2012 INTERNATIONAL CONFERENCE HEALTH SAFETY

& WELFARE OF JOCKEYS

BARRY SCHUMER M.D.KEENELAND MEDICAL DIRECTOR

Introduction

1. Keeneland First Aid

2. Jockey Health Information System (JHIS)

3. Minimum Standards for Racetrack Emergency Medical Services

4. Jockey Injury Database

Keeneland First Aid

Keeneland First Aid

Keeneland First AidRider Injuries

• Basilar Skull Fracture• Cervical Vertebrae Fracture• Fractured Shoulder• Multiple Rib Fractures• Chest Contusion• Closed Head Injuries

(concussion)• Pnemothorax• Blunt Abdominal Trauma• Bruised Kidney• Facial Fracture

• Fractured Humerus• Wrist Fracture• Fractured Fingers• Thoracic Vertebrae Fracture• Fractured Femur• Fractured Pelvis• Fractured Hip• Fractured Tibia• Fractured Fibula• Fractured Ankle

Keeneland First Aid

UK Medical center

Jockey Health Information System (JHIS)

Jockey Health Information System

First step is to fill out a username & password form

User May Choose to fill out information in English or Spanish

User Information PageUser must enter all of their contact information

User must add at least one emergency contact

Known Medications or Allergies Screen

User must choose yes or no to any surgeries they may have had

They must also choose yes or no to any broken bones they may have had

The user will fill out any treatments they may have had, and then hit update to save all of their information

Medical staff will then be able to view a form that gives them all the information they will need on a rider if injury occurs

Keeneland First Aid

JHIS ON-GOING CHALLENGES

• Validating Accuracy of Initial Health History

• Insuring Riders Make Regular Updates to History

• Usage Compliance Among Track First Aid Staff

• Upgrades to System Require Re-entry of All Data

Minimum Standards for Racetrack Emergency

Medical Services

OBJECTIVES

• To create a set of industry standards designed to improve the quality of race track emergency medical services available to riders injured during participation at U. S. Thoroughbred racetracks.

• To advise NTRA Safety and Integrity Alliance on appropriate guidelines to incorporate into racetrack accreditation in the area of rider safety.

OBJECTIVES

• To demonstrate to the jockey colony a long-term commitment on the part of our industry to improved emergency medical services available to injured riders.

• To educate racetrack administrators on minimum standards and ways to improve emergency care at their facilities.

OBJECTIVES

• To demonstrate to the public and to government regulators a plan to insure the availability of a high quality emergency medical response to rider injuries at U. S. racetracks.

OVERVIEW

• The Medical Director

• Ancillary Emergency Medical Staff

• First Aid Facilities

• Rider Transport

• Use of Trauma Level One Facilities

MEDICAL DIRECTOR

• Job description is to oversee all racetrack emergency services, including nursing staff, paramedic and EMT staff, facilities, injury treatment protocols, access to JHIS, as well as compliance with NTRA safety certification programs.

• Insure up-to-date certification, licensing of professional staff.

• Should be board certified M. D. in family practice, internal medicine, emergency medicine, or surgical specialty including orthopedics, neurosurgery, trauma surgery, etc.

EMERGENCY MEDICAL STAFF ON DUTY

• On-site physician with qualifications similar to Medical Director

• RN with experience in emergency medicine

• Paramedic – at least one on-site during all races

• EMT’s – to assist lead paramedic, nursing team, and Medical Director

• #’s of each to be determined by Director and lead paramedic

FIRST AID FACILITIES

• Trauma beds to accommodate up to two to three riders at a time if possible

• Treatment capabilities to include IV fluids, supplemental oxygen, suction, pulse oximetry, BP monitoring, EKG or rhythm strip capabilities, intubation tray, medications for ACLS resuscitation, neck brace, back boards, etc – LIST TO BE GENERATED

FIRST AID FACILITIES

• Equipment to be properly serviced, inspected, and updated as needed

• Use of Jockey Health Information System, including laptop/PC with printer and readily available fax capabilities

• Rider injury care to be HIPAA compliant

• Facilities to be OSHA compliant

TRANSPORTATION

• On-site fully equipped vehicles to transport injured riders either to nearest Trauma Level One facility or to track first aid for stabilization.

• Communication capabilities between first responders and first aid staff.

TRANSPORTATION

• If local ambulance service to be utilized, transport protocols to be put in writing by Medical Director and will need to be made available to all racetrack personnel to maximize speed, access, efficiency after injury.

• Back-up contingency plans for multiple rider spills, vehicle break-down.

• Vehicles to follow riders 1/8 to 1/4 mile behind last horse during race.

USE OF TRAUMA LEVEL ONE FACILITY

• Always first option where possible

• Establish relationship with area hospitals regarding readiness to accept injured riders in advance of emergency

Jockey Injury Database

JOCKY INJURY DATABASE PROJECT - 2012

LIST OF PARTICIPANTS:

JOCKEYS GUILD AND RIDER MEMBERSHIP

KEENELAND/DR BARRY SCHUMER

UNIVERSITY OF KENTUCKY DEPT OF SPORTS MEDICINE

U.S. RACETRACKS/EMERGENCY MEDICAL STAFF

NTRA SAFETY ALLIANCE

THE JOCKEY CLUB

Study Objectives

• INITIATE A LONG-TERM, ON-GOING PROSPECTIVE STUDY OF THE FREQUENCY AND TYPES OF INJURIES WHICH OCCUR AMONG U.S. JOCKEYS DURING THEIR PARTICIPATION IN THOROUGHBRED RACING

