Medical arrangements in 108 open-entry Britain marathons, 1983

In 108 open-entry full marathons held in Great Britain in 1983 (35 incorporating shorter races) the number of static first-aid posts varied from 0 to 28 (median 9). In 54 (50%) the first of these was within 3 miles of the start but in 11 (10%) there were none in the first 10 miles. Mobile first-aid arrangements did not compensate for the absence of static posts. The numbers of qualified first-aid staff ranged from 1-250 in events with fewer than 1,000 entrants (67%), and 18-930 in larger events. Intravenous infusion facilitates were available in 59 (55); defibrillators in 34 (31%). Drink stations were provided in all events but in at least 40 they were spaced more than 2 1/2 miles apart on average. Oral and intravenous fluid replacement facilities were available to no greater extent in summer events than at other times of the year; 25 of the 57 summer events started at or after 11.00 hrs. Races with fewer than 10 first-aid posts had mean contact rates of 75 per 1,000 entrants (S.E. 15.4); those with 10 or more, 107 per 1,000 (S.E. 14.4). Only 160 runners were taken to hospital from all events combined (2 deaths). The mean hospital contact rate was 1.6 per 1,000 entrants, and was not related to the size of entry, density of first-aid posts nor sophistication of the first-aid offered. The inadequacy of arrangements in some marathons for preventing dehydration and treating collapsed runners on the course suggests that marathon organizers should be required to apply consistent, high standards to their arrangements for preventing and treating medical problems.