Written by Dr Bob Hoekman, HARRA Medical Director
Since 1999 backpack wearing bikers wearing gold HARRA shirts have become common and expected sights in HARRA sponsored races. These bikers are trained in Cardiopulmonary Resuscitation(CPR) and the use of an Automated External Defibrillator(AED). They have given up their time (and race) to volunteer their skills -- possibly to save your life.
I started long distance road racing in 1988 and one of the first things I noted was that although many races had EMTs present they usually stayed near the finish area and most did not have the necessary equipment for cardiac defibrillation. Those who did were almost never close enough to the runners during the race to have much of a chance to help in an emergency. The cost to race directors to provide enough EMTs for truly good coverage would have been prohibitive.
In 1999 the Texas legislature passed a "Good Samaritan Act" that gave liability protection to non-medical personnel from law suits while using cardiac defibrillators (after appropriate training and under the direction of a physician). It also gives liability protection to medical personnel who are not working for reimbursement.
In 1999, at my recommendation, your HARRA Board (under the leadership of then-HARRA President Chiquita Taylor) agreed that we owed our runners better protection and our HARRA program was born. Our goal was to have a defibrillator within 3 minutes of every runner. The best way to accomplish that was for team members to move with the runners on bicycles.
Our program is a Public Access Defibrillation (PAD) program and you have probably read about other such programs initiated in workplaces, sports and entertainment facilities, airlines, government buildings and casinos. PADs require the supervision of a physician. The participants receive CPR and AED training which is repeated on a regular basis. Legal protection to the participants is covered under both Texas (see above) and Federal Good Samaritan Acts.
Do PADs work?
Resoundingly, YES!! "Saves" have gone from as low as 5% to as high as 80% depending upon the program. The key is rapid defibrillator access combined with CPR.
But why do "healthy" runners need this precaution? Sudden cardiac death occurs in races every year striking ordinary people like us who exercise for fitness and enjoyment. Unfortunately, exercise and fitness do not make us immune from sudden cardiac death.
It is not a question of IF one of us will die in one of our races -- rather WHEN!!
Regular aerobic exercise reduces our overall lifetime risk of sudden death but during the actual exercise period death risk goes up 700%. The primary cause of sudden death is ventricular fibrillation (VF) where the heart muscle is reduced to a quivering lump of useless activity and death occurs in minutes, even if cardiopulmonary resuscitation (CPR) is given promptly. VF can often be reversed by prompt application of external electrical shock (defibrillation), and heart function is restored. Combined with basic CPR technique, rapid defibrillation can be truly life-saving.
Unfortunately, defibrillation only works during the first few minutes following cardiac arrest with success dropping 7-10% every minute. Relying upon 911 calls alone results in about 90-95 % death rates in most communities. Many races do not have defibrillators and when they do it is often miles away from the runners.
From a start of one defibrillator and 19 volunteers we have expanded to six defibrillators and a current team of 77 members which includes health care professionals (doctors, a physicians assistant, nurses, physical therapists, paramedics and CPR/AED instructors) but mostly motivated lay people who undergo training in CPR and the use of an AED.
We do not replace but work in cooperation with race medical teams. Our team members carry 2 way radios for team communication. For back up (and cross communication with the race medical team) we also carry cellular phones.
We cover 22 races each year (including the fall road series, spring road series, spring cross country series and fall cross country series) and depending on the course, 5 to 12 people are required to provide adequate coverage. That is a lot of volunteer hours!! These people all deserve your thanks for what can be a rather unpleasant duty braving hours in the cold and rain or heat and mosquitos. I think each of them happily endures these physical hardships knowing how important they may be to you.
Since the HARRA Tour de Bayou spring and fall races have no hired medical team and few course volunteers our CPR/AED members assume additional responsibilities for these events including minor first aid, course monitors and "locating the lost". :-) Starting in 2006, the CPR/AED team has also provided coverage to the Power in Motion training runs.
If anyone has an interest in participating our requirements are simple. Most important is a strong desire to offer a valuble and possibly life saving service with a rational realization that not everyone with sudden cardiac death can be saved even with your best effort.
What do you get for your efforts? A bright gold HARRA CPR/AED T shirt, a bright gold CPR/AED bumper sticker, pizza at the training courses and lots of thanks from your fellow runners. Training is provided free of charge.
If you feel this description fits you and you want to actively participate in our program contact me at Bob Hoekman for further details.