Hannah Evans / Adventure Medic Staff Writer
Event medicine is great fun and a useful opportunity to keep your expedition medicine skills up when you have limited annual leave. Adventure Medic Staff Writer Hannah Evans tells us how to get involved.
The Cateran Trail
The Cateran Trail race starts and finishes in Blairgowrie, following some of the most spectacular scenery Highland Perthshire and Angus has to offer. Teams of 2 – 6 people hike distances of either 22, 36.5 or 52 miles in just 24 hours. Foot-related problems are the most common reasons for participants to require medical attention. Dressing wounds and blisters is often the mainstay of medical care. Challengers are provided with hot food at various points in the course; however some walkers are less conscientious about maintaining adequate fluid intake, leading to inevitable dehydration and exhaustion. Usually, with some encouragement, oral rehydration solution and a snack, they continue.
As a doctor for the event, I cover a particular part of the course and responding if and when there is a need. In addition to myself there are usually other doctors, mountain medics, armed forces personnel, British Red Cross first aiders and ambulances stationed throughout the course, who establish treatment requirements and points of evacuation to a local hospital if necessary. There is usually a reasonably well stocked ‘clinic’ type base, where participants can self-present and receive advice or treatment. I only carry essential equipment on the course with me, such as the airway devices and splints in an easily transportable rucksack.
Commonly participants don’t seek treatment for many conditions unless very severe or until the event has finished. Others require recurrent assessment and treatment during the event. The prospect of a severely injured challenger requiring immediate airway control on the course has not yet arisen in my practice, but the risk remains. Despite this possibility, or perhaps because of it, adventure racing is an exhilarating challenge to get involved with.
Events and adventure racing
For me, the thrill of riding around the Perthshire countryside in a 4×4, radio in hand, en-route to a casualty, and the satisfaction of treating a patient and helping them achieve their goal reminds me exactly why I studied medicine. Over the past decade, adventure racing has seen a surge in popularity throughout the world with increasing numbers of events and participants each year. Events are becoming increasingly challenging, and this often means more remote locations with tougher physical challenges and potential for injury and illness. Challenges may include adventure races, multidistance fundraiser hikes, large outdoor education groups, or commercial trips.
Wilderness events may involve a single activity, or a combination of activities as with multisport adventure races. Each component of the challenge has its own unique risks: rate and severity of injury and illness, weather conditions, nature of the medical complaint, proximity and ease of access and difficulty of evacuation. Competitors have often raised a significant sum for charity to complete these events and so the drive to succeed is even higher.
Working as a doctor
Working as a doctor on these events can be exciting, tiring and satisfying but most of all requires a keen ability to think fast on your feet and be ready for whatever happens. This often equates to a fair amount of ‘downtime’ where you are on standby. These quiet periods are interspersed with high priority calls to assess casualties. Certainly having a cool temperament and a love for the outdoors is essential to providing a sound contribution to the overall safety of adventure eventing.
A broad knowledge of emergency medicine principles and their application in an out-of- hospital setting is critical to work in this field. Sound general orthopaedic knowledge and assessment base is helpful, especially with diagnosis of fractures, sprains, tendons and ligament injuries generally with a focus on the foot, ankle, knee and shoulder. An appreciation of the effect of high emotions on a person’s drive to complete the challenge often despite injury must be held at the forefront of your mind when assessing participants throughout the course.
Useful courses and qualifications
PHTLS / Prehospital Trauma Life Support
ATLS / Advanced Trauma Life Support
PHECC / Prehospital Emergency Care Course
Dip. IMC / Diploma in Immediate Medical Care
See also the Adventure Medic Resources Section.
Useful Kit
- Medical Kit, often provided in the form of a Sandpiper bag with basic airway, supportive circulatory kit, dressings and basic medications
- Food and adequate fluids for yourself
- Cash in case of emergencies
- Waterproofs – in addition to a spare set of clothes depending on weather conditions and location. Uniforms may be provided.
Indemnity
Contact your defence union well in advance of any event work to ensure they are kept in the loop with what you intend to do, location and nature of support if you are of non-consultant grade or not a qualified GP. They will usually provide indemnity up to a certain level of earnings without it changing your annual subscription fees but check with your own provider for details.
Will I get paid?
Some events will pay a modest fee for a medic and others won’t depending on the event and company. Make sure you are clear about this before you accept a job. Events run by certain companies will not take into consideration rules from the EWTD (European Working Time Directive). Be sure you know what the sleeping/rest arrangements as well as those for meal breaks before you say yes. Ensure you are clear of your role – it’s often goodwill to help with other aspects of the event i.e. putting up marquees and signs etc. but be sure what the company’s expectations of you with regards to this are.
Hints for getting started
- Contact your local St John’s Ambulance or British Red Cross groups and ask whether you could shadow an event they are covering or come to training sessions
- If there is an event you are interested in near you, contact the organisers and ask who they use for medical cover, then contact the relevant body
- Get involved in your local Mountain Rescue, Motor racing circuit or BASICS scheme for experience in pre-hosptial care
- There are a few event companies in the UK who provide medical cover for concerts/festivals. Contact these directly and express an interest in firstly shadowing and becoming involved further.
- You need to have a genuine interest in event medicine and the event you are specifically covering – a lot of the work involves hours spent doing literally nothing and so having an interest in the event/sport is crucial for staying enthusiastic and useful!
