Bill Potts' reply via email:

"I was working AS 6 HS this year and while I did not directly respond to the incident, I did make efforts to relay messages to the finish line and have followed up Kelly Young and the nurse who performed 45 minutes of CPR on the runner. Both had valuable feedback.

When we have an adverse event in the hospital setting, it is always followed by an outcomes review. The purpose of the review is to examine ways to improve upon the delivery of services. Where and how can we do things better? It is not intended to find fault, but rather improve upon outcomes. At the conclusion of Highland Sky I found myself asking what would I have done if the runner had collapsed near my aid station and how would I have responded and I had no clear answer to that questions.

Given the diversity of running events that our club sanctions I feel that it would be beneficial to convene Race/Board directors to review our emergency preparedness process for every race. We may wish to establish some basic standards for emergency response for all races. I think this helps to improve upon the quality of races that we host while preparing for any future emergency. I would recommend a ½ day meeting with all RDs and Board to review race preparedness/emergency response and come up with a standard of care for all races. If we do not learn from past events then we aren’t making efforts to be better as a club.

I am happy to help facilitate this process in any way I can. I feel strongly about this."

USA track and field has a plan.  Mind you it includes evacuation of a facility but medical response is included.  

http://www.usatf.org/About/Privacy---Other-Policies/Emergency-Response-Plan.aspx

Also the rrca has some recommendations -  https://www.rrca.org/docs/default-source/default-document-library/race_guidelines_for_safety_-_2010.doc?sfvrsn=53fdc30d_0

I believe a 1/2 day meeting is a good place to start.  Is there an expert that we can contract to get some insight and guidance?   Having an objective third party would be helpful.  It might allow us to be more proactive than reactive to our specific incident.  Our situation at HS40m is not unique to ultras (rural, remote, and unconnected).   There is a line in one of those links that states, “The foundation of your medical coverage is communication.”

This is an issue with several of our races.  Is there an investment that could be made that would improve communication?  Could a portable repeater be placed in parking area of AS7 to allow communication to all AS.  Also at the DD, frosas, and trilogy?

i don’t know if it is appropriate to allow the specifics of the incident impact decisions and the plan.  I don’t think saving 10 minutes on the front end with better communications would have made a difference in that situation but we are planning for any medical emergency.  I don’t think having a defribulator At AS 5 would have made a difference.  Having the emts At AS4 and having a solid communication system could make a huge difference in a future incident.  

The RRCA page you linked to has some very useful guidelines that we may be able to use. Thank you DT.

Very insightful comment and information Dan.  Thank you.

I also agree that finding the time to meet would be extremely worthwhile.  Unfortunately, I believe that the soonest we could expect to formally get everyone together would be the Annual Meeting/RD-BOD Meeting that we are tentatively planning for next April.  In the meantime, we could certainly disseminate information (ie. educational materials that DT shared) to establish some basic standard operations for our race directors.

I’m glad this is a discussion. This is an issue with many variables. Great points by Dan T and Potts. I like Potts idea of a post event review 

I think we do a good job already, but making sure all our events are prepared would probably benefit from periodic reviews. 

There’s a lot of info out there to guide us  

http://wser.org/wp-content/uploads/medicalconf/Pasternak-Medical-Needs-at-Ultra-Endurance-Footraces-Medical-Directors-Perspecitve.pdf

You don’t think leadership could meet on this topic before then or do you feel having the RD input critical to success at this point in time?

You don’t think leadership could meet on this topic before then or do you feel having the RD input critical to success at this point in time?

Could we have Tim Daly give us some help on this subject seeing as how he has many years of service and experience. 

Here was another interesting one 

https://www.researchgate.net/profile/Volker_Scheer/publication/261762145_Medical_Services_at_Ultra-Endurance_Foot_Races_in_Remote_Environments_Medical_Issues_and_Consensus_Guidelines/links/54d9145d0cf24647581d70e5/Medical-Services-at-Ultra-Endurance-Foot-Races-in-Remote-Environments-Medical-Issues-and-Consensus-Guidelines.pdf?origin=publication_detail

Posted by: Daniel Todd

You don’t think leadership could meet on this topic before then or do you feel having the RD input critical to success at this point in time?

Dan, I think leadership could most certainly -- and will need to -- get together sooner.  I do not believe RD input is critical at this time.  The critical aspect is addressing this in a timely manner so that we are as prepared as possible for all future events.

How about a Friday night meeting in Marlinton on 8/10?

This is a great start.  

That is the first day of school for many of my customers so I can’t commit to anything too early.