August 2007

President’s Column – August 2007 As we all have experienced, running and endurance sports in general are a remarkable antidote for most of the diseases of modern life.  But, sometimes during a generally beneficial activity, things can go very wrong. Death at a Local Race.  The Rochester cycling community lost a valued member on June 16th at the Hardcore 24, a relay and solo mountain bike race held at Naples.  At around 8:30pm, Ben Pritchard, manager at Park Avenue Bike and a member of the shop team, went out for his 3rd lap of the 24-hour race.  A photo taken at the time showed him hammering on the bike with a big smile for the camera.  About ten minutes later, another rider (by chance a cardiologist) found him slumped on the side of the trail.  This rider began applying CPR.  The next rider on the scene was an emergency medical technician.  Both continued CPR and an ambulance was summoned.  Unfortunately, even with prompt trained care, Ben did not survive.  Reportedly, Ben (who was just 25) had open-heart surgery about two years ago to replace a valve in his heart.  His doctor had cleared him to be riding again months ago. How Great are the Risks?  How common are life-threatening events in races?  At the 2002 Road Race Management Race Directors' Meeting, Twin Cities Marathon medical director Dr. Bill Roberts reported that statistics on deaths in marathons demonstrate that running is not a high-risk activity, and that running is not the cause or a significant contributing factor to fatalities, as was often reported in the press 10 or 15 years ago.  The death rate, once 1 in 50,000, has dropped to one in 150,000 over the past eight years, according to Roberts. In runners over 40, the cause of death is usually coronary artery disease.  In those under 30, it is usually a cardiac abnormality, i.e., a congenital defect.  None of this lessens the tragedy of a sudden death, but it does provide context. How common are less serious medical problems?  Roberts reported the injury rate in a marathon can be up to 20%, triathlon injury rates are up to 33% and races under half marathon top out at a 5% injury rate.  These statistics are helpful in understanding and planning for treatment at races, says Roberts Benchmark Emergency Response.  The Peachtree Road Race, held July 4th in Atlanta, GA, sets a high benchmark for emergency response.  Over the last four years, three individuals have suffered cardiac arrest during the race.  All survived to be discharged from the hospital and resume normal lives.  Note:  With about 55,000 participants running in southern heat and humidity, the odds of having at least one life-threatening event are pretty high for this, the world’s largest 10K. During the Peachtree Road Race, Grady Hospital Emergency Medical Services implements a robust emergency medical response plan that includes both paramedic ambulances and bike teams strategically placed along the course. Concurrently, the Atlanta Track Club fields a large cadre of medical volunteers for both the course and finish line.  Both organizations integrate their communications plans, so runners in distress can be readily identified, and medical help dispatched.  In addition, the race is filled with participants who have learned CPR and are willing to stop and render assistance until professional rescuers arrive.  The combination of these elements results in an emergency medical response system that is prepared to provide an optimal response to cardiac arrest:  victims are quickly recognized, bystander CPR is provided and early defibrillation occurs in the context of an integrated emergency medical response system. Emergency Plan Basics.  While most Rochester races lack the resources to match the Peachtree Road Race medical response plan, every event should have an event medical plan.  The key elements of a plan are the same for all races, no matter the size, distance or type: 1.       Who is responsible for implementation of the emergency plan? 2.       How will runners in distress be identified? 3.       Who will render immediate assistance? 4.       How will emergency medical staff be notified? 5.       How will an incapacitated runner be transported? 6.       What is the plan for the race if a serious incident occurs? If the event plan relies on aid station workers & marshals to identify runners in trouble and render immediate assistance, then those volunteers need to be briefed on their responsibilities and the procedures to follow.  Trail races and longer road races present additional difficulties.  Runners may get into distress miles from the nearest aid station or course marshal.  Race participants should be briefed on what to do if they come upon a runner in distress, including whom to call for emergency assistance.  Some races have comped entries for the next year's race to those who stop and help a downed runner on the course. Some Things We Can Do.  Get a refresher course on CPR and emergency first aid.  Be alert to the condition of runners around you.  Be prepared to stop and offer assistance if you see someone in trouble.  Carry your mobile phone and know whom to call. If you have an existing medical condition, wear a Medic Alert bracelet or at least write down the info on the back of your bib.  And, don’t forget to consider your training runs… at least tell someone where you are going and when you will be back and carry your mobile phone.   Good running to you. Tom Perry August 2007