title: Characterization of medical care at the 161-km Western States Endurance Run.
abstract: OBJECTIVE
  To examine the medical care at a highly competitive 161-km mountain ultramarathon.
  
  
  METHODS
  Encounter forms from the 2010 through 2013 Western States Endurance Run were analyzed for trends in consultation and use of intravenous fluids.
  
  
  RESULTS
  A total of 63 consultations (8.2% of starters) were documented in 2012 and 2013, of which 10% involved noncompetitors. Most (77%) of the consultations with competitors occurred on the course rather than at the finish line, and were generally during the middle third of the race. Of the on-course consultations, the runner was able to continue the race 55% of the time, and 75% of those who continued after consultation ultimately finished the race. Relative number of consultations did not differ among competitors within 10-year age groups (P = .7) or between men and women (P = .2). Overall, consultations for medical issues were predominant, and nausea and vomiting accounted for the single highest reason for consultation (24%). Although there was an overall decrease in finish line consultations and intravenous fluid use from 2010 through 2013 (P < .0001 for both) that was independent of maximum ambient temperature (P = .3 and P = .4), the proportion of those being treated with intravenous fluids relative to those receiving consultation at the finish line was directly related to maximum ambient temperature (r = .93, P = .037). Both 2012 and 2013 had a single medical emergency that required emergency evacuation.
  
  
  CONCLUSIONS
  This work demonstrates that the medical needs in a 161-km ultramarathon are mostly for minor issues. However, occasional serious issues arise that warrant a well-organized medical system.
authors.affiliation: Department of Physical Medicine & Rehabilitation (Drs McGowan and Hoffman), University of California Davis Medical Center.
authors.forename: Vanessa
authors.initials: V
authors.lastname: McGowan
authors.affiliation: Department of Physical Medicine & Rehabilitation (Drs McGowan and Hoffman), University of California Davis Medical Center; Department of Veterans Affairs, Northern California Health Care System (Dr Hoffman), Sacramento, CA. Electronic address: martin.hoffman@va.gov.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Hoffman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance; D012420:Running; D055815:Young Adult
keywords: endurance; exercise; injury; medical coverage; running; ultramarathon