RANT: IMAZ Medical for BOPERS sup bar IMHO (Page 3)

I guess if you really feel the need to play the blame game and fault someone then I guess you can fault the individual working the tent entrance, not the entire medical staff.  However, I do not think that anyone and everyone that wants into the med tent should be allowed in.  I think Flyboy summed it up best in his previous post:

"The last two years I've worked at IMCDA, my job was meeting athletes at the gate to the medical area and triaging them either into the tent or to the chairs where they can recover for a bit and then go on about their evening.  I can't tell you how many times I've heard "I need an IV."  99% of the time you don't.  If you are walking and telling someone you need an IV, you probably don't need one and you won't go into the med tent.  Instead, we have dozens of chairs outside that we direct athletes to and have them sit down and take a load off for a few minutes, drink a little bit, warm up, and they're fine.  Do they feel horrible?  Yes...they just finished an Ironman for crying out loud!  But a few minutes of down time, something to drink, and getting warmed up are all the vast majority need.  Basically if you can walk, even with assistance, to the med tent and you can talk coherently and are able to keep water or ice or broth down and aren't throwing up on my shoes, you just need to sit down for awhile and let your body slowly recover.  I know you may feel like you want to curl up and die, you're shivering, maybe nauseated...I've been there and can empathize, but you'll be ok with a few minutes of R&R time."

If the job of the volunteer at the med tent entrance is to keep those that don’t need in from coming in, isn’t that exactly what happened in this case?  He talked to the OP, desided that she did not need in, and was not let in.  Maybe he needs to work on his bedside manor.

As someone who spent a few hours in the IMAZ medical tent late (sometime around 9:00 - 11:00) here are a few of my observations:

1) The medical tent is staffed by volunteers who seem competent and were working very hard.

2) I can imagine that it is very hard to organize a group of people into a "well oiled machine" after one volunteer meeting.  But the lack of organization was apparent and some ways should be improved.  For example the sharps management was very poor, I observed two different instances where random used IV needles were found lying on the floor.  It also did not appear that they made specific assignments of medical people to specific patients.  Different people would randomly come by and make various adjustments to my IV that would seem to undo what the last person had done.  No one (except for me) seemed to know exactly how much IV fluid I had taken because the person that hung the first bag was not the same person that hung the second bag, and charting did not appear to be a priority.

3) The communication to family and friends outside seemed particularly poor.  The medical higher-ups seemed very frustrated with all of the family and other people who were somewhat forcing their way into the tent.  If a more organized and well executed system of relaying information between patients and family was implemented then I think many of the unwanted people wouldn't be there in the first place.

4) The triage system didn't seem well organized.  It appeared that the same people who had responsibilities to circulate out in the "waiting/recovery" portion of the medical area also had responsibilities inside the medical tent and would often get side tracked at one place leaving the other place uncovered for extended time frames.  It would seem more effective to dedicate certain people to triage and other people to more intensive patient care.

5) I do think that there is a significant percentage of people who want/demand IV's unnecessarily.  (This is not directed at the OP or anyone else in particular)  There were a lot of small IV bags hung which I got the feeling many of which were simply to placate people rather than out of medical necessity.  I think this phenomenon jades the thinking of some of the higher-ups and may cause people with legitimate need to be treated improperly.  I overheard one of the men who seemed to be in charge state to another medical person "50% of the people in here would be just fine if they went back to their hotel, cooled off and drank some water".

6) The medical tent is clearly not set up to handle true emergencies and I'm sure that any emergency would have been immediately put on the ambulance that was waiting at the back of the medical tent.  The main benefit of the medical tent is to provide a place for people to recover with some level of medical supervision.  This surely prevents a lot of costly emergency room visits and probably also results in a few needed emergency room visits that the patients might not realize they need.  I for one would probably have ended up in the ED without the IV services of the medical tent which helped stop the vicious dehydration cycle where the dehydration leads to persistent vomiting which leads to dehydration which leads to.......

Based on what I saw, I would not view an IM medical tent as something that is there to save your life, but as a place to go to recover if you're not quite sure that you are going to be OK.  They have some capabilities to treat certain conditions, but don't expect it to be the Mayo clinic.  The ambulances are there for the real emergencies. 

My personal experience was very smooth making it directly from the course right in to the tent where I was immediately evaluated and almost immediately given a couple of liters of IV fluid.  However I did observe situations and circumstances which would corroborate some of the less than ideal experiences other people had as detailed in previous posts.

Finally, I strongly disagree with the post that was made earlier which insinuated that medical was needed primarily for the FOP folks who's more intense efforts would cause more legitimate need for medical help than the BOP folks who's walking would lead to less legitimate medical need.  I would certainly expect people entering the medical tent earlier in the day to have more heat-related problems (heat exhaustion or stroke).  A quick read of the medical literature however, will show for example that hyponatremia is most prevalent in people who have spent the most time on the course (BOP).  These hydration and electrolyte problems seem to be what the medical tent is most well equipped to treat and it makes no sense for them to close before the last official finisher has the opportunity to be evaluated.