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Injury Patterns and Levels of Care at a Marathon

Published online by Cambridge University Press:  28 June 2012

Richard B. Nguyen*
Affiliation:
Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
Andrew M. Milsten
Affiliation:
Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
Jeremy T. Cushman
Affiliation:
Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
*
Emergency CenterHoly Cross HospitalSilver Spring, Maryland 20910USA E-mail: [email protected]

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.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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References

1.Sanders, AB, Criss, E, Steckl, P, Meislin, HW, Raife, J, Allen, D: An analysis of medical care at mass gatherings. Ann Emerg Med 1986;15:515519.CrossRefGoogle ScholarPubMed
2.Friedman, LJ, Rodi, SW, Krueger, MH, Votev, SR: Medical care at the California AIDS Ride 3: Experiences in event medicine. Ann Emerg Med 1998;31:219223.CrossRefGoogle ScholarPubMed
3.Crouse, B, Beattie, K: Marathon medical services: Strategies to reduce runner mortality. Med Sci Sports Exerc 1996;28:10931096.CrossRefGoogle Scholar
4. USA Track & Field: 2004 Marathon Report. US Marathon Demographic Snapshot. Available at http://www.usatf.com/news/specialReports/2004Marathon Report.asp. Accessed 13 November 2007.Google Scholar
5. Popular marathons, half marathons, and other long distance runs: Recommendations for medical support. Br Med J 1984;288:13551359.CrossRefGoogle Scholar
6. National Climatic Data Center. Available at http://www.ncdc.noaa.gov/oa/ ncdc.html. Accessed 13 November 2007.Google Scholar
7. The Weather Underground, Inc: Baltimore, Maryland, on Saturday, October 20, 2001. Available at http://www.wunderground.com/history/airport/ KBWI/2001/10/20/DailyHistory.html?req_city=NA&req_state=NA&req_ statename=NA. Accessed 13 November 2007.Google Scholar
8. Heat index. NOAA's National Weather Service, Jackson, Kentucky, June 15, 2006. Available at www.crh.noaa.gov/jkl/?n=heat_index_calculator. Accessed 13 November 2007.Google Scholar
9.Mear, G, Batson, D: Mass Gatherings. In: JE, Tintinalli, Ruiz, E, Krome, R (eds). Emergency Medicine: A Comprehensive Study Guide, 4th ed.New York: McGraw-Hill, 1996:2629.Google Scholar
10.Grange, JT, Green, SM, Downs, W: Concert medicine: Spectrum of medical problems encountered at 405 major concerts. Acad Emerg Med 1999;6:202207.CrossRefGoogle ScholarPubMed
11. The Baltimore Marathon. Available at http://www.marathonguide.com/ results/browse.cfm?MIDD=1629011020. Accessed 13 November 2007.Google Scholar
12.Oroszlan, F: Baltimore Marathon hits the streets.Available at http://www.pressboxonline.com/story.cfm?id=932.Accessed 13 November 2007.Google Scholar
13.Jacobs, SJ, Berson, BL: Injuries to runners: A study of entrants to a 10,000 meter race. Am J Sports Med 1986;14:151155.CrossRefGoogle Scholar
14.Milsten, AM, Maguire, BJ, Bissell, RA, Seaman, KG: Mass-gathering medical care: A review of the literature. Prehospital Disast Med 2002;17:151162.CrossRefGoogle ScholarPubMed
15.Armstrong, LE, Epstein, Y, Greenleaf, JE, et al: American College of Sports Medicine position stand: Heat and cold illness during distance running. Med Sci Sports Exerc 1996;28:ix.CrossRefGoogle ScholarPubMed
16.Ridley, SA, Rogers, PN, Wright, IH: Glasgow Marathons 1982–1987: A review of medical problems. Scott Med J 1990;35:911.Google Scholar
17.Maron, BJ, Poliac, LC, Roberts, WO: Risk for sudden cardiac death associated with marathon running. J Am Coll Cardiol 1996;28:428431.Google Scholar
18.Roberts, WO: A 12-yr profile of medical injury and illness for the Twin Cities Marathon. Med Sci Sports Exerc 2000;32:15491555.CrossRefGoogle ScholarPubMed
19.Arbon, P: The development of conceptual models for mass-gathering health. Prehospital Disast Med 2004;19:208212.CrossRefGoogle ScholarPubMed
20.Richards, R, Richards, D, Whittaker, R: Method of predicting the number of casualties in the Sydney City-to-Surf fun runs. Med J Aust 1984;141:805808.Google Scholar
21.Masters, K: Hypnotic susceptibility, cognitive dissociation, and runner's high in a sample of marathon runners. Am J Clin Hypn 1992;34:193201.CrossRefGoogle Scholar
22.Stevinson, CD, Biddle, SJ: Cognitive orientations in marathon running and “hitting the wall”. Br J Sports Med 1998;32(3):229235.CrossRefGoogle ScholarPubMed
23.Chan, DW, Lai, B: Psychological aspects of long-distance running among Chinese male runners in Hong Kong. Int J Psychosom 1990;37:3034.Google ScholarPubMed
24.Thomas, AC: Hitting the wall. Available at http://www.tech.mit.edu/V122/N21/col21andre.21c.html. Accessed 13 November 2007.Google Scholar
25.Milsten, AM, Seaman, KG, Liu, P, Bissell, RA, Maguire, BJ: Variables influencing medical usage rates, injury patterns, and levels of care for mass gatherings. Prehospital Disast Med 2003;18:334346.CrossRefGoogle ScholarPubMed