Diagnosis and prevention of hyponatremia at an ultradistance triathlon.
OBJECTIVE
To evaluate a method of medical care at an ultradistance triathlon, with the aim of reducing the incidence of hyponatremia.


METHODS
Descriptive research.


METHODS
New Zealand Ironman triathlon (3.8 km swim, 180 km cycle, 42.2 km run).


METHODS
117 of 134 athletes seeking medical care after the triathlon (involving 650 race starters).


METHODS
A prerace education program on appropriate fluid intake was undertaken. The number of support stations was decreased to reduce the availability of fluid. A body weight measurement before the race was introduced as a compulsory requirement, so that weight change during the race could be included in the triage assessment. An on-site laboratory was established within the race medical tent.


METHODS
Numbers of athletes and diagnoses, including the incidence of symptomatic hyponatremia (defined as symptoms of hyponatremia in association with a pretreatment plasma sodium concentration [Na] < 135 mmol/L); weight changes; and changes in [Na].


RESULTS
The common diagnoses in the 117 athletes receiving attention were exercise-associated collapse (27%), musculoskeletal complaints (26%), and dehydration (12%). There was a significant reduction in the number of athletes receiving medical care for hyponatremia, from 25 of the 114 athletes who received care in 1997 (3.8% of race starters) to 4 of the 117 athletes who received care in 1998 (0.6% of race starters). Mean weight change among athletes in the 1998 race was -3.1 kg, compared with -2.6 kg in 1997.


CONCLUSIONS
A preventive strategy to decrease the incidence of hyponatremia, including education on fluid intake and appropriate placement of support stations, was associated with a decrease in the incidence of symptomatic hyponatremia.
Speedy
D B
DB
Department of General Practice and Primary Care, University of Auckland, New Zealand.
Rogers
I R
IR
Noakes
T D
TD
Thompson
J M
JM
Guirey
J
J
Safih
S
S
Boswell
D R
DR
D001642:Bicycling / Q000193:education / Q000293:injuries*; D001835:Body Weight; D003681:Dehydration / Q000517:prevention & control; D004632:Emergency Medical Services; D005260:Female; D006266:Health Education; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis* / Q000517:prevention & control; D015994:Incidence; D008297:Male; D009140:Musculoskeletal Diseases / Q000209:etiology; D009520:New Zealand; D010807:Physical Endurance; D015532:Rehydration Solutions / Q000627:therapeutic use; D012420:Running / Q000193:education / Q000293:injuries*; D012964:Sodium / Q000097:blood; D013550:Swimming / Q000193:education / Q000293:injuries*; D015431:Weight Loss
D015532:Rehydration Solutions; D012964:Sodium