500 MILES TO GO Barburu Webb, R.3.

Ylay 30 i n Hooaierland is the day of days. It’s the annual Indianapolis \lotor Speedway 500 !We Race.

The race has become a successful interna- tional event each year through efforts of many people. The medical division staff and facilities. provided at no cost to spectators, is a higlil! organized part of the Speedway operation.

The medical staff consists of ’2ledical Direc- tor Dr. Thomas 4. Hanna, two assistant direc- tors, a director of medical personnel, 21 active staff pliysicians, 20 consuIting physicians, one dentist. 75 residents and interns, a director of nurses, four assistant RN’s and 65 volunteer RN’s. One of five RN’s honored by certification as official Gnited States Auto Club nurses, I have directed this program for 16 years.

Due to the growth in the size of the crowds and to the increased speed of racing cars, it has become necessary to begin plans in January of each year for the race. The USAC nurses meet to review previous years‘ experiences with the goal of improving nursing care.

The medical facilities at the Speedway con- sist of a main hospital in the center of the infield, seven first aid stations strategically lo- cated around the track, 16 ambulances and two helicopters.

In the main hospital are six treatment cubi- cles. Each cubicle, enclosed by a curtain, is arranged to care for special types of cases. The treatment tables were built to our specifica- tions. They are wooden, high enough to allow us to work comfortably over the patient, on

Barbara 1.w Webb, K.>., OKs a t llrthodist Hospital in Indianapolis. Indiana, has worked as Acting Clinical Instructor of students and as Assistant Supervisor and Supervisor of the OR since 1952. She also has been the director of nurses for the Indianapolis llotor Spredw\.ay SO0 Mile Race. Miss Kehb was honored .imong five other nurses in 1967 by the United States .Auto Club Nurses.

wheels to provide mobility and padded with foam rubber strips, covered with conductive rubber for safety and restraining straps to pro- vide for the safety of the patient. The first cubicle is set up for the treatment of all eye injuries. Eye equipment, medicine, sutures and dressings are available at this cubicle.

The second and third cubicles are set up for lacerations with dressings, sutures, instruments sets, \layo stand and medications provided. Also, burn cases may be treated in this area. These cubicles are kept quite busy as many barefoot teenagers encounter broken glass in the infield. I t is not unusual to treat multiple lacerations. A fourth cubicle is for orthopedic injuries. We have an X-ray machine, plaster splints, slings, etc. This unit is in use through- out most of race day. We encounter many sprains, and fractures are not uncommon. Minor fractures may be set and plaster applied

Miss Barbara Webb, director of nurses at the Zndian- apolis Speedway. chats with race driver Mario Andret- ti, who is recuperating from facial burns he suffered during a fiery crash at a practice session.

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by one of the orthopedic staff doctors. Cubicle five is set up as a cardiology unit. We

have a resuscitator, EKG, defibrillator, oxygen, and all medications and intravenous solutions necessary for the care of a cardiac patient. A cardiac team has been organized with each person preassigned a duty when a cardiac pa- tient arrives. The sixth cubicle is a backup cardiac unit, also used for other internal medical patients.

The hospital has equipment and staff to care for patients needing emergency surgery, frac- ture treatment, obstetric or gynecologic care, cardiac assistance, and first aid.

Next to the hospital is a large tent contain- ing separate recovery sections for male and female patients, a section for less serious first aid patients and a section for the morgue. These areas are equipped with dispensary-type metal cots. The front of the tent is a hospitality division where coffee and sandwiches are avail- able for the press and personnel.

Nearby is the heliport, where two heli- copters are on stand-by to take patients to Methodist Hospital. The helicopters, which pro- vide room for two patients, one attendant and the pilot, can make the flight to the hospital in six minutes. Due to traffic inside the Speedway grounds this is frequently the only practical means of transportation for patients needing additional hospital care.

Seven first aid stations are located in strate- gic areas throughout the Speedway grounds. Identified by a white flag with a green cross at the center, each first aid station is staffed by two volunteer physicians, and six RN’s. Each station is equipped with complete medical kits to render first aid. Six cots are available for patients in each station, which also can be used as a sorting area in the event of a disaster.

