Medical strategy for race day

[mfuters]

We are starting to build our medical strategy for race day. Our event is a 10k, 10k power walk, and 1k walk...

I have an RN on the Race Committee that is helping to build our strategy and ensure we are prepared for race day.

We will have either a GP or Sports Med physician, along with an RN on-site race day. Will we need more medical support than this in the medical tent?

FYI - Our medical tent will also have a chiropractor and RMTs.

We are also enlisting St. John's Ambulance to provide event coverage. As well as having a local ambulance unit on-site.

Lastly, we are currently developing our equipment/needs list for the tent.

We will also have a communication expert from the local amateur radio club in the tent to assist with communications.

Any TIPS you can offer???

[JamesM]

It sounds like you have done more planing than most 5 or 10K races in the states. Impressive so far.

We often have an ambulance crew staged near the finish line, but for races of 10K or under do little else.

It does help if you have good communication with people on the course. Issuing cards to volenteers that list the emergency procedure and phone numbers to call if a runner is down can help.

We seem to get two categories of problem. The first are minor injuries from slips, falls, twists, sprains and finish line cramps. The walking wounded who need little more than hydration, some antiseptic and a ride home. In this crowed I include the people who insist on eating sausages for breakfast and then throwing up on you after they have crossed the finish line.

We don't seem to get much in the middle between minor stuff and the real serious stuff. The people who fall over dead, or do a good job of attempting to get dead by having a heart attack.
This second group are seen less frequently but when such an emergency arises getting the alarm to the medical staff and getting to the patent in a timely way, with appropriate equipment, is the problem.

I suspect the second group is a lot smaller just becuase they don't often come back for another race. This seems to be especially true of the ones who died during the previous years race.

Getting the alarm quickly is just a matter of training volenteers, and having them carry cell phones and knowing who to call. Figuring it is a real emergency and not just a runner down with a stitch is more complicated.

You may want to have one person dedicated to the job of phone or radio triage, from a comfortable desk in the dry. You should also consider giving the emergency medical contact number to all runners, since a lot of them now carry cell phones when running and they will be the first responders.
Emergency numbers can be printed on the back of the numbered bibs and you can announce this at the start. Get people to look on the back of the bib to see the numbers.

Part II of a serious emergency is getting medics to the downed runner. If you have ever attempted to drive through a herd of cows you know what it's like to attempt to drive through a stream of runners. This is worse on runs where RD's unfortunately allow headphones.

For this reason you need several important things planed out before hand.

1) How to identify that person on the course has a serious problem and not a minor one. This is the job of your calm medical triage expert on the end of the phone or radio. For expediency they should start the dispatch of help before fully diagnosing the problem, but a good medical brain should be able to ask a couple of quick questions to determine the level of emergency.

Having pe-written scripts, and a decision tree to help with remote diagnostics helps a lot.

2) Identify where on the course the problem is. The triage person should have an assistant with a map and good local knowledge. They can turn to the assistant and say "They say the corner of xxx street, where is that?"

Some races even have intermediary mile marks, i.e. 21, 21.5, 22, 22.5 to assist in phoning in the location.

3) Dispatch medics. To approach the subject the shortest route on the map may not be the shortest route on the day, because the roads are clogged with runners and other traffic is backed up. Plan before hand how emergency vehicles will get to each section of the course. This may give you ideas on where to stage medics.

4) Consider having medics on motor bikes. They can get through past backed up traffic and can easily cut through a sea of runners. This is more common in the UK and Europe.

5) Know when to call in the cavalry. 911, 999 or equivalent. Unfortunately this is the default mode for a lot of smaller races, no matter what the incident. This is especially true in the US where everyone is petrified of being sued for medical expenses because they don't have a national health service so everything is expensive and everything is someone elses fault.

Plan to have someone with a heart attack, some where on the course, and work backwards from there.

When I was young I went to sea with a dower old captain. He expected to lose the ship EVERY time we went to sea. He explained that with this attitude he was both mentally and physically prepared for the event, so it would not come as a surprise or a shock.

That first minute or two of surprise or shock is what costs lives. Like many men who had been in the war, he now was always on the lookout for a sudden expected surprise, planned accordingly, and made us all do so too.

He was pleasantly disappointed each time he arrived home with the ship and all his men. He expected all his men to expect every sort of disaster, on every trip. Our attitude was considered gloomy and paranoid, but we were rarely caught off guard, no mater what happened.

If you assume you will have someone with a hart attack, stroke or lightning strike, and plan for that happening at any point on the course, you have it mostly covered.

One last thing: A weather emergency can turn into a medical emergency in a hurry, but with a lot of potential patents. Part of your medical planning should be what the race will do if it get's too hot, too cold, floods or you get lighting strikes. (All four have happened to races). Have written plans of action for each.

Low tech low cost things can avert a lot of medical problems caused by weather calamities.
Think of a place of refuge indoors for a number of wet runners.
A backup supply of Mylar blankets, a few cases of plastic rain ponchos, cases of extra cups at each water stop all cost very little and if not used, and can appear again at the next race.
Simple things like giving each water stop a simple garden hose so they can refill cups when jugged water runs out.

[mfuters]

THANK YOU, THANK YOU, THANK YOU! This is absolutely amazing information, and I so appreciate you taking the time to share it all with me. I have just printed it so I can re-read and digest all of the valuable information you have shared. Once I have done so I will get back to you with any further questions.

Have the best day!