Austrian racer loses leg

Very bad scenario. I agree that the city should have had some means of transportation to get skiers to the hospital in critical times. I wish Lanzinger a good recovery although he will never be the same again. Thanks for sharing this article.

I read about this yesterday, pretty gruesome injury. Good luck with the recovery Lanzinger.

Wow, that is unbelievable. It really does come as a shock that there was no helicopter on site.
Having to wait hours with that kind of injury is unimaginable. Living with the possiblity an amputation could have been avoided is equally unimaginable. My heart goes out for him.

Geez, I'm sorry to hear that. I hope you can relay our hope for him. I'm sure he will find a way to go on, maybe even someday find a way to ski again.

My heart goes out to the guy. That was one of the worst crashes I've seen - you can see in the video that he suffered a terrible break, the leg is twisted almost backward. What a terrible blow.

Words can't describe how shocking that video was. I turned it off right when I saw the crash the first time. I feel terrible about how there wasn't a helicopter to help such a tragedy. It's just terrible how the amputation could have been avoided, but the poor planning of an event led to a scenario that will affect the life of one man and his family for the rest of his life.

My thoughts and prayers are with him.

This just makes me sick to my stomach. (and I didn't even check out the video). Certainly this incident will have ramifications in alpine skiiing with regards to safety standards and risk management, but I can help focus more on Mattias Lanzinger himself.

While all athletes take inherent risks in the course of competition and training, the last thing you are thiking is, 'gee, a few hours from now I won't have my leg, my arm, etc...' No doubt Mattias will have some rough times ahead as he comes to terms with the accident and the impact on his life. Surely though he can bounce back...challenged athletes do amazing things and are every bit as much an athlete as abled bodied athletes. Think Rudy Tolson Garcia, Sarah Reinertsen, Carlos Guzman and the list goes on.

Thanks for all of your comments on this tragedy, it means a lot to me as a skier and I'm sure Lanzinger would be glad to know that people truly care about his situation. Alpine skiing is a dangerous sport but there is no excuse for the poor safety measures taken by the Kvitfell race organization. It's unfortunate that it took an incident of this magnitude to wake organizers up to the reality of serious injury and evacuation procedures. I for one am not going to let this go until something changes for the better of the athletes safety!

thanks for listening...

Bryon

My thoughts are with Lanzinger and for his recovery. I hope that the print/TV media in Austria will be respectful so that he has some privacy in which to recover and rehabilitate. (And for the privacy of his teammates, family and friends as well). It's got to be hard enough to deal with such trauma, let alone when your story has been on the front pages of the national newspapers.
I think it is worth noting that the doctors have now said that the leg was almost surely doomed from the time of the crash. It was not swelling that cut off the circulation, but the fact that the continued rotation of the foot after the initial tib/fib break(s) severed all the blood vessels and (many) nerves and caused severe tissue damage.
I do think it was inexcusable not to have a med-evac chopper on stand-by given that the closest trauma center was 45 minutes away by road in Lillehammer. Even if the med-evac chopper had been on-call in Lillehammer, it probably could have been there in 15-20 minutes, which would have been just about the time needed to get the patient ready to be transported. (Depending on the type of chopper and the readiness of the crew, a med evac can be in the air within 3-5 minutes of a call and have a top speed of 150 mph). But the regulations are set by the FIS, not the local organizing committees - perhaps the FIS needs to up the standards, rather than assuming that local committees will take the fullest precautions. It may be that there are not enough normal med-evacs in that region of Norway to permit one to be taken out of service just for the race, thus FIS may need to set aside funds to help committees fund private med-evacs or paying for regular crews to take an additional shift.
That said, I fully agree with the decision to bring Lanzinger to Lillehammer first - the initial concern was the head injury, and Lillehammer is the regional trauma and neurology speciality center. FYI, it's no tiny hospital - according to the website (in Norwegian) it's got 169 beds and sees more than 113,000 cases in its emergency room every year. There's not much you can do for a severe head injury outside a hospital setting, and it would have been very risky to send someone on an hour+ med evac ride to Oslo without clearing him/her neurologically first. Lanzinger's injury was the very rare kind that needed facilities only available in a very few hospitals (or more specifically from a very few vascular surgeons).
Again my thoughts are with Matthias and his family (and I hope to see you skiing again Bryon, as I remember you from US/Ivy Athletic Trust).
Kate

this story is definitely a tragedy... thanks bryon for letting us know your thoughts about it! I heard that there was no chance to save his leg also if there would have been a helicopter, but for me this isn't an excuse of course, b/c I think that safety standards should be improved... not just during races also during trainings. I mean, how was your medical care? Was it different b/c your crash happened in training, do you think there are differences?
It's always sad that something bad has to occur so that changes happen... there are so many discussions about safety now... what do you think has improved since the crash of silvano beltrametti for example? or what do you think can be done/improved?
I would also be interested in how the situation is for you as a racer after such bad crashes? I mean we all know that ski racing is dangerous, but how can you handle such a situation, do you think about it a lot, or are you just trying to repress your thoughts?
well, would be really great to get some answers from a racer at first hand... if you don't want to answer some questions it's ok with me of course... thanks...
besides, please keep making the best music I've ever heard... your songs are awesome ;)

