How doctors are evaluating NASCAR drivers after they crash – For The Win
RICHMOND, Va. – Finishing a race with a banged-up car is pretty standard for NASCAR races. But if a car is so badly wrecked that it can’t finish the race, new NASCAR rules dictate the driver must be immediately evaluated at the in-field medical care center.
Usually within about 10 minutes of entering the center, NASCAR announces the driver has been cleared. But what exactly are these doctors looking for and what type of test are they running inside the track?
For The Win spoke with some of the medical professionals at Richmond International Raceway just prior to the start of the Toyota Owners 400 to find out.
Basically, it comes down to a physical and neurological exam, said Dr. Angela Fiege, NASCAR/American Medical Response safety team medical director. From a driver’s balance to dramatic personality changes, she said there’s a lot the doctors identify before starting the actual exam.
Asking, “Are they at their baseline personality?” Fiege said is a good indicator of a neurological injury. “Are they angry and hostile like they are every time they crash, or is the guy who typically has a little bit of a personality after a crash suddenly very flat? Are they engaged when you talk to them?”
Although each track staffs its medical team following NASCAR’s minimum requirements, the examining doctors are entirely independent from the sport – at Richmond, it’s VCU Health – and they work with five nurse liaisons, who are employed by NASCAR.
After a head-to-toe physical exam, the doctors switch to a neurological test. The doctors at the care center included a neurosurgeon, a neuropsychologist and a neuro-ophthalmologist, Fiege said.
Looking for concussion symptoms and other brain trauma, Fiege said they test balance, coordination, reaction times and vision and ask basic question like, “Do you know where you are? Do you know why you’re here?” as a starting point.
“I wouldn’t say that they try to deceive us, but I think what happens is they don’t really know that they perhaps have had an injury that could blossom into something more severe,” she said. “And that’s our job – to tease that out because there’s no imaging you can do. There’s no inspection of the brain you can do.”
If the driver appears to be OK, they’re released from the center, but the nurse liaisons follows up with each driver evaluated the next day.
But if a driver is involved in a terrible wreck, he or she might have to be transported to the nearest hospital – by ambulance if it’s less than 15 minutes away, by helicopter if it’s more.
“Reasons we would transfer out of the care center would be if we need imaging, like if we need to do a CT (computed tomography scan) of them, which we don’t have the capability of doing here,” said Kevin Stephenson, NASCAR’s medical liaison coordinator. “Or, if there’s a serious injury that just cannot be handled here, they would be transferred to a local hospital.”