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Considerations for Road Race Medical Staff

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Exertional Heat Illness

Abstract

As road races are typically warm weather events, runners are at risk for heat-related illnesses, including exertional heat stroke. On-site medical care provides timely treatment to afflicted runners as well as help to prevent overwhelming community emergency medical services. This chapter will discuss the organization of a medical team including staffing needs based on the event’s number of participants and environmental conditions, specific protocols and procedures used to treat casualties, how adverse conditions may alter these plans, and the supplies needed for on-site health care at mass participation events. Using the Falmouth Road Race as a model, this chapter will serve as a guide for road race medical staff to plan for future events or to enhance existing medical care plans. It will also discuss how pre-race runner education may decrease casualties at large-scale events, an underutilized resource to optimize runners’ safety as a part of the medical care plan.

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References

  1. Running USA. 2018 National Runner Survey. https://www.runningusa.org/.

  2. De Lorenzo RA. Mass gathering medicine: a review. Prehosp Disaster Med. 1997;12(1):68–72.

    Article  PubMed  Google Scholar 

  3. Armstrong LE, Epstein Y, Greenleaf JE, Haymes EM, Hubbard RW, Roberts WO, Thompson PD. American College of Sports Medicine position stand. Heat and cold illnesses during distance running. Med Sci Sports Exerc. 1996;28(12):i–x. Review.

    CAS  PubMed  Google Scholar 

  4. American College of Sports Medicine. Mass participation event management for the team physician: a consensus statement. Med Sci Sports Exerc. 2004;36(11):2004–8.

    Article  Google Scholar 

  5. Yao KV, Troyanos C, D’Hemecourt P, Roberts WO. Optimizing marathon race safety using an incident command post strategy. Curr Sports Med Rep. 2017;16(3):144–9.

    Article  PubMed  Google Scholar 

  6. Adams WM, Hosokawa Y, Troyanos C, Jardine JF. Organization and execution of on-site health care during a mass participation event. Athl Train Sports Health Care. 2018;10(3):101–4.

    Article  Google Scholar 

  7. DeMartini JK, Casa DJ, et al. Effectiveness of cold water immersion in the treatment of exertional heat stroke at the Falmouth Road Race. Med Sci Sports Exerc. 2014;47(2):240–5.

    Article  Google Scholar 

  8. Hosokawa Y, Adams WM, Belval LN, Davis RJ, Huggins RA, Jardine JF, et al. Exertional heat illness incidence and on-site medical team preparedness in warm weather. Int J Biometeorol. 2018;62(7):1147–53.

    Article  PubMed  Google Scholar 

  9. Roberts WO. Management of mass participation events. In: Madden C, Putukian M, McCarty E, Young C, editors. Netter’s sports medicine: the team physician’s handbook. 2nd ed. Philadelphia PA: Elsevier; 2017. p. 736–43.

    Google Scholar 

  10. Cianca JC, Roberts WO. Distance running events: medical coverage. In: Wilder RP, O’Connor FG, Magrum EM, editors. Running medicine. 2nd ed. Monterey, CA: Healthy Learning; 2014.

    Google Scholar 

  11. International Association of Athletics Federations. IAAF Competition Medical Guidelines: A practical guide. Jan 2013. Monaco: IAAF. https://www.friidrett.no/globalassets/aktivitet/dommer/annet-materiell/iaaf-competition-medical-guidelines.pdf. Accessed 8 Jun 2019.

  12. Roberts WO. Determining a “do not start” temperature for a marathon on the basis of adverse outcomes. Med Sci Sports Exerc. 2010;42(2):226–32.

    Article  PubMed  Google Scholar 

  13. Roberts WO. Heat and cold: what does the environment do to marathon injury? Sports Med. 2007;37(4–5):400–3.

    Article  PubMed  Google Scholar 

  14. DeMartini JK, Casa DJ, Belval LN, Crago A, Davis RJ, Jardine JJ, Stearns RL. Environmental conditions and the occurrence of exertional heat illnesses and exertional heat stroke at the Falmouth Road Race. J Athl Train. 2014;49(4):478–85.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Nguyen RB, Milsten AM, Cushman JT. Injury patterns and levels of care at a marathon. Prehosp Disaster Med. 2008;23(6):519–25.

    Article  PubMed  Google Scholar 

  16. Drezner J, Courson R, Roberts WO, Mosesso V, Link M, Maron B. Inter-Association Task Force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement. J Athl Train. 2007;42(1):143–58.

