I swam in the Midmar Mile family event on Saturday 8th Feburary, an event I have always enjoyed, and which contributes much to local tourism, I have no doubt. However, this year, post-event dialogue in the written press and social media has been acrimonious and charged following the drowning of Thabo van Staden - with accusations of apathetic response by the organisers.
As a medical doctor, I would like to add my contribution to the public domain, following my involvement and support of a resuscitation at the damside, in which I noted obvious deficiencies in crisis event planning, and appalling response by paramedics. This included landing the patient at an arbitrary damside location, failure of ambulance to answer the phone, or to reach the location timeously, or to have appropriate cardio-pulmonary resuscitation equipment. At no stage after the resuscitation was the family member notified or called for over the public address system, despite my attempts to inform security personnel. I notified the Midmar Mile organisers of my concerns by email on 10th February, to which I received no reply. Today, I followed up my email with a telephone call. The administrator of the organisation expressed that the fuss about safety is unwarranted, as participants sign an indemnity form. She indicated that my email is on file, and has been forwarded to the Chair of the organisation. I informed the organisers of my intention to forward this email to the press.
Below is the text of the email I submitted to them in which I address my concerns. I do believe that the public should hold organisers of events such as these accountable to provide appropriate, well organised responses to medical misfortunes that are bound to take place at events of this size. While organisers have minimal control over the crises that take place during the event, they have every responsibility to address these and provide an appropriate first response.
Dr Kerrigan McCarthy MBBCh, FCPath (Micro)
From: Kerrigan McCarthy
Sent: 10 February 2014 07:41 PM
Subject: Concern regarding safety at Midmar mile -
Dear Midmar organisers,
I’d like to bring to your attention a ‘rescue’ at the Midmar Dam that was conducted in a less than optimal manner - While I was setting up a picnic blanket and chairs with my friends on the waters edge about 500, east of the finish, in front of the midmar chalets, the emergency services brought in a man who had been experiencing difficulty in the water, and laid him on the shore. When I assessed the patient, as I assisted the paramedic, it seemed he was having, or had experienced a myocardial infarction – he could barely talk and was experiencing ongoing chest pain. The subsequent management of this patient was less than optimal in the following way: -
1. There was no sense of urgency the way the paramedics brought him to shore
2. All paramedics who brought the patient to shore left a single paramedic in charge, and sauntered off – I’m not sure where – perhaps to call the ambulance?
3. He was brought to shore at an arbitrary place, where the public was sitting, about 500m from the finish, and no where near any emergency services/tent, other paramedics
4. When my friends and I tried to call an ambulance with the number the paramedic gave, the number was engaged.
5. When a paramedic eventually arrived, he said that an ambulance was on its way, but apparently it could not make it thro the cars/people to get in
6. When the ambulance arrived it did not have advanced life support, nor a defibrillator.
7. The paramedics on duty could not tell me to which hospital they were planning to take the patient
8. The patient himself could not remember his wife’s celphone number; a security personnel who arrived about 10 minutes after the patient had been brought ashore took the patients name and race number, and indicated that he would find the wife. But at no stage subsequently was any announcement made; neither could my friend, find the patient’s wife.
9. The only paramedic who was engaging with the patient said that they could not take him straight to hospital, they’d have to assess him at the emergency tent first. Only about 10 minutes after the ambulance drove him off towards the race finish area, did we see the same ambulance making its way to the dam exit. In total it had been about 30-40 minutes after he was taken off the water.
To my mind, the event covered a number of gaps in the emergency services at the event:
1. There did not appear to be a plan for emergencies of this sort, or if there was, the emergency services in this rescue weren’t aware of it.
2. Persons who are rescued from the water should be ‘landed’ at a designated place
3. Shore teams should have a defibrillator/ and be familiar with advanced cardiac life support– myocardial infarctions are not uncommon at events of these size, especially where novices participate
4. Ambulance should be parked at the side of the water, at this designated place.
5. All support and security personnel should know the local hospitals, and specific details regarding capacity of local hospitals to deal with different kinds of emergencies.
6. All these gaps caused delays in getting this patient off to a hospital. – these delays can cost patients their lives. In the case of an MI, time is critical.
On the positive side, the single paramedic who remained there did have asprin to put under the patient’s tongue, and competently took the patient’s blood pressure, dripped the patient and was prepared and able to give him morphine, should it have become necessary. The patient’s name was x(omitted for confidentiality's sake) I am unsure of the spelling, or of his race number. I would very much like to know how he is – I hope he made it to hospital and received appropriate care.
I am also disappointed to hear that the family of the missing swimmer, Thabo van Straten, experienced emergency services as unsympathetic and unhelpful.
The event is most certainly fantastic, and I’m sure it takes an enormous amount of organisation. However, attention to these important details are absolutely essential. The reality is that en event of this size is bound to have life-threatening emergencies, and plans need to be in place to take care of these in good time, and with appropriate expertise.
Please feel free to call on my cel below should you require further information on the events described above.