Sixteen ambulances are stationed at points around the Speedway grounds, each equipped with oxygen and medical kits, and staffed by two volunteer physicians and a driver. One ambulance is stationed on the apron exit to the track and one a t each of the four turns on the track to care for the race drivers. Eleven ambu-

lances are available for the spectators, four outside and seven inside the track oval.

All ambulances have direct radio communi- cation to the observation tower where a physi- cian observes all the activities on the track through binoculars. The tower physician has a direct line to the hospital. When an ambulance is called, he phones the track hospital informing us of the nature of the ambulance run and giving us time to prepare for the patient.

The track opens for practice on May 1. Two physicians are in attendance from 9 till 6 during the 25 practice days in May. No driver is allowed on the track unless the physicians and one ambulance are in attendance.

Each race driver must pass a rigid physical examination and uniform inspection at INDY before being permitted on the track. For this purpose a small area in the main hospital is set up as an emergency first aid unit the last week in April. The examination includes a complete physical, reflex tests, electrocardiograms, eye examinations (from color blindness to depth perception) and dental examinations. The driver also must present his racing helmet, goggles, gloves and uniform for inspection and approval. The helmet must have padding to protect the skull; the goggles must be unbreak-

Race Driver Dennis Humes receives an eye examina- tion, part of the extensive physical necessary for participation in the IND Y 500.

January 1970 57

able; the uniform must be flame resistant, have fasteners around tlie ankles and wrists and have a full zipper.

Earlirr in ipril I have gathered all the supplies needed for the hospital, first aid sta- tions and ambuldiice. in a room at Methodist Hospital. The first part of the second I+eek in \la> two panel trucks are loaded with tlie supplies. The) include such items as general sterile wpplies, linens, anesthesia machine, res- pirator, defibrillator, suctioii machines, traclie- otomj set-up, and \la! o stands.

In two hours with all fi\e USAC nurses Iielping. the track hospital is set up and made read! for operation as an emergenc! care center for 300.000 people. The ambulaiice and first aid Itits are prepared and set aside for quali- fication. ancl raw da! .

Qualification5 or time trials take place the two Saturda! s arid Sunda)s prior to the race. On these da)s the hospital is fullv staffed, as are the first aid stations and ambulances.

Race da? and "500 miles to go" starts for the ITS\(: nurses at 2:30 a.m., EDT. b e arrive at the hospital at S:00 am., one hour before the gates open. 1 final check is made to be certain all is read! to treat ailments ranging from sunburns to coronaries. Each CSAC nurse has a preassigned dut! to follow race day.

The I Sic nurses arc specialists. \liss Betty Haldemati, supenisor of the medical service at the \'eterans Hospital in Indianapolis, super- \ises the two medical units. IIiss Janet Renson, an industrial nurse for a large firm in the East, returns each \lay to work at the track. She is assigned as supenisor of tlie e)e and fracture cases. \list, Joan \-ogel, who is employed in the office of an Indianapolis physician, is supervisor of the laceration areas and pediatric cases. '1 fourth nurse, I lks Lowanna Schlotter, is a hernodialysis nurse with the United States Public Health Service in bashington, D.C. Her responsibilities are to supervise the recovery areas. As director of nurses it is my duty to coordinate all nursing care activities, answer any questions and assign patients to the desig- nated area for treatment.

On race day, the medical caravan arrives at the hospital at 8:OO a.m. The caravan is made up of buses that have picked up the doctors and nurses at the local hospitals. Four ambulances have arrived at the Speedway at 4:00 am.; the remaining 12 arrive with the caravan.

The volunteer nurses are reoriented to pro- cedures and policies of the medical aspects of nursing at the Speedway. Earlier in the month each nurse has received complete instructions on procedures and policies, assignments, and time off and on duty. Each nurse volunteers her services to work two hours of the day. When off duty she has a seat in the tower extension terrace to watch the race. All volunteers know they must return to the hospital in case ot a major disaster.

