ABSTRACT
A medical infrastructure designed to ensure the safe participation of athletes and staff should be behind every mass participation event. The provision of medical support for these events facilitates an opportunity for community outreach, collaboration with colleagues across the medical continuum of care, service to participants, and often a great deal of personal satisfaction. Mass participation events can be dened as any sporting pursuit involving more participants than a standard two-team competition and frequently involves multiple venues and extensive geographic territory. Common examples are marathons, triathlons, and team sport tournaments and may include long distances and varying terrains and obstacles. Participation has continued to grow and includes not only increased entrants in traditional events but the development of a new series of
community sanctioned and unsanctioned combat, obstacle, and adventure challenges. It should be noted that the planning and coverage for these events are separate and unique from that utilized in the planning for mass gathering events such as outdoor concerts, sporting event spectators, and religious pilgrimages.3,11,27,35,37 Extensive advanced planning is critical to provide safe and effective medical care.1,2,11,17,25 The medical leader must be adept at communication, planning, collaboration, and sport-specic medical condition diagnosis and management to prevent serious injury or illness to the participants and support staff.22 The required advanced preparation cannot be underestimated and an intimate understanding of the event rules, goals, peculiarities, and participants will prove invaluable. The requirements for coverage must be considered well in advance of the event to provide optimal number, distribution, and training of medical assets. Having a fully operational emergency action plan is an essential piece for the successful execution of a mass participation event (Table 34.1).7,42
A key consideration in planning for the coverage of any event is an intimate understanding of the potential medical requirement associated with it. Competitor demographics, course demands, water, speed, terrain, equipment, climate, and temperature are only a few of the variables to be considered. The utilization of the event’s past history and that of similar events is often most helpful in planning for the current event. This reinforces the importance of maintaining accurate medical contact statistics from year to year. Focusing on injury type and distribution associated with event duration and location
34.1 Introduction ................................................................................................................................................................... 339 34.2 Epidemiology ................................................................................................................................................................. 339 34.3 Safety Considerations .................................................................................................................................................... 340 34.4 Contingency Planning for Mass Casualty Situations .................................................................................................... 340 34.5 Medical Chain of Command ......................................................................................................................................... 341 34.6 Medical Philosophy ....................................................................................................................................................... 341 34.7 Stafng Plan .................................................................................................................................................................. 342 34.8 Education ....................................................................................................................................................................... 342 34.9 Communication Plan ..................................................................................................................................................... 343 34.10 Finances and Logistics .................................................................................................................................................. 343 34.11 Transportation Plan........................................................................................................................................................ 344 34.12 Triage and Treatment Guidelines .................................................................................................................................. 344 34.13 Medicolegal ................................................................................................................................................................... 345 34.14 Conclusion ..................................................................................................................................................................... 345 References ................................................................................................................................................................................. 345
TABLE 34.1 Key Clinical Considerations 1. Open collaboration, generous support, and mutual respect between the
sites where their utilization will be optimized.
