Continued Excellence in Race Medicine
Posted on 20 September 2017
The Excellence in Race Medicine Conference in Cape Town focused on excellence in injury prevention and medical care at mass-participation, community-based sports and endurance exercise events.
Mediclinic leads the way in providing the very best in roadside medical care during large sports events, such as the Sanlam Cape Town Marathon and Absa Cape Epic. This was brought to the fore again the past weekend at the Excellence in Race Medicine Conference, in Cape Town, where Mediclinic hosted a variety of sports medicine experts and specialists and gave them a platform to discuss the latest trends and research in sports event management.
Dr Courtney Kipps, a sports and exercise medicine specialist based in the UK, presented his guidelines on best practice in both preventing collapse during a race and the treatment of runners who have collapsed. Like many of the speakers on the day, Dr Kipps pointed to a few common causes of illness and injury during mass-participation race events. These include:
Hyperthermia – including heatstroke;
Hypothermia (when an athlete’s core temperature drops below 35-degrees, and which can occur in warm temperatures); and
Exercise-associated hyponatraemia – or drinking too much water.
Dr Kipps outlined the importance of race medical staff performing the ABCDEFGH assessment to evaluate and assist collapsed runners:
Disability (mental status)
Environment (rectal temperature)
Fluid status, including any change of body temperature
Blood Glucose and Sodium levels, and
History – including the site of collapse.
Professor Martin Schwellnus, head of the Sports, Exercise, Medicine and Lifestyle Research Institute at the University of Pretoria, also discussed the importance of pre-race screening for race medical staff. He argued that effective screening for runners’ chronic conditions can cut down on a variety of injuries during a race by preparing medical staff for the most likely eventualities.
He references the SAFER studies: a body of research used to govern screening and educational interventions in large-scale exercise events.
“The question is can a pre-race screening reduce medical complications during a race?” asked Prof Schwellnus. “The SAFER studies suggest that we institute three basic guidelines to do so. First, runners must complete a medical questionnaire before the event, and then be placed within a set risk-factor group of participants – ranging from low or intermediate to high and very high risk. Finally, we educate the individual in the form of personalised feedback designed to help them make safer, more informed decisions about their level of exercise.”
Chris Troyonas, executive director of racemedicine.org, took a close look at a common cause of collapse: heat illness. The heat illness spectrum includes heat cramps, heat syncope, heat exhaustion, exertion- related heat stroke – and should be considered a medical emergency.
The condition presents with a core temperature of between 40 and 41-degrees and general central nervous system dysfunction. In many cases this may present in a similar way to other pathologies, such as concussion.
He mentioned the Golden Half Hour rule of treating a runner’s heat illness, saying it is imperative to lower a runner’s body temperature within 30 minutes after the collapse, or risk organ damage and even death. It is this efficient intervention that makes race medical staff so critical, said Troyonas, who has served as a medical coordinator at the Boston Marathon.
“Medical assistance providers play a major role in the impact of any mass-participation sports event. The Sanlam Cape Town Marathon can have a great impact on the local community, and it is important that the race’s roadside medical teams understand their huge role in ensuring the whole event is a success.”
Finally, Cape Town Marathon race medical director Dr Jann Killops took the stand to express her excitement at the event’s IAAF Gold Label Status, which places the event as one of the top 35 road races in the world.
One major factor in the awarding of that coveted status is a high standard of roadside medical care, proudly delivered on the day by Mediclinic and ER24 medical staff.