title: Innovative Operations Measures and Nutritional Support for Mass Endurance Events.
abstract: Endurance and sporting events have increased in popularity and participation in recent years worldwide, and with this comes the need for medical directors to apply innovative operational strategies and nutritional support to meet such demands. Mass endurance events include sports such as cycling and running half, full and ultra-marathons with over 1000 participants. Athletes, trainers and health care providers can all agree that both participant outcomes and safety are of the utmost importance for any race or sporting event. While demand has increased, there is relatively less published guidance in this area of sports medicine. This review addresses public safety, operational systems, nutritional support and provision of medical care at endurance events. Significant medical conditions in endurance sports include heat illness, hyponatraemia and cardiac incidents. These conditions can differ from those typically encountered by clinicians or in the setting of low-endurance sports, and best practices in their management are discussed. Hydration and nutrition are critical in preventing these and other race-related morbidities, as they can impact both performance and medical outcomes on race day. Finally, the command and communication structures of an organized endurance event are vital to its safety and success, and such strategies and concepts are reviewed for implementation. The nature of endurance events increasingly relies on medical leaders to balance safety and prevention of morbidity while trying to help optimize athlete performance.
authors.affiliation: Departments of Orthopaedic Surgery and Emergency Medicine, Feinberg School of Medicine, Northwestern University and Northwestern Medicine, 211 East Ontario Street, Chicago, IL, 60611, USA. g-chiampas@northwestern.edu.|Bank of America Chicago Marathon and Shamrock Shuffle, Chicago, USA. g-chiampas@northwestern.edu.|US Soccer Federation, Chicago, USA. g-chiampas@northwestern.edu.
authors.forename: George T
authors.initials: GT
authors.lastname: Chiampas
authors.affiliation: Saint James School of Medicine, The Quarter, Anguilla.
authors.forename: Anita V
authors.initials: AV
authors.lastname: Goyal
mesh_terms: D000465:Algorithms; D001265:Athletic Injuries / Q000517:prevention & control* / Q000628:therapy; D000066491:Clinical Decision-Making; D003163:Competitive Behavior / Q000502:physiology*; D003681:Dehydration / Q000517:prevention & control; D004632:Emergency Medical Services / Q000458:organization & administration*; D006323:Heart Arrest / Q000517:prevention & control / Q000628:therapy; D018882:Heat Stress Disorders / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007010:Hyponatremia / Q000517:prevention & control / Q000628:therapy; D010807:Physical Endurance / Q000502:physiology*; D013178:Sports Medicine / Q000458:organization & administration*; D064133:Sports Nutritional Physiological Phenomena