It's been a relatively quiet year for the Mongol Derby medics ably supplied by Prometheus Medical. That's not to say they've not been kept busy though. Especially when they feel obliged to treat the herders if there are no emergencies with the riders.
Here's the highlights of their blog from medic Mike & doctor Carl.
1008 horses 1003 kilometres 37 degrees of heat 37 riders, 28 legs, 14 drivers, 13 interpreters, 13 hypothermic patients, 9 days, 8 Vets, 8 event managers, 7 IV lines, 3 stitches, 2 Medic teams and 1 evacuation.
We met up with Medic 1 at horse station 3 and heard about Dr Carl's valiant efforts at lancing a herder's boil. We all gave him a round of applause.
We were made aware of a rider at horse station 10 who had come in dehydrated and unwell. We made our way to the station which was 37km from our location. This took us about 50 minutes across the unmade roads of Mongolia.
When we got to her, she was unwell with severe dehydration and heat exhaustion. We treated her with 1500ml of normal saline and encouraged her to drink oral fluids and eat. We 'held' her at the station until she improved as she was keen to push on.
Medic 1 has been busy with the riders towards the back of the pack. They have been treating a number of riders for dehydration and exhaustion. The weather is hot and dry with a fierce sun. They can only carry a maximum of 2 litres in their hydration packs, which is all that the packs can take, and they need far more than that to ride in this heat.
One rider needs to be evacuated back to UB as she is not recovering well. Medic 1 is organising her transfer as we write this blog.
Hydration and electrolyte replacement has been the mantra of the medics and other crew from the first day and continues to be a talking point for all of the riders. Riding all day in this heat has meant a much increased need for water for both rider and horse. Several riders continue to volunteer their input and output information, which may be in some cases a little too detailed (!), but conscious efforts to stay topped up are the order of the day.
We received a call on the satellite phone from Derby HQ alerting us about a rider between Urtuus 12 and 13, who had not moved for some time. We knew who the rider was and had treated her a couple of times over the course of the race.
We were told that the closest vet at Urtuu 12 had gone out to get the rider and bring her back to Urtuu 12. We gathered our driver and interpretor and rushed across the Steppe to the Urtuu.
We got to the Urtuu before she arrived with Pete the vet. We had set up a mini treatment area in one of the gers where we helped her to lie down. She was confused, breathing fast, had a fast heart rate and was very dry. Her blood pressure and blood sugar levels were normal and her temperature was just within normal range.
I set about putting a cannula into her arm whilst Deb prepared the fluids, which we gave rapidly. She quickly improved, but was vomiting from heat exhaustion. As she improved, she was able to hold down small sips of water.
I stayed in the ger with her and had to treat her through the night as she started to vomit again. By the morning, she was much improved and was able to keep food down.....decent, wholesome food such as Pringles, an apple and Coca Cola.
Deb was called into action to see a finger vs some part of a motorbike, which had happened a couple of days before. The unlucky chap had amputated the end of one digit but then managed to treat it with some combination of cotton, fire and a banknote which had stopped the bleeding and kept it clean. A digital block, some decent cleaning and course of antibiotics later the plucky motor biker’s luck had changed for the better thanks to a chance of meeting with Sister Swann.
From heat exhaustion and dehydration last week, hypothermia now seems a more likely risk today as the rain continues relentlessly and the skies have turned to a grey-white. It is some respite from the heat but still far from ideal riding conditions for those already feeling exhausted.
The riders we treated earlier in the week seem to be recovering well and we are hoping to see many more cross the line in the coming hours and days. What state some will be in at the finish once their grit and resolve to take them over the line has loosened its grasp remains to be seen, but we will be keeping a close eye on everyone once they make it in.
The Medics provided support across all of the 1003 kilometers through IV rehydration, antiemetic’s, stitches (a deep facial wound), passive warming, haematuria, wound dressings and that's just the riders. The locals soon got word when a medic team was in the area. The Mongolians provided an array of different conditions including a finger amputation, rotator cuff tear, angina aplenty, migraine, gastritis, kidney pain (god knows what that was), post thyroidectomy care, trauma to many areas from falls from many devices both mechanised and living, and over 50 blood pressure checks
It has been a privilege to be met by, stayed with and fed by so many generous Mongolian families. Their hospitality was limitless, including some giving up their own bed to accommodate the sick and injured. We have enjoyed the experience of traversing this endless rolling landscape, from the open Steppe to the river gorges to the mountains. Looking forward to 2016.