• IMPROVE RACING'S UNDERSTANDING OF THE INCIDENCE OF INJURY, THE MOST COMMON TYPES OF INJURY, AND THE CIRCUMSTANCE OF INJURY OCCURRENCE FOR THE PURPOSES OF IMPROVING SAFETY MEASURES IN OUR SPORT

• IN THE PROCESS, IMPROVE INJURY PREVENTION AS WELL AS PREPAREDNESS FOR THE MOST EFFECTIVE TREATMENT BY FIRST RESPONDERS OF INJURIES WHEN THEY DO OCCUR

• CREATE STATISTICALLY SIGNIFICANT DATA THAT CAN BE COMPARED WITH THAT COLLECTED IN OTHER RACING VENUES AROUND THE WORLD TO MAXIMIZE A LIST OF BEST PRACTICES AS IT RELATES TO INJURY PREVENTION AND TREATMENT

Study design

• CREATE A STANDARDIZED INJURY REPORT FOR USE BY ALL U.S. RACE TRACK FIRST RESPONDERS

• PROMOTE PARTICIPATION IN THE PROJECT WITH THE ASSISTANCE OF THE NTRA TRACK CERTIFICATION PROGRAM

• EDUCATE JOCKEYS AND TRACK STAFF TO REPORT INJURIES - INCLUDING MINOR INCIDENTS

• TRAIN EMERGENCY STAFF AT TRACKS TO FILL OUT THE INJURY REPORT AT THE TIME OF INCIDENT

• DEVELOP PRIVACY SAFEGUARDS REGARDING RIDER CONFIDENTIALITY

• ENTER INJURY INFO INTO A COMPUTERIZED DATABASE AT THE UNIVERSITY OF KENTUCKY UNDER THE OVERSIGHT OF THE PROJECT CO-INVESTIGATORS

• ONCE ADEQUATE NUMBERS OBTAINED, ANALYZE DATA BASED ON A LONG LIST OF VARIABLES

confidentiality

• INJURY DATA IS COLLECTED AT ALL U.S. RACETRACKS FOR PURPOSES OF FILING INSURANCE CLAIMS AND REQUIRE RIDER IDENTIFICATION

• INDEPENDENT STUDY INJURY REPORT WITH RIDER AND TRACK IDENTIFICATION WILL BE COMPLETED

• PRIOR TO BEING ENTERED INTO THE DATABASE AT THE UNIVERSITY OF KENTUCKY BY THE CO-INVESTIGATORS, INFORMATION WILL BE DE-IDENTIFIED BY THE JOCKEY GUILD AND WILL BE REFERENCED BY CODE NUMBER WITH ONLY THE JOCKEY GUILD HAVING ACCESS TO THE DE-CODING INSTRUCTIONS - RIDER I.D. AND TRACK NAME WILL BE DELETED AT THAT TIME

• TRACK AND RIDER UNDERSTANDING OF THIS CONCEPT IS DESIGNED TO INCREASE THEIR WILLINGNESS TO COOPERATE WITH DATA COLLECTION - EVEN WHEN INJURY MAY NOT BE SEVERE ENOUGH TO PROMPT COMPLETION OF INSURANCE REPORTS

Injury report

Injury report

DATA ANALYSIS -POTENTIAL USES

COMPARE INCIDENCE OF INJURY AND TYPE OF INJURY BASED ON:• AGE OF RIDER• SEX OF RIDER• # OF YEARS EXPERIENCE OF RIDER• SURFACE TYPE AND CONDITION - TURN, DIRT,

SYNTHETIC• CLASS OF RACE• RACE DISTANCE• RACE PURSE LEVEL• WEATHER CONDITIONS• FIELD SIZE• LOCATION ON TRACK • AGE OF HORSE INVOLVED

DATA ANALYSIS -POTENTIAL USES

CROSS ANALYZE ABOVE WITH:

• TYPE OF RIDER INJURY

• TYPE OF EMERGENCY CARE REQUIRED

• TYPE OF EMERGENCY STAFF ON SITE

• LENGTH OF INCAPACITATION

• TYPE OF SAFETY EQUIPMENT UTILIZED

• INCIDENCE OF HOSPITALIZATION AND/OR SURGERY

DATA ANALYSIS -POTENTIAL USES

• TRACKS WILL HAVE ACCESS TO THEIR OWN INJURY DATA AND CAN COMPARE WITH NATIONAL RATES

• SUPERIOR STATISTICS AND OUTCOMES MAY HELP TO REDUCE LIABILITY INSURANCE COSTS

• SUPERIOR STATISTICS MAY ASSIST IN PR WITH PUBLIC AND SERVE AS A DRAW FOR RIDERS, OWNERS, AND TRAINERS

DATA ANALYSIS -POTENTIAL USES

• JOCKEY GUILD WILL HAVE ACCESS TO DATA FOR USE BY MEMBERS THAT IDENTIFIES HIGH RISK RIDERS, TRACKS, RACE SCENARIOS, AND GAIN ADDITIONAL STATS ON PARTICULAR SAFETY EQUIPMENT, AND HELP IN NEGOTIATING WITH INDIVIDUAL TRACKS REGARDING SAFETY POLICY

DATA ANALYSIS -POTENTIAL USES

• NTRA AS A CERTIFIYING ENTITY MAY GAIN DATA ON FIRST RESPONDER PROTOCOLS AND STAFFING AS A MEANS OF IMPROVING RECOMMENDATIONS FOR MINIMUM STANDARDS FOR EMERGENCY CARE