    PubMed  PubMed Central  Google Scholar 

  17. Kim JH, Malhotra R, Chiampas G, d’Hemecourt P, Troyanos C, Cianca J, et al.; Race Associated Cardiac Arrest Event Registry (RACER) Study Group. Cardiac arrest during long-distance running races. N Engl J Med. 2012;366(2):130–40.

    Article  CAS  PubMed  Google Scholar 

  18. Roberts WO, Roberts DM, Lunos S. Marathon related cardiac arrest risk differences in men and women. Br J Sports Med. 2013;47(3):168–71.

    Article  PubMed  Google Scholar 

  19. Roberts WO. Exertional heat stroke during a cool weather marathon: a case study. Med Sci Sports Exerc. 2006;38(7):1197–202.

    Article  PubMed  Google Scholar 

  20. Roberts WO. Exercise-associated collapse care matrix in the marathon. Sports Med. 2007;37(4–5):431–3.

    Article  PubMed  Google Scholar 

  21. Asplund CA, O’Connor FG, Noakes TD. Exercise-associated collapse: an evidence-based review and primer for clinicians. Br J Sports Med. 2011;45(14):1157–62.

    Article  PubMed  Google Scholar 

  22. Rav-Acha M, Hadad E, Epstein Y, et al. Fatal exertional heat stroke: a case series. Am J Med Sci. 2004;328(2):84–7.

    Article  PubMed  Google Scholar 

  23. Ronneberg K, Roberts WO, McBean AD, Center BA. Temporal artery and rectal temperature measurements in collapsed marathon runners. Med Sci Sports Exerc. 2008;40(8):1373–5.

    Article  PubMed  Google Scholar 

  24. Armstrong LE, Maresh CM, Crago AE, Adams R, Roberts WO. Interpretation of aural temperatures during exercise, hyperthermia, and cooling therapy. Med Exerc Nut Health. 1994;3(1):9–16.

    Google Scholar 

  25. Roberts WO. Assessing core temperature in collapsed athletes: choosing the best method. Physician Sportsmed. 1994;22(8):49–59.

    Article  Google Scholar 

  26. Casa DJ, McDermott BP, Lee EC, Yeargin SW, Armstrong LE, Maresh CM. Cold water immersion: the gold standard for exertional heat stroke treatment. Exerc Sport Sci Rev. 2007;35(3):141–9. Review.

    Article  PubMed  Google Scholar 

  27. McDermott BP, Casa DJ, Ganio MS, Lopez RM, Yeargin SW, Armstrong LE, Maresh CM. Acute whole-body cooling for exercise-induced hyperthermia: a systematic review. J Athl Train. 2009;44(1):84–93.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hosokawa Y, Adams WM, Belval LN, Vandermark LW, Casa DJ. Tarp-assisted cooling as a method of whole-body cooling in hyperthermic individuals. Ann Emerg Med. 2017;69(3):347–52.

    Article  PubMed  Google Scholar 

  29. McDermott BP, Casa DJ, O’Connor FG, Adams WB, Armstrong LE, Brennan AH, et al. Cold-water dousing with ice massage to treat exertional heat stroke: a case series. Aviat Space Environ Med. 2009;80(8):720–2.

    Article  PubMed  Google Scholar 

  30. Casa DJ, Armstrong LE, Kenny GP, O’Connor FG, Huggins RA. Exertional heat stroke: new concepts regarding cause and care. Curr Sports Med Rep. 2012;11(3):115–23. Review.

    Article  PubMed  Google Scholar 

  31. Hosokawa Y, Johnson EN, Jardine JF, Stearns RL, Casa DJ. Knowledge and belief toward heat safety and hydration strategies among runners: a preliminary evaluation. J Athl Train. 2019;54(5):541–9. https://doi.org/10.4085/1062-6050-520-17.

    Article  PubMed  PubMed Central  Google Scholar 

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Jardine, J.F., Roberts, W.O. (2020). Considerations for Road Race Medical Staff. In: Adams, W., Jardine, J. (eds) Exertional Heat Illness. Springer, Cham. https://doi.org/10.1007/978-3-030-27805-2_11

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  • DOI: https://doi.org/10.1007/978-3-030-27805-2_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27804-5

  • Online ISBN: 978-3-030-27805-2

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