Injury Patterns and Levels of Care at a Marathon

Abstract

Introduction:Marathons pose many challenges to event planners. The medical services needed at such events have not received extensive coverage in the literature.Objective:The objective of this study was to document injury patterns and medical usage at a category III mass gathering (a marathon), with the goal of helping event planners organize medical resources for large public gatherings.Methods:Prospectively obtained medical care reports from the five first-aid stations set up along the marathon route were reviewed. Primary and secondary reasons for seeking medical care were categorized. Weather data were obtained, and ambient temperature was recorded.Results:The numbers of finishers were as follows: 4,837 in the marathon (3,099 males, 1,738 females), 814 in the 5K race (362 males, 452 females), and 393 teams in the four-person relay (1,572). Two hundred fifty-one runners sought medical care. The day's temperatures ranged from 39 to 73°F (mean, 56°F). The primary reasons for seeking medical were medication request (26%), musculoskeletal injuries (18%), dehydration (14%), and dermal injuries (11%). Secondary reasons were musculoskeletal injuries (34%), dizziness (19%), dermal injuries (11%), and headaches (9%). Treatment times ranged from 3 to 25.5 minutes and lengthened as the day progressed. Two-thirds of those who sought medical care did so at the end of the race. The majority of runners who sought medical attention had not run a marathon before.Conclusions:Marathon planners should allocate medical resources in favor of the halfway point and the final first-aid station. Resources and medical staff should be moved from the earlier tents to further augment the later first-aid stations before the majority of racers reach the middle- and later-distance stations.

An Organized Medical Response for the Vancouver International Marathon (2006–2011)

“…A direct comparison of the VIM medical teams with the 2001 Baltimore medical team (17), the team with the highest reported MTR, revealed several differences (Table 5). Specifically the number of personnel qualified to provide medical care and the diversity of skill sets available were greater at the VIM.…”

“…In 2008, Nguyen et al (17) examined injury patterns at a metropolitan multievent marathon consisting of the 3 events: a 5-km run, a standard marathon, and a 4-person marathon relay. Most injuries sustained by runners were minor, and the majority of the presenting runners have not run a marathon previously.…”

“…These individuals require urgent advanced assessment to stratify risk of serious illness. On-site facilities, personnel, and care may enable patients' conditions to improve enough to obviate the need for ambulance transfers, decreasing impact on the prehospital system and the local emergency departments (17,19,24).…”

“…On-site triaging, relocating teams during a given event, and strategic placement of medical stations in order to accommodate surges in patient presentation better are endorsed (4,17,20). These articles offer a foundation for event planners; however, they address neither the unique risks that are specific to each race (e.g., the range of possible weather, course conditions, runner experience, and training levels) nor the unique emergency service infrastructure.…”

Minimum Data Set for Mass-Gathering Health Research and Evaluation: A Discussion Paper

“…Some authors report on the level of care, making comparison of onsite health resources, such as number of medical officers, nurses, paramedics, volunteers, and ambulances compared to the number and type of patients treated. [14] Additionally, some authors include patient disposition, such as return to the event or transported to hospital. [3] In collecting biomedical data from mass gatherings, there may be an agreed upon minimum data set.…”