Characterization of medical care at the 161-km Western States Endurance Run

To examine the medical care at a highly competitive 161-km mountain ultramarathon.

Encounter forms from the 2010 through 2013 Western States Endurance Run were analyzed for trends in consultation and use of intravenous fluids.

A total of 63 consultations (8.2% of starters) were documented in 2012 and 2013, of which 10% involved noncompetitors. Most (77%) of the consultations with competitors occurred on the course rather than at the finish line, and were generally during the middle third of the race. Of the on-course consultations, the runner was able to continue the race 55% of the time, and 75% of those who continued after consultation ultimately finished the race. Relative number of consultations did not differ among competitors within 10-year age groups (P = .7) or between men and women (P = .2). Overall, consultations for medical issues were predominant, and nausea and vomiting accounted for the single highest reason for consultation (24%). Although there was an overall decrease in finish line consultations and intravenous fluid use from 2010 through 2013 (P < .0001 for both) that was independent of maximum ambient temperature (P = .3 and P = .4), the proportion of those being treated with intravenous fluids relative to those receiving consultation at the finish line was directly related to maximum ambient temperature (r = .93, P = .037). Both 2012 and 2013 had a single medical emergency that required emergency evacuation.

This work demonstrates that the medical needs in a 161-km ultramarathon are mostly for minor issues. However, occasional serious issues arise that warrant a well-organized medical system.