title: Managing collapsed or seriously ill participants of ultra-endurance events in remote environments.
abstract: Increasing participation in ultramarathons and other ultra-endurance events amplifies the potential for serious medical issues during and immediately following these competitions. Since these events are often located in remote settings where access may be extremely limited; the diagnostic capabilities, treatment options, and expectations of medical care may differ from those of urban events. This work outlines a process for assessment and treatment of athletes presenting for medical attention in remote environments, with a focus on potentially serious conditions such as major trauma, acute coronary syndrome, exertional heat stroke, hypothermia, hypoglycemia, exercise-associated hyponatremic encephalopathy, severe dehydration, altitude illness, envenomation, anaphylaxis, and bronchospasm. A list of suggested medical supplies is provided and discussed. But, given that diagnostic and treatment options may be extremely limited in remote settings, it is important for medical providers to understand how to assess and manage the most common serious medical issues with limited resources, and to be prepared to make presumptive diagnoses when necessary.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of California Davis Medical Center, Sacramento, CA, USA, mdhoffman@ucdavis.edu.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Hoffman
authors.forename: Ian R
authors.initials: IR
authors.lastname: Rogers
authors.forename: Jeremy
authors.initials: J
authors.lastname: Joslin
authors.forename: Chad A
authors.initials: CA
authors.lastname: Asplund
authors.forename: William O
authors.initials: WO
authors.lastname: Roberts
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Levine
mesh_terms: D001265:Athletic Injuries / Q000175:diagnosis* / Q000628:therapy*; D003163:Competitive Behavior / Q000502:physiology; D004638:Emergency Treatment; D004777:Environment; D006801:Humans; D010807:Physical Endurance / Q000502:physiology*; D012420:Running / Q000502:physiology*; D014218:Triage