Logistics of medical support a real marathon effort

Medical support will be on standby at the Standard Chartered Singapore Marathon on Dec 3.
Medical support will be on standby at the Standard Chartered Singapore Marathon on Dec 3.ST PHOTO: KEVIN LIM

This year, at the age of 52, I participated in my first 10km race. Being an emergency-medicine specialist who sees casualties from various sports contests and then running my first event gave me the unique experience of being on both sides of the fence. Medical support often goes unnoticed, especially if you complete the event unscathed (that is what we want), but it is still a key component of any mass-participation event.

There are several safety considerations to remember when planning for such contingencies, as part of the medical support team.


Medical support starts way before the event. The medical team liaise with organisers to roll out educational efforts, focusing on getting participants physically fit, and exercising personal responsibility of not going beyond physical limits, especially if they are feeling unwell or are unfit to participate. As they say, prevention is better than cure.


No two events are the same. Multiple visits are made to the site to understand the terrain in which the race is scheduled and mitigate any potential hazards.

This allows us to plan and position the emergency vehicular access points, bearing in mind the crowd and road closures, as well as the medical posts and stations that are required along the race routes.

Hospitals in the vicinity are placed on alert, to be ready to receive casualties on race day.


Like any "service", we need to be prepared for our "clientele". Medical teams typically keep data from different events - from the types of injuries to the locations.

Such information allows us to plan ahead and to distribute resources adequately. Data from previous local mass runs indicates a casualty rate of about 20 per 10,000 participants, with the bulk being musculoskeletal conditions like sprains and strains.

Less frequently, we see physical exhaustion and heat-related illness.

Life-threatening conditions like arrhythmias are fortunately uncommon but will make the headlines when they occur.


The heart of race-day medical coverage is the command post, usually at the race site. This is also usually where the main medical post is - as most participants require medical assistance at the end of the race.

Interspersed along the route are the medical-aid stations which may be staffed by first aiders, volunteers, medics or even nurses and doctors.

These teams are further supported by a fleet of ambulances at the ambulance posts and medics at casualty collection points. Each point is fully equipped with resuscitation equipment like defibrillators and connected via a network of walkie-talkie among team leaders.

The goal is to transfer the casualties to the hospitals as quickly as possible so that treatment can be administered.

I got through my first race well, thanks to adequate training and I was reassured by the medical support I saw on standby.

At the upcoming Standard Chartered Singapore Marathon, do not forget to appreciate all the efforts taken to keep you safe and sound.

  • Associate Professor Malcolm Mahadevan is the head and senior consultant of the emergency medicine department at the National University Hospital.
A version of this article appeared in the print edition of The Straits Times on November 25, 2017, with the headline 'Logistics of medical support a real marathon effort'. Print Edition | Subscribe