Race day the track hospital will admit an average of 130 patients, dispense 100 aspirin, and 135 band-aids. Including tlie five days of qualifications, an average of 560 patients is treated. The variety of cases is amazing. Cigar- ette filters have been removed from the ears of people trying to deafen the noise of the racing engines-cotton really works better. A safety patrolman once lost a battle with a bee; they both were trying to eat the same sandwich. Result: bee sting on the roof of the mouth! The track hospital treats at least one severe coro- nary each year. This is probably due to the eucitement, the walking of long distances, and climbing of many flights of stairs.

We have a few patients who imbibe too much and get into fights, resulting in lacera- tions, fractured skulls, bloody noses and, on one occasion, a human bite. h o t far from the track hospital is a portable jail which houses troublemakers. Incidents of injuries sustained in fights have been reduced greatly since the port- able jail was put into use.

One of the busiest days at the track hospital was in 1960 when a handmade metal scaffold built on the top of a truck parked in the infield came crashing to the ground. The scaffold was constructed in five tiers with approximately 25 people on each tier. The impact of the crash ripped out all communication lines to the area.

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Thomas A. Hanna, M.D., and Miss Wood display the cool efficiency with which they handle INDY emergencies.

Within minutes the hospital was swamped with 115 casualties.

Our disaster plan was put into effect. Metho- dist Hospital was immediately notified that it would receive many seriously injured patients within a short time. All track hospital-assigned doctors and nurses reported to the hospital. Screening and tagging of patients began imme- diately with medications and intravenous solu- tions being administered as needed. The patients with the most serious injuries were placed in ambulances. The other patients were transported to the hospital by station wagon.

The Indianapolis chief of police immediately closed all four lanes of 16th Street to all except emergency traffic, thus the ambulances were able to make the riin to Methodist Hospital and back to the track hospital in 15 minutes.

Ninety-five of the 115 injured were hurt seriously enough to require transfer to Riletho- dist Hospital. Two fatalities were incurred.

A Protestant minister and a Catholic priest, chaplains for the Speedway, were of great help to the hospital staff. They rolled up their sleeves, administered to the injured, carried stretchers, and informed the next of kin of the loss or injury of their loved ones. We feel that they are a very necessary part of our structure.

Within two hours the hospital was back to normal operation; however, restrained atmos- phere prevailed. We had almost forgotten that the race was still in progress. The race crews

and most of the spectators were unaware of the occurrences of the previous two hours.

Until this year we have had at least one spectator fatality. This year we had only minor or correctable injuries. Working together for a number of years the USAC nurses have devel- oped the ability to move rapidly from one area of responsibility to another as the need arises. This type of flexibility was especially helpful during the 1967 race when an unruly group of men assaulted young couples before the police were able to apprehend them. Suddenly we were deluged with several hysterical youngsters needing suturing, treatment of sprains and frac- tures and a lot of old-fashioned T.L.C.

Happier times are when a friend comes by to say, “Hello,” or one of the drivers drops by for a cup of coffee and probably the reassurance that comes with knowing “his” doctor and nurses are there. The track hospital is a good place for him to get away from the crowd, the noise and the tenseness. However, according to track regulations, we will see him professionally if he ever hits the wall. Following an accident on the track, we all breathe a sigh of relief when, upon examination, we find no evidence of injury to the driver. There are fewer serious injuries each year due largely to improvements such as flame resistant uniforms, safety belts and quick-release harnesses. The amazing thing is that, following an accident, the driver’s pulse and blood pressure remain normal.

The track hospital has been compared to the operations of an Army field hospital and may well be compared with most of the emergency rooms in any modern hospital today.

The day after the race we return to the hospital to pack the supplies and return them.

Working days are long during the month of May. But we enjoy every moment of race month just as we enjoy seeing old and new friends and knowing that we have helped the spectators and the drivers when injury or illness threatened them. There are four other USAC races during the summer months for which we provide medical coverage. But always we eager- ly await the next “500 miles to go” in May.

January 1970 59