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Published on August 06, 2019

Falmouth Road Race: a test case for heat treatment

Falmouth Road Race

The number one concern for the medical team at the New Balance Falmouth Road Race is being prepared for traditionally hot, humid weather, and on alert for exertional heat illnesses (EHI), especially life-threatening heat stroke, said race medical director John Jardine, MD.

Studies conducted by the Korey Stringer Institute (KSI) at the University of Connecticut found that Falmouth is a unique race because of the environmental conditions and the relatively short distance, which allow runners to maintain a high intensity throughout the seven miles. This leads to EHI, especially exertional heat stroke, that is more than in other races.

“Falmouth is like a mobile working lab for the Korey Stringer Institute,” said Dr. Jardine. “We’ve had a great relationship and the work has heightened interest from around the country. We’ve learned so much from studying runners and how to treat them. We’ve saved lives, no question.”

Dr. Jardine, an emergency medicine specialist, said in his 20 years at the race he has seen upward of 400 cases of exertional heat illness among runners and all have been treated successfully.

The Falmouth Road Race is an annual centerpiece of the Cape Cod summer sporting calendar, a test of fitness and fortitude combined with an atmosphere of class reunion frivolity. The 47th renewal is Sunday, Aug. 18 and nearly 13,000 runners -- including Olympians and world champions -- will gather in Woods Hole for the seven-mile jaunt to Falmouth Heights.

Official Medical Care Provider

Cape Cod Healthcare is a gold level sponsor of the race and the official medical care provider. The road race fits CCHC’s mission to promote health and well-being and its commitment to the community. Cape Cod Healthcare also plays a prominent part at the weekend health and fitness expo at race headquarters at the Falmouth High School Field House.

The race medical team is comprised of Falmouth Hospital physicians, nurses and other ancillary services from Cape Cod Healthcare, led by Falmouth Hospital Emergency Center physician Sarah Todd, MD.

KSI was founded after pro football player Korey Stringer died of heat stroke in 2001 during training camp with the Minnesota Vikings. The Institute focuses on research and education to prevent the sudden deaths of athletes, soldiers, laborers and active individuals. Dr. Jardine, who is the chief medical officer at KSI, has partnered with the race in recent years to research and develop important protocols for treatment of heat illness.

Heat stroke is essentially the body’s inability to cool itself and can be fatal, Dr. Jardine said. The internal temperature rises to at least 104 degrees and can lead to brain damage, organ failure and shock. Timing and rapid recognition is the key, he said, and it’s imperative the patient be treated quickly in an immersion ice bath.

Heat exhaustion and dehydration are other heat-related concerns and often can be treated successfully with fluids, resting and shade from the sun.

Many of the medical protocols for treating heat exertion were developed by the Falmouth Hospital medical team that worked the race over the years. They were the first to discover that submerging ailing runners into tubs filled with ice water would quickly lower dangerous body temperatures. Experience over the years has taught the medical team to focus on immediate cooling and then, if necessary, transferring the patient to the hospital.

However, if attended to on-site, typically a runner will respond and recover in 20 to 30 minutes, said Dr. Jardine, who co-authored the research paper, “The Effectiveness of Cold Water Immersion in the Treatment of Exertional Heat Stroke at the Falmouth Road Race.”

This year more than 30 medical personnel working with KSI will be on hand at the race to study athletes and the medical team’s treatment of those suffering from EHI.

Logistical Challenge for the Medical Teams

For Cape Cod Healthcare and the race’s medical team, the New Balance Falmouth Road Race is a logistical challenge spread out over narrow, hilly roads and sun-baked stretches along the beach. While runners prepare and train for months, so, too, does a medical committee of about a dozen.

In addition to Dr. Todd, Dr. Jardine is assisted by medical coordinator Chris Troyanos, president of Sports Medicine Consultants and Falmouth Hospital Emergency Center director Michael Rest, MD. Together, they are supported by more than 200 volunteers, including physicians, nurses, emergency medical technicians, pharmacists, physical therapists and others.

Their mandate is comprehensive coverage of the race from start to finish and the safety of all the runners and spectators. Dr. Rest will be at his post at Falmouth Hospital, while Dr. Todd will be on site at the finish line medical station, along with Dr. Jardine and Troyanos.

Falmouth’s medical operation includes five tents – at the start, three on the course, and at the finish – all fully staffed with personnel, supplies and radio communications. The stations are strategically located to allow for optimum access and egress. In addition, there are observers all along the route watching for runners who might need assistance. And again this year, the first aid company Race Guards will have support teams of medical professionals running the race and spread out among the waves of competitors.

The race medical team does an excellent job minimizing the stress on Falmouth Hospital by handling most situations on site, said Dr. Rest.

But even without the thousands at the race, it’s still a summer weekend on Cape Cod, so the ER will be fully staffed.

“We’ll see walk-ins from the race with orthopedic issues, sprains or abrasions, things like that, and perhaps a few runners will be transported to the ER. We’ll be ready,” said Dr. Rest.

“It’s a collaborative effort and we’re all on the same page,” said Troyanos, also medical coordinator of the Boston Marathon and about a dozen other races. “We plan and plan, and prepare and prepare, but you just never know. We want eyes on you all day. We don’t want any surprises. We couldn't do this without the corporate support of Cape Cod Healthcare, the community and, of course, all the volunteers.”

Be Safe on Race Day

Dr. Jardine’s tips to avoid heat issues:

  • Proper training and preparation for race-day conditions.
  • Hydrate in the days before and during the race, and avoid drinking alcohol.
  • Eat and sleep well.
  • Wear loose-fitting or sweat-wicking running clothes.
  • Use common sense; slow down, especially if it’s hot and humid; enjoy the race, but save your effort to achieve a personal record for another day.