering the sport because of relatively easy things that can be improved, so I think that addressing this recurrent issue is also important to grow the sport (and make people's life better). 

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TeamGreen
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5/1/2023 12:06pm
spimx wrote:
Too many racers in wheelchairs now. Lots of vital guys are going to say "o but they are doctors and nurses and work on EMS"; Then...

Too many racers in wheelchairs now. Lots of vital guys are going to say "o but they are doctors and nurses and work on EMS"; Then why do they do absolutely nothing for Webb? They should have told Webb don't move at all and then they immobilize him with a scoop stretcher and move him to the x-ray for a better evaluation before anything. 

 

That was a direct hit to the spine and you can see alpinestars directing him to walk off the track then he is just sitting up on the mule. Anyone can help a rider to the mule and then drive so what does alpinestars provide??? 

 

They really need to practice some spinal trauma management on the track. The racers should understand ahead of time that if they take a big hit and are already off the track they need to just not move and alpinestars will extricate them to the mobile x-ray and a more controlled environment before they are allowed to sit up and walk around potentially exacerbating a spinal chord injury.   

The way they had Webb on the mule is exactly how they had Brian Moreau? No lessons learned???

 

Here you go FIFA is using whats called a stokes stretcher which would be better than letting Webb stumble around, make him stand then ride sitting up with nothing supporting his spine across a dirtbike track s1200 photo

 

FD282972-3CD7-482B-B332-F5FA3B4C6116

 Laughing

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Splat03
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5/1/2023 12:33pm
Splat03 wrote:
We don’t immobilize or treat based on mechanism. That’s old medicine and no longer taught in EMS. We evaluate the pt based on their complaint and...

We don’t immobilize or treat based on mechanism. That’s old medicine and no longer taught in EMS. We evaluate the pt based on their complaint and take mechanism into account. If they don’t have a current CTLS complaint AND are able to make sound medical decisions AND refuse immobilization then guess what, no collar and or board. I was not privy to the conversation held between Webb and the Asterisk crew members but if Webb refused then no immobilization. 
Adults are allowed to make their own decisions regarding their own medical treatment. They are even allowed to make poor decisions that medical providers disagree with that are later documented as an AMA refusal (against medical advice refusal).

I watched the same race and saw the same thing everyone else did. I also thought a collar and board would be appropriate as a precaution but providers can’t force medical treatment on a sober and competent adult. 

spimx wrote:
The long spine board actually has worse outcomes in some research. The benefit of the cervical collar is inconclusive. Also we're talking about a very specific...

The long spine board actually has worse outcomes in some research. The benefit of the cervical collar is inconclusive. Also we're talking about a very specific demographic of patients here that are elite level athletes. Most of the detriment to the long spine board and cervical collar was patients with things like obesity lordosis kyphosis history of respiratory disease. The infield of a supercross track is probably not the place to evaluate and inform the patient, that's just my idea. If it was up to me they would be aware ahead of time that they are going to be removed from the track with spinal motion precaution which would be the scoop stretcher, because vacuum mattresses take a long time to apply. Anything is better than making them stand up and walk when they are clearly disoriented and then bouncing them off the track on the back of a mule and absolutely nothing supporting their spine. 

I hear ya on the scoop vs board. I don’t disagree with having a high insect of suspicion towards injury and safety. But the downside of spinal immobilization while on track is having multiple people including riders at longer risk of being unintentionally struck by other riders still competing. And, the downside to red flag/race stoppage is restart and we’ve all seen the carnage that can happen during restarts. 
I disagree on the implication that Webb was clearly disoriented. I totally recognize that he was wobbly when he first tried to stand and then was able to, but, without performing the eval or being present I’m not going to knock those providers and say they did it wrong. Sure, they could have totally messed up but they are incredibly more educated in concussion protocol and riders consent as it stands in this race series than an average, everyday, on the street provider. 

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5/1/2023 12:33pm

I'm really glad I didn't look at this thread all weekend. I guess you guys are saying they should have just sedated him when he was trying to get up with his fully functioning legs so that they could put a collar on him and strap him onto the backboard? 

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captmoto
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5/1/2023 12:49pm
ZinAZ wrote:

xrays aren't used for spinal cord injury...CT scan and MRI are. but keeping digging.  always remember uneducated opinions are waaaaaay more important than evidence based medicine.  

X-rays show vertebral displacement and fractures. They sure can point to the possibility of cord injuries. 

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spimx
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5/1/2023 1:28pm
captmoto wrote:

X-rays show vertebral displacement and fractures. They sure can point to the possibility of cord injuries. 

sure CT or MRI would be most conclusive! I think when a high forces event is identified, getting them off of the track with some precautions then an x-ray get to a place where you can actually communicate and perform an assessment; thats probably good enough to say, you can go to the LCQ or emergency traffic to the trauma room or somewhere in between. 

