25 Years of Expertise at the Cape Town Cycle Tour

Posted on 5 March 2020

Bringing 25 years of experience to the Cape Town Cycle Tour, Mediclinic is proud to be the official medical provider to the world’s biggest timed cycle race. Since 1995, Mediclinic has been deeply involved in supporting the Cape Town Cycle Tour – providing the expertise to co-ordinate and rally a number of key emergency service providers to ensure a safe and successful event.

Mediclinic works carefully with each role player to understand the expertise they bring to the event and then lays out the expectations for any situation. Each service plays a key role in the flow of cyclists, services and staffing – planning for which begins as soon as the previous race ends.

On average we see up to 150 riders coming through the race hospital, with varying degree of severity requiring hospital transfer in some cases. To deal with these numbers we always need to be prepared – we have a fully-fledged ICU in the race hospital at the finish line, ready for any eventuality. Our staff at the finish line are experienced within the Emergency Medicine environment with many either operating within an Emergency Centre or as ICU nurses in our hospitals. Advanced life support stations are available at each medical point, with more than 130 Automated External Defibrillators (AEDs) allocated across the route to ensure the most appropriate care is readily available to riders.

Changing conditions

But even with the best plans in place – things change on race day. “One year we have rain, another year strong winds or the potential for protest action. Each of these on their own would not appear to greatly influence plans – until one considers that there are 12 medical points and a race hospital across the route and then nearly 60 ambulances and an additional 20 emergency response vehicles travelling across the course. For each eventuality we have plans and our team needs to communicate effectively to ensure the plan’s success,” explains Dr Darren Green, Race Doctor to the Cape Town Cycle Tour.

Dr Green explains some of the implications, “If a portion of the route is closed, this impacts on where teams will need to be on route. The weather may also impact what injuries we are likely to see. It will also influence where we need essential things such as ice and water delivered during the day, to ensure we can keep the athletes hydrated.”

Team approach

This year, Mediclinic, ER24 and other key service providers will have 30 doctors, 50 nurses and more than 160 medics on route. They will then work together to deliver a safe, enjoyable race for an estimated 35 000 participants. Support services across the route include Metro EMS, Medics in motion, Community Medics, Cape Medical Response, False Bay EMS, Immediate Medical as well as NSRI from Hout Bay and Kommetjie, SA Paramedics and St Johns.

According to Dr Green, Mediclinic is privileged to be supported by all these entities to provide an integrated team effort and their key focus as a team will be on early recognition of risks and appropriate intervention to minimise impact. To achieve these interventions, team integration and communication become essential.

Good data

Another key area is accurate record keeping is essential for clinical governance and planning at mass participation events. Data directs the optimal distribution of resources to mitigate risk. Tools such as Scinapse (a cutting-edge patient-records app) indicate at which point athletes are experiencing cramps, where riders are falling, where intervention may be necessary. A high incidence of cramps at Suikerbossie could mean looking at water points before that point to ensure good hydration. Falls could indicate something on route posing a risk to riders that may need to be adjusted. Another source of valuable information is our pre-screening surveys, which riders complete prior to the race. “Our job is to assist cyclists to ride their best race ever – the survey allows for risk stratifying patients with appropriate evaluation and preparation for the event. Knowing their risk profiles also informs our plans,” says Dr Green.

“Monitoring the Heat Stress Index allows Mediclinic to reallocate resources on the day. But after the fact this data becomes essential for planning future events, being proactive and moving with the times,” explains Dr Green.

The Heat Stress Index is also displayed along the route in order for participants to optimise their own requirements for hydration.

Different skills

“We have to consider that the main race contenders will finish in a time of about 2 hours 30 minutes. But our last participants will only start at about 10am and are expected to finish all the way up to the cutoff point at 5pm, this means that we need medical responders for the entire day until the last participants pass that point on the route. We need sufficient supplies to support them at each water and medic point,” explains Dr Green.

The challenge in terms of health concerns is often not the front runners. It is the casual cyclist who participates for the first time aka ‘Weekend Warrior’. Those that have not trained in a peloton situation and do not know how to manage with cyclists around them. Those that have chosen to complete 100kms of riding without sufficient time in the saddle or those that simply get carried away in the moment and push themselves too hard. The added phenomenon this year is e-bikes participating for the first time, as they pose a challenge as they will be moving between groups as they will be faster on climbs but may not be on the flats.

“My best words of advice to riders is to simply to do the training work before the time. Invest in getting to the right fitness level – this way your event will be enjoyable and you will reach your personal goals in terms of completion time,” concludes Dr Green. “And once you set foot on the start line, we will be with you every pedal stroke to ensure a safe race.”