These are some great questions that I will answer the best I can. At this point I understand there was virtually no chance to save Lanzinger's leg, however it doesn't change the fact that there was a significant breach in safety at the event. The point is not to go back in time and say "what if," the point is to move forward and make World Cup events more safe and to have the best evacuation resources on hand 24/7 during competition and training runs. In my case, I broke my leg in a training run and was taken by helicopter to the nearest hospital where I was under the knife within a few hours. In my case getting to the hospital was quick and the doctors recognized the seriousness of my injury early on. Had I been waiting for a helicopter to show up or been taken to an alternate hospital before my final destination, who knows what would have happened? At the very worst I could have lost my leg, which is why it's so important to have a med evac on hand regardless of the venue.

As an athlete the last thing you want to think about is whether or not there's a helicopter standing by in case I crash and get hurt. These "what ifs" need to be taken out of the equation so we can race with the knowledge that our best interests are taken care of, and in many ways they are, but not always. After Beltrametti was paralyzed a lot of things changed, such as fence regulations as well as using dye on course to help racers see terrain in flat light conditions. As the sport progresses there will be more and more safety challenges, which need to be addressed today. Ultimately there are no guarantees in ski racing, injury, or in life for that matter, but if there's a way to limit such tragedies then my question is why don't we? I shouldn't have to argue this point any further, safety is a major concern for us as racers and we deserve more attention to safety precaution and procedures from FIS and race organizers.

I don't know one racer on the World Cup that hasn't been injured or hospitalized from skiing in some way shape of form. Skiers have shed blood, lost limbs, been paralyzed, or even died in races. That's the reality of our sport and that's what FIS is up against in order to provide the best they can for each athlete that participates. I love this sport and want to watch it grow, which is another why I'm so adamant about changes in safety policy.

Hope this helps...thanks for your great questions, and I'm glad to hear you like my music!

Bryon

I do want to make it clear that I certainly think all the skiers deserve the best treatment possible. And that I think it was utterly irresponsible for the Kvitfjell organizers to not have a med-evac helicopter available given the distance to the trauma center in Lillehammer. A private helicopter should never EVER be considered an acceptable replacement in terms of an stand by med-evac.
But, from what I've read, I think the treatment on the ground and once Lanzinger was at Lillehammer was first class, and as would be expected under accepted trauma protocols. My point was that Lillehammer is, by all accounts, an excellent trauma center and was well within standards as the designated hospital for the event. What was lacking in this situation was a proper plan of evacuation and an acceptable med-evac. (I used to be an EMT, albeit one that saw very little trauma, so have some perspective of medical emergencies from the side of the medical crew and worked on a couple of calls which involved med-evacs)
But it sounds to me like the problem is with the FIS, and medical procedure regulations which would appear to be rather vague and not up to a sufficient standard to ensure the safety of the skiers. Given the World Cup races take place across several continents and many countries, thus involving many different organizing committees, types of locations and medical systems, a very clear and detailed medical protocol is clearly needed.
There needs to be a very detailed checklist of requirements, including clear guidelines as to exactly what type of medical support & transport must be available depending on the distance to the closest acceptable trauma center and as to what is acceptable as far as a designated trauma center. And the manpower needs to be in place to ensure that arrangements are approved and checked by the FIS to make sure each racing venue complies with the regulations.
The other factor is tightening up the regulations to ensure that on-scene staff (medical and otherwise), and the med-evac crews are properly trained/briefed in procedures. It can save valuable time if the me-evac crew knows where they will be able to land and who the medical contact will be on the ground, and if the ground staff know what to do if the med-evac is called.
The big hang-up in all this is probably, $$$ and $$$$ and $$$$$. For instance, in the US, the cost of a med-evac is around $15,000-$20,000 once the chopper has left the ground, whether or not a patient is actually transported, and surely much more to pay for coverage for a multiple day event. Coverage may be free or heavily discounted in some countries, but not in others and I don't think it's fair to expect a med-evac to be diverted from normal duties specifically to be on-site for a skiing event. So the FIS needs to ensure that money is available for training and coverage - and that may mean making some hard decisions about where events can be held and when events need to be cancelled (i.e. if the weather conditions are too bad for a med-evac to fly, even if it's still OK for skiing, should the event be cancelled or postponed?). And whether organizers need to rely less on volunteers and more on paid staff, especially since getting volunteers to training sessions can be a challenge (not to in any way demean the efforts or experience of volunteers, but volunteers may not help out with many WC level events each year and may have difficulty missing regular work to attend training sessions etc.)
One possible idea - perhaps not doable, but maybe now's the time to start thinking outside the box - is to have a 'medical' sponsor. Not a medical company/hospital per se, but a sponsor for the season or for each venue/couple of venues. This sponsor would agree to fund all or a portion of the cost to have a med-evac available (in exchange for the usual ad space), and also to fund a half-day or day training session for the med-evac crew and on-scene staff/volunteers.
In any case, I hope the FIS takes a good hard look at the events of this season, and makes some significant changes to the medical regulations. The skiers deserve nothing less...(and so much more than they sometimes get now).
Two questions to throw out.... I have no idea if there's a right/single answer to either of them....
1) In the case that the med-evac chopper is used to take an injured skier to hospital - and thus the course is without an on-site med-evac - should be the racing be postponed until the chopper returns or alternate coverage is found?
2) There is a severe, multi-car crash 20 miles from the race course... additional med-evacs are needed for victims of the crash. The med-evac for the race is privately hired, but much closer than any other available med-evacs... Do the race organizers have a responsibility to allow the med-evac to go the car crash? And by doing so possibly delaying the racing?
Kate