I dont think they need to be getting a refusal or performing a detailed assessment on the side of the track when you probably can't even hear yourself talk, just, identify the high forces event, take precautions and get them off of the track safely.  

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300exc
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5/1/2023 2:19pm

This thread is in the stratosphere of lunacy.

Next some of you will have the riders all strapped to individual backboards at the gate.

(They can choose scoop or not.)

that way if they crash they can just be carefully carted off, no matter what.

Webbs freakin fine except for a concussion.

if you need to see how it goes in a different situation watch how well they handled Fernandis in his crash. 
 

 

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DonM
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5/1/2023 2:23pm
spimx wrote:

Yes I am a paramedic and the way they handled Webb would not be acceptable under my medical director or on my medic unit

DonM wrote:
If you are a paramedic then you should know better than trying to evaluate a situation from your couch and then criticize those that are on...

If you are a paramedic then you should know better than trying to evaluate a situation from your couch and then criticize those that are on the scene…

Can we be too safe with our guys risking it all out there?

Being safe and improving safety is one thing criticizing those that are there doing their job while you sit on the couch is another...every downed rider should receive the best care possible but criticizing how that that care is performed from what you see on TV is insane....

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pgstmx1
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5/1/2023 4:34pm

OP is 100% correct. Just a vacuous discussion here.

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kpiper
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5/1/2023 6:26pm Edited Date/Time 5/1/2023 6:26pm

Maybe Webb first told them to leave him alone? I kind of expected to see him try to get on the bike again or in the LCQ as tough as he is. Like when Stewart tried but was unsteady.

Racers are tough and want to race. The medical people have to respect that and keep it in mind. That is how I see it.

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LungButter
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5/1/2023 7:32pm

OP, have you offered to volunteer for the AStars unit ever?

Given your vast knowledge and expertise I’m sure they’d love to have you. 

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5/1/2023 8:35pm

They actually had him walking around when it first happened. They should have red flag the damn race and got an ambulance in there immediately. 

If that's the case, every crash that is not witnessed, or medics believe a backboard is required, stop the race.

I'm not saying yes, or no. It's just a question.

PFitzG38
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5/2/2023 5:30am
LungButter wrote:

OP, have you offered to volunteer for the AStars unit ever?

Given your vast knowledge and expertise I’m sure they’d love to have you. 

Yeah….NO. I would be scared shitless to be extracted by spiguy. As opposed to AStar guys who are trained specifically for moto. What a typical vital kook 😂😂😂

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5/2/2023 6:44am
pgstmx1 wrote:

OP is 100% correct. Just a vacuous discussion here.

Downvoted for making me look up what vacuous means

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Hodge336
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5/2/2023 7:23am
spimx wrote:
No you can't. It's much better to take proper precautions and get imaging. https://www.revzilla.com/common-tread/ryan-dungey-out-with-cracked-vertebrae Dungey was racing on a c6 fracture. You can not spot these...

No you can't. It's much better to take proper precautions and get imaging. https://www.revzilla.com/common-tread/ryan-dungey-out-with-cracked-vert…

Dungey was racing on a c6 fracture. You can not spot these things from "a mile away" You also can not just ask the racer if they are ok. They need to take precautions and get an image. Dungey could have easily been in a wheelchair and he was still out riding the bike

You do realize it's completely possible to break something in your neck, and to have it have absolutely no involvement with the spinal cord, right?

Its definitely is possible. It is also possible that you have an unstable fracture that seems fine but you move the right way and bone fragments injure your cord. 

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5/2/2023 7:47am
spimx wrote:
Too many racers in wheelchairs now. Lots of vital guys are going to say "o but they are doctors and nurses and work on EMS"; Then...

Too many racers in wheelchairs now. Lots of vital guys are going to say "o but they are doctors and nurses and work on EMS"; Then why do they do absolutely nothing for Webb? They should have told Webb don't move at all and then they immobilize him with a scoop stretcher and move him to the x-ray for a better evaluation before anything. 

 

That was a direct hit to the spine and you can see alpinestars directing him to walk off the track then he is just sitting up on the mule. Anyone can help a rider to the mule and then drive so what does alpinestars provide??? 

 

They really need to practice some spinal trauma management on the track. The racers should understand ahead of time that if they take a big hit and are already off the track they need to just not move and alpinestars will extricate them to the mobile x-ray and a more controlled environment before they are allowed to sit up and walk around potentially exacerbating a spinal chord injury.   

The way they had Webb on the mule is exactly how they had Brian Moreau? No lessons learned???

 

Here you go FIFA is using whats called a stokes stretcher which would be better than letting Webb stumble around, make him stand then ride sitting up with nothing supporting his spine across a dirtbike track s1200 photo

 

As soon as I read this, I thought "He is right but he will get flamed for posting this" and that's exactly what ensued lmao. 

