PREVENTION IS BETTER THAN CURE
The Comrades Marathon Association, with Dr Jeremy Boulter at the helm of its Medical Portfolio, has its prime focus on the health, safety and wellbeing of its runners and as such, has prioritised its medical provisions. It is important to remember that the medical attention is retro-active, i.e. we only respond when a runner is in trouble. Prevention is better than cure, and the prevention of problems is in the hands of you, the runner.
The CMA will provide the following medical facilities for runners:-
ON THE ROUTE:
16 ambulances equipped with satellite tracking to enable us to accurately position the vehicles and ensure optimal response times to attend to runner’s difficulty.
6 rapid response vehicles with advanced life support paramedics and full emergency equipment
4 motor bikes / quad bikes with paramedics
This will be controlled from the medical joint operations control, based on the finish, where there will be 8 computers, a full complement of staff to operate and record all details and dispatch vehicles as and when necessary.
All calls for medical assistance for runners should be made to Netcare 911 medical emergency number 082 911. These calls will then be routed directly to the Medical JOC.
Netcare 911 Physio/ 1st Aid Stations:
8 stations incorporating qualified Physios / Professional Nurses / Paramedical staff.
These will treat minor medical problems. It will also do blood sugar testing. Can be used to treat/ stabilise runners until arrival of ambulance. Physio students will also be at certain refreshment stations along the route. Physio tent is also positioned at finish.
Adcock Ingram Critical Care Medical Tent
50 Doctors and interns
Mini laboratory provided by Ampath Laboratories
A three bed, fully equipped, ICU type, resuscitation area. This area will have a dedicated specialist emergency team to provide appropriate emergency care if needed.
We will have a mobile medical resuscitation trailer on the finish line. This will be staffed by an emergency care doctor and a paramedic. Its purpose is to be used as a primary, emergency resuscitation area if a runner is in severe trouble at the finish and needs care immediately, prior to being transferred to a medical tent.
In addition there will be an advanced life support paramedic being stationed along, or at the end of the Toyota Mile. The paramedic will be able to respond to calls to runners in that area who are in trouble before they enter the stadium.
St. John’s Ambulance tent.
For R&R, Rub downs, strapping and massage etc.
St. Anne’s Hospital in Pietermaritzburg will be utilised for those runners who require hospitalisation before halfway.
St. Augustine’s Hospital in Durban will be our referral hospital from the second half of the race and the finish.
Runners with Medical Aid may be charged at Medical Aid rates. Those without will be treated free of charge for a maximum of 24 hours. [sponsored by Netcare].
PUBLIC 1ST AID:
Will be provided by Netcare at the finish venue at the Sahara-Kingsmead Stadium in Durban.
What can runners do to prevent serious health problems?
Firstly, it is important to appreciate that runners, who collapse after they have finished a race, even if they require urgent medical attention, will almost certainly recover fully. However, those who collapse during a race are most probably suffering from a very serious and potentially fatal condition. So what can be done to prevent this latter situation from arising?
The first thing that runners can do is to make sure that they are adequately prepared. This means that they should have done enough training. They should also do their best to ensure that they have no underlying medical problems, of which they may or may not be aware. The following is a list of questions that runners should ask themselves. If you have answered “yes” to any of these questions, it is strongly recommended that you see your doctor or a cardiologist for a full check up before starting the Comrades.
- Has your doctor ever warned you that you have “heart issues” or that you should only be physically active or do sports under medical supervision?
- Are you overweight or underweight?
- Is your girth over 88cm (for women) or 102cm (for men)?
- Are you over 35 and have not been physically active for a longer period of time?
- During blood pressure monitoring, have you ever recorded high blood pressure?
- Have you ever been diagnosed with high cholesterol?
- Do you smoke or have you smoked extensively in the past?
- Has anyone in your direct family ever suffered from high blood pressure, calcification of the conary blood vessels/heart attack, blood sugar disease, or stroke?
- Do you have diabetes?
- In the past few months, have you had the sensation of a ‘racing heart’, problems breathing, or chest pains, whether while at rest or during athletic activity?
- Are you taking any medication for high blood pressure, heart or breathing conditions?
- Do you ever feel dizzy or pass out, whether at rest or during physical activity?
- Do you have any problems with your musculoskeletal system, which worsen during physical activity?
Remember, any of these symptoms could be indicative of a serious underlying medical problem.
The next thing that you can do is to be aware of any unusual symptoms that may develop during the race, e.g.: Chest pain, dizziness, severe nausea, unusual shortness of breath, change in your running style, confusion and disorientation. If this happens, stop running and seek medical attention. It has become apparent over many years that people feel it is more important to finish the race than to be concerned about their health. [Or is it a matter of pride!]
The third way is DO NOT TAKE ANY MEDICATION AT ALL during the race, especially anti-inflammatories [e.g. Voltaren, Cataflam, etc]. This also includes other pain killers and supplements for cramp etc. There are increasing numbers of runners developing renal failure after Comrades, and one of the major contributing factors to this trend is the taking of anti-inflammatories during the race. Renal Failure is a serious condition and can be fatal.
Another method is a “medical orientated” enforcement of the rules. As the name and the origins and ethos of the Comrades implies, it is a personal battle to the finish, and the support and encouragement of one’s fellow runners is an intimate part of the race. However this could, and has led to runners being helped and carried when they should have stopped running and sought medical help. Any runner who is unable to move forward under their own power, [i.e. is being carried by other runners] will be prevented from continuing and medical attention will be called for - and that runners race will be over!
My appeal to runners is that they demonstrate a great degree of self responsibility. Take care of your health. Make sure that you are adequately prepared to run Comrades. The following is a list of the basic principles every runner should adhere to.
DO eat if necessary
DO listen to your body
DON’T run if you are not fit enough or not properly prepared.
DON’T run if you have been sick or on antibiotics in the three weeks prior to the race.
DON’T take ANY medication during the race.
DON’T be afraid to bale.