Hosting and working marathons makes the elderly die quicker

Alan L Serve

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https://www.wsj.com/articles/marath...-the-elderlywho-arent-even-running-1492030802

Article says that the clogged streets and insufficient staffing results in people who aren't part of the 'thons dying. I know EMS talks all about having additional crews and plan in place to work this out but in the end all that doesn't matter and people are dying as collateral damage.

Remember how angry we got when protesters shut down streets and forced ambulances to divert and delay care? This ain't any different.
 

EpiEMS

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Thanks for posting this - wasn't sure if anybody was going to.

It is an interesting concept, and while I couldn't get full access to the paper, it seems reasonably robust.

I'm not thoroughly convinced, though, that the observation that "[a]mbulance scene-to-hospital transport times for pickups before noon were 4.4 minutes longer on marathon dates than on nonmarathon dates (relative difference, 32.1%; P=0.005)" is necessarily of clinical significance for cardiac arrest (it might be for AMI)...

And since no cost/benefit analysis is performed, I am not so clear on what the policy recommendation ought to be.
 
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Alan L Serve

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And since no cost/benefit analysis is performed, I am not so clear on what the policy recommendation ought to be.
Don't host marathons and such because even the best of preparations means people are unnecessarily going to die?
 
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Alan L Serve

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That's not an option. You can't stop life because EMS had a hard time getting to people. It's a deployment issue.
Life is literally being stopped because of the marathons and such. It doesn't seem that any sort of deployment mitigation has been able to fix the problem of road closures causing people to die.

Seems like a simple fix. Life > marathons.
 

GMCmedic

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Life is literally being stopped because of the marathons and such. It doesn't seem that any sort of deployment mitigation has been able to fix the problem of road closures causing people to die.

Seems like a simple fix. Life > marathons.
People die. Banning guns, 32 oz sodas, and marathons isnt going to change that.

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Alan L Serve

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People die. Banning guns, 32 oz sodas, and marathons isnt going to change that.

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Yeah, ending marathons will change it for some who would have otherwise made it. Not sure why you'd say it wouldn't change it when it really literally actually would. Like no joke.
 

GMCmedic

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Yeah, ending marathons will change it for some who would have otherwise made it. Not sure why you'd say it wouldn't change it when it really literally actually would. Like no joke.
People are going to die because a train delayed an ambulance, or snow, or a tree fell and blocked the roadway.



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EpiEMS

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People get enjoyment out of marathons. You can quantify that. Apply a tax on the externality they impose on other people - then use that revenue to provide for EMS staffing.

But that's econ 101. Sadly, the real world doesn't work so simply. What do we do? Deploy better, staff better...

And as far as the "conclusive proof", meh. *Maybe* it is true, maybe not. I'm sure that there is some effect of marathons (or other public disturbances, broadly construed), but are outcomes, conditioned on EMS treatment necessarily worse? Maybe, maybe not - there isn't enough in here to tease that out, as far as I can tell (from the brief freely available content).
 

StCEMT

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Wait, are you being serious?

Oh and living/working in one of those areas with those lovely protestors...yea, there is a difference. In that case people were being *******s. In the case of a Marathon? That's people being involved with their community, doing something that betters themselves. You know, being active, healthy, and all those things we hate that people DONT do? Yea, sports and other events cause congestion, I've been there. Never has actually caused a negative outcome in my experience though.
 
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Tigger

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The hypothesis for the title of your thread is absurd at best.
 

EpiEMS

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In all fairness to the authors of the study, the lead author of this study publishes a lot of interesting work based on natural experiments and cool retrospective datasets. I particularly like his cardiology conferences and mortality study.
 

Chimpie

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I don't subscribe to TWJ so I can't read the full article, but I will add some comments anyway....

I host a 5K (shorter than a marathon) right next to a hospital. We submit traffic plans in advance which are submitted to all public safety agencies and the dispatch center. Everyone is aware of what is going on and what steps need to be taken.

I also work large events that last 12+ hours and affect many roadways. Traffic plans are submitted WAY in advance, plus there is constant communications with us and dispatch so that if an ambulance is running emergency and needs to get through, it will get through.
 

Carlos Danger

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Don't host marathons and such because even the best of preparations means people are unnecessarily going to die?

"Ban any event that could potentially slow down an EMS response". That is easily one of the dumbest ideas I have ever read related to EMS......and that is saying quite a bit.

There are many potential ways to address this problem (if it even is a real problem) aside from simply banning marathons and parades and similar events. I'm sure we can easily think of more than a few.

Before we even discuss that, however, how about we consider that the presence of these events probably encourages enough people to exercise regularly that the net effect on mortality is positive? I bet a heck of a lot more people have their health positively effected by the presence of a marathon than have it negatively effected. Ever think about that? Or the positive ways that the economic impact of these events might have on public health? Or the way that quality of life factors into these calculations.

If you are going to make sweeping and dramatic recommendations in the name public health or safety and you want them to be half way rational, then there are an awful lot of things to consider aside from simple ambulance response times. EMS is far from the be all / end all of public health issues.
 

VFlutter

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Call a helicopter. Problem solved.
 
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Alan L Serve

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"Ban any event that could potentially slow down an EMS response". That is easily one of the dumbest ideas I have ever read related to EMS......and that is saying quite a bit.
Remember those protesters who blocked roads and caused ambulances to be diverted? Or Chris Christie who blocked a bridge and killed a patient in an ambulance?
 

Carlos Danger

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Remember those protesters who blocked roads and caused ambulances to be diverted? Or Chris Christie who blocked a bridge and killed a patient in an ambulance?
You clearly didn't read a single word of my post.
 
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StCEMT

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The response time to that call was 7 minutes. Yes, extended by what they could have been, but 7 minutes isn't an unreasonable amount of time all things considered. That's also assuming a 4 minute response would have yielded a different outcome. Cardiac arrest already have low odds, not once did I see mention of cpr prior to EMS or if it was witnessed, which are much more important details than a few extra minutes.
 
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