57. Adventure sport events tend to entail specific medical challenges and emergencies. These should be identified in the event risk assessment and appropriate control measure put in place to mitigate the risks well before the event takes place.
58. The medical team at the event should be suitably resourced to provide a safe, effective and resilient service on site whilst helping to minimise the impact on NHS resources. See Medical chapter.
59. Often adventure sport participants will deal with an injury themselves that might have otherwise ended up being treated by the event medical team. However, organisers need ensure that sufficient support is available for those who need it.
60. Hypoglycaemia, hyperthermia and hypothermia are common at adventure sport events. More unusually, rhabdomyolysis, hypernatremia (hypokalaemia, and other electrolyte imbalances etc.) are seen and a medical team that is familiar with the identification and field management of these conditions is critical.
61. Event organisers need to ensure that the medical professionals, and first aiders, they use have relevant experience and skills relating to the type of event they are supporting. A well-intentioned doctor, who is trained as a General Practitioner, is unlikely to make an ideal medic for an adventure sport event. Likewise, a team of first aiders used to festivals is unlikely to have the skill set to respond to an emergency far from the Event Centre, which is where the most serious incidents can occur.
62. As in all events, the organiser is responsible for exercising due diligence when selecting competent medics.
63. For the serious and remote adventure sport events more extensive medical support may be needed. A good starting point for assessing such an event’s medical requirements can be found in Medical Services at Ultra-Endurance Foot Races in Remote Environments: Medical Issues and Consensus Guidelines, published in 2014 by Hoffman et al.
64. Risk assessments should address how an emergency would be dealt with in areas that are difficult to access and/or a remote. Simply, defaulting to the emergency services is never acceptable.
65. As an event grows, the requirement to have a dedicated and specialist emergency response team increases.
66. As with all sporting events, the event medical team must be familiar with Exercise Associated Collapse (EAC)and have a well-rehearsed team and protocol for finish line collapses, especially if the event is competitive.
67. Statistics from mass participation sporting events (like the big city marathons), show that finish line collapses are rarely serious, but that collapses on the course usually are. The same is true for adventure sport events and a clearly defined plan for how the event will respond to course collapses should be a core document within the medical risk assessment.
68. Some adventure sport events may have established relationships with a local rescue service, such as a mountain rescue team, who agree to attend the event to provide emergency medical cover. It is important to make sure that this resource is ring-fenced and understand/agree what would happen if the team is called to another emergency elsewhere.