Abstract
The Okayama Marathon has started in 2015, and about 15,000 runners participated since then. We have organized 13 first-aid stations along the racecourse and assigned about 50 doctor runners to assist runners. We also have organized automated external defibrillator (AED) teams specialized in treating sudden cardiac arrest (SCA) during the race. The AED teams consisted of 37 standby teams spaced out by 0.5 to 1.0 km along the racecourse, 12 bicycle teams, and 12 finish area teams. All team members, a total of about 200 members, belonged to either NPO Life Saving Okayama composed of medical professionals and paramedics providing CPR training workshops, or medical and nursing students. In all seven races, 99,795 (81.3% male) marathon runners participated, and four male cases suffered from witnessed SCA-the four patients developed ventricular fibrillation, followed by the return of spontaneous circulation by the AED applications, and transferred to the hospital with successful discharge without any neurological deficits. The incidence of SCA is hugely higher in the Okayama Marathon than other marathons, estimated at 4.0 per 100,000 runners. However, our emergent medical system has functioned effectively. First aid and emergency care have essential roles in large-scale events in the local city, considering the regional context of the medical delivery system.
