Safety and risk management at races is something that few people ever have to think about because injuries are really pretty rare in comparison to the size of an event. Most surprisingly, it also seems to be one of the most overlooked steps in race planning. Everyone thinks about the fun times until they have that "oh shit" moment once something goes wrong.
As a race organizer of 21 years, I've seen a little bit of everything, but each emergency brings its own challenges. Likewise, no two events are the same with respect to emergency management. On many occasions, I've had new RDs ask for a peek at our emergency plan and I get a bit uncomfortable because there is no one formula that works everywhere; it's a process that you have to develop.
So, what makes for a good emergency plan?
KNOW YOUR RESOURCES. You either have to build the size and scope of the race around the resources available, or you bring in resources to match that size and scope. It's usually the latter. The Sinister Sports (SSI) team uses what is called an ICS or Incident Command System. This is a way of organizing our people so that they know their specific roles and the people to whom they report. Under our ICS model, just on the Safety side, the chain of command will look something like this: RD > Operations Chief > Safety Director > Medic (stationary) / SAR (mobile). The RD manages how the race unfolds with both Operations (people) and Logistics (moving stuff). The OC has a handle on everything that is happening with people at the race. The SD works directly with safety implementation and management. Medics and SAR are the boots on the ground giving treatment and picking up damaged or expired racers.
The number of Medics and SAR responders will vary based on many factors including the number of competitors, the time of day, the terrain, the capability of the local hospital/EMS/SAR, and how easy it is to get someone out if they are hurt. There are races like Lost Soul Ultra (great friends of mine and solid RDs) where they can call 911 and get an ambulance 24/7. Others, like Sinister 7 Ultra, bring you way out into the middle of nowhere with only ATV access. If you get hurt on remote singletrack and cannot make your way out under your own power, it's probably a helicopter rescue for you.
KNOW YOUR CAPACITY. At SSI races, we always have contracted Paramedics (Advanced or Primary Care) to perform on-site medical. Normally, that will be 1-2 Paramedics per transition area throughout the race, depending on the number of competitors. We do sometimes have volunteer first-aiders, but they are typically doing initial triage or simple bandaging. The reason we (I) insist on contracted professionals for the "heavy lifting" is simple: what do you do in your worst-case scenario? Upon deep reflection, our worst-case scenario is a fatality (and there are a thousand ways it could happen). If there is a fatality, I can turn to a contracted Paramedic and say, "You handle this, I'll talk with the RCMP and liaise with the public". I could NOT in good conscience put that responsibility on a volunteer, even if they are completely qualified. We need to have someone who is briefed, on point, and ready for anything. I don't want to take the chance of scarring a volunteer for life! This also allows us to take the burden off of the local hospital and EMS by diverting 80-90% of incidents away from their doors.
Part of capacity management is also determining your level of service and your limits. For our events, we will do anything up to and including intravenous hydration and using an AED. Our Medics are there to keep your blood in and the bad stuff out. If at any time we feel an injury is beyond our capacity to treat on-site, we call 911. Every race is different based on the available resources.
The SAR side works a little differently in that they are mostly about getting to an incident quickly, determining what resources are needed, treating what they can, and evacuating critical patients if possible. Similar to Medics, our SAR teams work to their capacity and we call 911 for anything that is beyond their skills or the limits of their equipment. SAR, at most of our races, is contracted to local experts. With Canadian Death Race, we have received incredible help from Grande Cache SAR, Grande Prairie SAR, and the Canadian Rangers. SSI has three of its own side-by-side ATVs for both logistics and SAR use; you're lucky if you never have to ride in one during the race.
KNOW YOUR COMMON INJURIES. Knee, ankle, and hip problems are pretty common at trail runs and luckily they generally go away with stretching and rest. I'll bet you dollars to donuts, however, that most people don't know the one injury that worries me the most. For me, it's the heat. Racers can dress up in the cold, but there is no way to dress down enough when it's hot. Whenever we have a really hot race, we mobilize more Logistics people (a whole other side of ICS planning) with water/supplies, and we alert our medics and SAR to be ready for lots of pick-ups. Environmental exposure of any kind requires a quick response.
A realistic example of a SAR call will have them show up at a checkpoint with three racers in various states of disrepair. One is tired and grumbly but OK (Green flag), one has a twisted ankle and can't walk (Yellow flag), and one is hypothermic (Red flag). Red patients and Yellow or Green who may turn into Red patients are the first priority for evacuation. SAR would determine if the patient can be treated by our Medics, or if they need an ambulance to meet them at the nearest road for referral to the hospital. Remote rescues take time and a round trip can be hours in length, so you need to get it done efficiently every time. This level of coordination means really knowing both your capacity and your resources.
As I mentioned above, you have to know the level of service for your event. If a race is known for lots of cases of dehydration, it's probably beneficial to have Paramedics on standby to give IVs. At others, like the Glouchester cheese race (you have to Google that now), competitors commonly snap bones or dislocate joints, so it's imperative to have specialists who can treat these injuries... We (SSI) refer those big breaks to the hospital PDQ.
PREPARE THE COMPETITORS. The racers themselves are the #1 best people to take care of their safety out in the woods. RDs have to prepare competitors by letting them know the risks - by guiding them to smart choices. It isn't often that someone comes to one of our races and says, "wow that's so much harder than I expected". Our reputation proceeds itself, and I'm glad! Smart choices. Many of you have heard me say at Sinister 7, "If you go out onto leg 4 without a headlamp, you're DEAD TO ME!". Looking out for yourselves, being prepared, and looking out for each other will really make your race 100x better. It could be a sunny day and you are running strong, but when you twist your ankle and the clouds start to roll in, you're gonna have a bad time.
So that's a whirlwind tour of safety planning, but it's really just the tip of the iceberg. Now enjoy the photo of me goofing around on one of our SAR side-by-sides. Tally HO!
~ Brian Gallant / Owner+Director - Sinister Sports
*The witching hour is usually some time between dusk at 2:00am - people get crazy once the darkness creeps in.
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