I am not a medical professional and don't really have any advice for the Astars crew, but w/ the Moreau situation happening the way it did you would think they would treat someone who just took an extremely hard hit directly to the neck and spine with a little more delicacy. 

I was watching the race with 5 people and all of us had the same verbal reaction of confusion when we saw him riding upright in the mule rather than laying down. Just a thought. 

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5/2/2023 9:07am
kpiper wrote:
Maybe Webb first told them to leave him alone? I kind of expected to see him try to get on the bike again or in the...

Maybe Webb first told them to leave him alone? I kind of expected to see him try to get on the bike again or in the LCQ as tough as he is. Like when Stewart tried but was unsteady.

Racers are tough and want to race. The medical people have to respect that and keep it in mind. That is how I see it.

What if they allow a racer that is out of it to get back into the race and then he causes others to be hurt?  I think that the Astars guys are great to have at the races, and all the equipment they have in the rig has helped out many of the racers I know.  I was listening to a podcast with a Rally racer. He and another rider had crashed in the same area. The one being interviewed  did not feel like  he had been injured to badley and the other got a helicopter ride out. It turned out that the rider who was thinking he was fine , also had damaged vertebrae in his neck. He is fine now.  A local b class racer I used to ride with told me a story about when he broke his back. He didn't think anything was wrong. He had gone home after loading his bike up, unloaded the bike and washed it and put it away, had a normal night. But woke up in the middle of the night unable to move his legs. He ended up fine. 

I'm not sure how common it is for somebody to have a break and not know it. But including myself, I know of  a few that it has happened to. Everybody ended up OK.  I'm glad I do not have to make the decision of what acceptable risk is.  I would rather play it safe. But I can see how those guys put everything into trying to win. And I would hate to make a wrong decision that held somebody back for nothing. If not for the issue with  the young french rider Brian, I may not question the lack of precaution.  And I understand that every racer takes the risk when they line up. But they also rely on the medical people to keep them safe. So they should trust their opinions if they tell a rider that they should be on a board to be safe. Most of the time the rider is going to be ok. Is that just statistics , or because of the way the rider is taken care of?  If Cooper turned out to have  an injury that is almost impossible to know about for sure before they moved him, would everybody feel the same way? Just because they guessed right with the info they had this time.

PS. I was checked out trackside at an Arenacross , by local EMT's and they told me my foot was probably just bruised. They had told me that they had a rider the week before who had a similar looking injury and they thought it was a break and it ended up not being one. So they were experienced with racers to some level.  11 years later I have a fused foot, went through 6 surgeries, got an infection that almost resulted in the loss of my leg and made me very sick .  Some of that was because I told Dr.s and EMT's that I did not have pain as bad as it was , because I wanted to ride. Not for millions of dollars, chances at a title or fame. Just because I loved to ride. So I feel like when you add in how determined the top guys are, all the money they can make, etc. it makes it even harder to protect a rider from themselves. And airing on the side of caution would be the way I would go when there is any chance of something happening that can not be undone or fixed. 

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MX455
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5/2/2023 10:10am
gharmon wrote:
I would not call them incompetent at all.  You cannot force a patient to do anything that is capable of making their own decisions. If he...

I would not call them incompetent at all.  You cannot force a patient to do anything that is capable of making their own decisions. If he says no,then its no. If, as a professional on that field in that moment you would try to tell the patient the potential risks of their treatment refusal and if they still refused then its on them (not really,the can still turn around and sue later). You would definitely make a not later that they refused treatment. Never force them.

Im not a medic or first responder. Im talking from what i see in almost all of the people that ems brings in to the ed. The patient would have most likely been collared (the ambulance he got in may have very well added a collar before getting to hospital). I DO NOT know ems protocols. I know as a nurse triaging a pt that walked in what we would do. Nothing, if they didnt complain of any neck/back pain. If,the ER dr saw that impact or was told of the possible impact im almost certain he/she would have told us to collar them. Just until ct cleared them.

I assume when the medics first got to coop they may have not seen the initial impact, thus he appeared to be more concussed than neck damage. That said, the medic was then trying to manually hold neck immobilization while riding on the mule. They knew for sure by then. 

In hindsight, everything checked out fine. Im happy for Cooper.

Glad this is all a moot point and we at least are having a discussion about rider safety. Thats never a bad thing.

 

@gharmon I completely agree with your outlook and specifically your statements about "the medic was then trying to manually hold neck immobilization while riding on the mule". We all can agree that this is all speculation, we were not on the floor with the rider. However, we can make observations that make us question the validity of their actions. If a rider refuses treatment then a simple ride back to the truck is all the assistance that might be needed. If at any point the situation changes, requiring immobilization or medical intervention, then everything should stop and procedures should be followed from that point forward. There should never be a scenario where medical staff are trying to immobilize a riders neck with their hands in the back of a moving piece of equipment.

