A sports medicine physician should work closely with the race director to enhance the safety and provide adequate medical care for all participants. The medical director should understand exercise physiology, interpretation of meteorological data, heat and cold illness prevention strategies, potential liability, and the treatment of medical problems associated with endurance events conducted in stressful environments.
Medical organization and responsibility: The medical director should alert local hospitals and ambulance services and make prior arrangements to care for casualties, including those with heat or cold injury. Medical personnel should have the authority to evaluate, examine, and stop runners who display signs of impending illness or collapse. Runners should be advised of this procedure prior to the event.
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Medical facilities: Medical support staff and facilities must be available at the race site. The facilities should be staffed with personnel capable of instituting immediate and appropriate resuscitation measures. The equipment necessary to institute both cooling therapy ice packs, child’s wading pools filled with tap water or ice water, fans and warming therapy heaters, blankets, hot beverages may be necessary at the same event. For example, medical personnel treated cases of hyperthermia and cases of hypothermia at an endurance triathlon involving competitors: air temperature was F, water temperature was F.
The physical training and knowledge of competitive runners and joggers has increased greatly, but race organizers must not assume that all participants are well prepared or informed about safety. Distributing this position stand before registration, publicizing the event in the media, and conducting clinics or seminars before events are valuable educational procedures.
All participants should be advised that the following conditions may exacerbate heat illness: obesity, low degree of physical fitness dehydration lack of heat acclimatization, previous history of heat stroke sleep deprivation, certain medications, including diuretics and antidepressants, and sweat gland dysfunction or sunburn. Illness wk prior to an event should preclude participation especially those involving fever, respiratory tract infections, or diarrhea.
Prepubescent children sweat less than adults and have lower heat tolerance.
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