07/11/2012 3:48PM

Hovdey: Herrera's death raises emergency care issues

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Ten or so years ago Jorge Herrera, now famous for dying last week after being thrown from a Thoroughbred at the Alameda County Fair, wanted to learn a rider’s trade badly enough to spend eight months at Frank Garza’s jockey school north of the L.A.Basin while working off his tuition, his room, and his board in chores at the ranch.

“He was walking hots at Hollywood Park,” said Garza, who rode for 27 years. “He called me up and told me he wanted to be a rider. When I picked him up he was waiting at the stable gate with his suitcase.”

This is how the picture of the unsung Herrera is coming into focus, a snapshot at a time, with details layered on over the past week by friends and workmates who knew just enough about the 33-year-old native of Jalisco, Mexico, to be desperately sad that he is gone.

“He was intelligent and well mannered, but very quiet,” Garza said. “I started him on an old racehorse named Uncle Bob. He never showed any fear. We had racing mules at the time – everybody falls off mules – and when he would fall I would ask him, ‘You sure you want to ride?’ He would answer, very serious, ‘Yes, I do.’ ”

It was the deal Herrera was willing to make, same as any other jockey, that falling off and getting hurt or worse can be part of the job. Of course, even in the most remote racing outposts there exists among riders a reasonable expectation that the inherent dangers of the sport are not exacerbated by local conditions, which is why riders and their representatives at the Jockeys’ Guild are forever encouraging racetracks to be vigilant about surface condition, quality of rails, pre-race veterinary exams, skilled gate crew personnel, and the best possible emergency care.

The California Horse Racing Board has launched an investigation into all aspects of the incident that cost Jorge Herrera his life. This will include a review of the emergency trauma procedures in place at the Pleasanton track, which were apparently in keeping with the basic standards mandated by the Rules and Regulations of the racing board, as empowered by the State of California’s Business and Professions Code – “basic” being the operative word, to wit:

“The association shall provide the services of an ambulance and its properly qualified attendants at all times during the running of races at its meeting . . . ”

There is no stipulation as to the level of expertise required for those attendants other than being “properly qualified,” nor that the ambulance be equipped with Advanced Life Support (ALS). It should be noted that, in the wake of Herrera’s death, Alameda County Fair officials have added a paramedic to its team of emergency medical technicians following the horses and jockeys as they compete, prompting a layman to say both “good for them” and “what’s the difference?”

Huge. According to the website of UCLA’s David Geffen School of Medicine Center for Prehospital Care:

“EMTs usually complete a course that is about 120-150 hours in length. Paramedic courses can be between 1,200 to 1,800 hours. . . . EMTs are educated in many skills including CPR, giving patients oxygen, administering glucose for diabetics, and helping others with treatments for asthma attacks or allergic reactions. With very few exceptions .  .  . EMTs are not allowed to provide treatments that requiring breaking the skin: that means no needles.

“Paramedics are advanced providers of emergency medical care and are highly educated in topics such as anatomy and physiology, cardiology, medications, and medical procedures. They build on their EMT education and learn more skills such as administering medications, starting intravenous lines, providing advanced airway management for patients, and learning to resuscitate and support patients with significant problems such as heart attacks and traumas.”

So that’s pretty clear. If you’re a jockey who has just broken a finger or sprained an ankle an EMT usually can do the job and then some. But sustain possible head trauma or internal damage with diminished pulse and respiration, and a paramedic is about your only chance until you get to a hospital.

At California’s county fairs, there are always paramedics somewhere at the fairgrounds to respond to racetrack emergencies like the Herrera accident. How long they take to arrive on the scene depends on where they are headquartered and what other emergencies they might be dealing with at the time.

California racing commissioner Bo Derek has spent the past year urging all associations to adopt the Del Mar model of emergency staffing and care, a model that includes backups and redundancies with the highest available level of trauma response and personnel.

“I was like everyone who assumed that because they were being followed by an ambulance they would be getting Advanced Life Support, or that there was not a difference between EMTs and paramedics,” Derek said. “I got a quick education between ‘basic’ and ‘advanced.’ ”

In attempting to craft a regulation that would mandate the best care available to a fallen rider, Derek and her fellow commissioners have run into jurisdictional snags between local public and private emergency services.

“Right now it’s all voluntary,” Derek said, “and other than agreeing that it is important, everyone has a point of view.”

Whether or not the life of Jorge Herrera could have been saved had paramedics with Advanced Life Support been immediately at his side is a tragic negative impossible to prove. There is only one positive outcome, and that is the racing board go forward with its mandate that all tracks – fairs included – adopt the Del Mar model.

“Eventually it will be required,” Derek promised. “And I hope tracks around the country would consider this. Once you know the level of care that is possible, how do you not go forward and have it? It’s the least we can do, especially after we’ve seen once again how terribly dangerous the sport can be.”

Frank Garza saw Jorge Herrera for the last time on the evening of June 29 at Hollywood Park.

“He told me he was driving to Pleasanton that night after the races to ride at the fair,” Garza said. “I asked him if he was going to ride any mules. He smiled and said, ‘Oh no. Way too dangerous.’ ”