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gharmon
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5/2/2023 10:37am
spimx wrote:
Too many racers in wheelchairs now. Lots of vital guys are going to say "o but they are doctors and nurses and work on EMS"; Then...

Too many racers in wheelchairs now. Lots of vital guys are going to say "o but they are doctors and nurses and work on EMS"; Then why do they do absolutely nothing for Webb? They should have told Webb don't move at all and then they immobilize him with a scoop stretcher and move him to the x-ray for a better evaluation before anything. 

 

That was a direct hit to the spine and you can see alpinestars directing him to walk off the track then he is just sitting up on the mule. Anyone can help a rider to the mule and then drive so what does alpinestars provide??? 

 

They really need to practice some spinal trauma management on the track. The racers should understand ahead of time that if they take a big hit and are already off the track they need to just not move and alpinestars will extricate them to the mobile x-ray and a more controlled environment before they are allowed to sit up and walk around potentially exacerbating a spinal chord injury.   

The way they had Webb on the mule is exactly how they had Brian Moreau? No lessons learned???

 

Here you go FIFA is using whats called a stokes stretcher which would be better than letting Webb stumble around, make him stand then ride sitting up with nothing supporting his spine across a dirtbike track s1200 photo

 

As soon as I read this, I thought "He is right but he will get flamed for posting this" and that's exactly what ensued lmao.  I...

As soon as I read this, I thought "He is right but he will get flamed for posting this" and that's exactly what ensued lmao. 

I am not a medical professional and don't really have any advice for the Astars crew, but w/ the Moreau situation happening the way it did you would think they would treat someone who just took an extremely hard hit directly to the neck and spine with a little more delicacy. 

I was watching the race with 5 people and all of us had the same verbal reaction of confusion when we saw him riding upright in the mule rather than laying down. Just a thought. 

I knew it was gonna get flamed and roasted as well. May have come across as harsh but the message and question was a legitimate one. Then he get flamed for a "strong opinion". 

Im like you, post Brian i would have thought they'd be a little more cautious but i wasnt on the ground and had a much better view than the medics did, initially. But even they suspected something as they were riding off holding his neck manually.

Then some got on here saying so now they gonna stop the race for everything. Making it very petty. No one is asking them to board and collar someone limping off. 

Like always on vital there is always someone to flame you. At least the flaming went away some and more people with experience chimed in. Im not an ems expert either but work very close to some very good ones! I always admire their ability to perform without guidance. Makes me wish id had some medic experiece before going to nursing.  

At the end of the day cooper was fine which is the outcome we all wanted. Iv actually enjoyed this thread, even the was "super" bad. 

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5/2/2023 10:37am Edited Date/Time 5/2/2023 10:41am

5 pages and my conclusion is that it must look like a clown show, people need to sleep well and come back next year and nobody actually really care except the ones employing them because their jobs relies on them (aka milking too). Some fans do but they are too tough anyway. When it is rotten, it is rotten. When people have no race, at some point we see it from miles away. It is like a religion, at some point you need education. Btw, i will get downvoted, but i do not give a dam.. sh... because you don't know how anything about me neither, life is good.

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LungButter
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5/2/2023 10:41am
Question wrote:
5 pages and my conclusion is that it must look like a clown show, people need to sleep well and come back next year and nobody...

5 pages and my conclusion is that it must look like a clown show, people need to sleep well and come back next year and nobody actually really care except the ones employing them because their jobs relies on them (aka milking too). Some fans do but they are too tough anyway. When it is rotten, it is rotten. When people have no race, at some point we see it from miles away. It is like a religion, at some point you need education. Btw, i will get downvoted, but i do not give a dam.. sh... because you don't know how anything about me neither, life is good.

Whoa

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IGotbored274
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5/2/2023 11:39am

I’ll talk shit… I believe they could hire a first year nursing student and they would do better

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5/2/2023 11:59am

I think they have a tough job.   I only have experience with my own injuries and with seeing/hearing from riders who have been helped by them. I think that racing is overall safer with them around. I was just surprised at how they moved Cooper with how serious it seemed to be with KTM putting out that statement. Everybody makes mistakes . I'm glad that they got this one right and Cooper did not have any spine injuries. I hope that they had some reason to think that was the case. I feel like after Brian was hurt that would weigh in on the process of deciding how to transport. And it must be a horrible thing to have to think of, and wonder if you were responsible in any way for making his injury and worse.   I think that most of those people on the medical crew are not being paid to be there and are doing it to help keep the racers safe. A friend that is a nurse had the chance to work with them many many years ago now. And it was not a paid thing. Maybe it has changed. 

I can understand all of the emotions , and do agree that they should play it on the safe side. But the Alpinestars crew has done and keeps doing a lot of good too.   

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