OOOOOOOOOOOOOOccccccccccccccchhhhhhhhhhhhhhhhhhhhhhh

Those are great questions Kate and I really like your idea of finding a medical sponsor that would take care of the med-evac for each event in exchange for add space. Hopefully FIS can get their act together and make something happen!

As far as your first question, some venues actually have two helicopters standing by in case the first has to take an injured skier to the hospital. That is why it's so surprising and inexcusable that Kvitfell didn't even have "a" helicopter on site.

Your second question raises some ethical questions regarding what to do if someone (such as a car accident victim) needs a med-evac and the closest one is designated to our race. Who's to say which life is more important...that of the skier or that of the car accident victim? In my opinion, our safety should not be compromised and the med-evac should not leave the site of the race unless this particular situation was imbedded into the protocol and the race delayed. I have no problem with a race being delayed if the med-evac is used in a dire situation that could save lives, but I do have a problem with risking our safety if the race is continued without a med-evac on standby. Ultimately there are a number of scenarios, what ifs, and circumstances thrown into the equation of everyday life, which we cannot project with 100% certainty. All we can do is prepare the best we can, have a set protocol for specific scenarios and hope that athletes like Matthias Lanzinger are given the best care possible. In my opinion, we aren't there yet!

Thanks for your responses to the questions....and BTW, to clarify, I wasn't intending that medical sponsors would be medically related companies (probably better if they weren't, to avoid conflict of interest). They could be any company that wanted to donate money - and what better advertising than to say you're contributing towards the safety of the skiers!
Two helicopters!!...that suggests there's some serious cash being spent. I'm guessing then that most of these helicopters are privately hired, either from police, private companies or military. I don't think any normal med-evac service would be able to take two choppers out of normal service for several days.
I am certainly gobsmacked that Kvitfjell would not even have a helicopter on stand-by. Since it does take a bit of time to prep a patient to be moved, if the hospital is no more than 15 minutes flying time, I'd think it OK for the helicopter to stay there rather than at the race course. (For instance, at Beaver Creek and Kitzbuehl, the helicopter could be at the site in 5 minutes from the respective medical centers). But still, it's got to be there with the crew ready to go.
One interesting note - the Norwegian hospital in Oslo where Lanzinger was eventually taken has been named as the location for the institute that will research ski-racing injuries - and the institute will be headed by the doctor who operated on Lanzinger - Dr. Engbretsen. (Hmmm..think they might need a PhD epidemiologist to analyse their data....)
Given the comments/controversy over the FIS medical regulations, I did a bit of web surfing yesterday to try and compare the FIS regs to those established for FEI equine 3-day eventing, another elite sport that has had a spate of serious injuries in recent years (9 riders were killed last year, 7 in national/international events). The speeds in eventing aren't as high (35 mph?) and riders must wear both certified helmets and body protectors, but there's the big additional risk of 1000+lbs of horse coming down on top of the rider...
At least in the US, the medical standard is that a helicopter must be on stand by (but not privately hired or solely for the use of the event) if the closest Level One trauma centre is more than a 20 minute ride away by ambulance. There must be an ambulance on site the entire time, and a set number of paramedics/trauma physicians, depending on the number of riders and level of the event.
The medical preparations look to be pretty similar for FIS and FEI (eventing), though the FEI would at least appear to have much more in the way of online informational material and detailed emergency plans for medical volunteers and professionals. The one big difference I did notice was that the FIS had basically nothing in the way of statistics about injuries available, while the FEI had detailed breakdowns from the past three years of the types of falls (which cause the fatal injuries) and the number of fatal or severe injuries per 1000 rides (for every 1000 rides, there are 3 to 5 severe or fatal injuries to riders). The FEI site also provides a complete set of presentations from a safety conference held this past January to address the concerns over the high number of deaths last year.
Whilst the sports might seem very different, both involve high-speed impact injuries, and both are starting a push to research ways of reducing injuries. And the more bright minds you put together, the better the results can be...
Kate

Also, I did want to say that I was very impressed with Lanzinger for the guts and composure he showed in this morning's news conference (partial transcript and a few sound clips are available at www.kurier.at or www.oe24.at, and images at yahoo.). Based on what I could gather via online translators and my limited knowledge of Danish & Dutch, he was calm, collected and spoke at length. Given what he's been through, I give him a huge deal of credit with handling all the publicity so well.

Not all surprisingly he looks pale and has lost weight, but apparently is doing very well and will go to the rehab clinic next week.

Kate