1 00:00:00,568 --> 00:00:02,820 Rob Simmelkjaer: Hi there. This is Rob Simmelkjaer, the CEO of New 2 00:00:02,820 --> 00:00:06,600 Rob Simmelkjaer: York Roadrunners here with a special pre- marathon episode of 3 00:00:06,600 --> 00:00:09,810 Rob Simmelkjaer: Set The Pace. And today we're talking about a topic 4 00:00:09,810 --> 00:00:13,590 Rob Simmelkjaer: that is especially important to me. People always ask me 5 00:00:13,680 --> 00:00:18,210 Rob Simmelkjaer: what makes a successful marathon day? And the answer I 6 00:00:18,210 --> 00:00:21,900 Rob Simmelkjaer: always give is pretty simple. I'd like every single person 7 00:00:22,020 --> 00:00:26,460 Rob Simmelkjaer: who started the race to finish the race safely. That's 8 00:00:26,460 --> 00:00:29,610 Rob Simmelkjaer: what it comes down to. And that's a tall order 9 00:00:29,610 --> 00:00:33,060 Rob Simmelkjaer: with over 50,000 runners taking the starting line of the 10 00:00:33,060 --> 00:00:36,540 Rob Simmelkjaer: TCS New York City Marathon. But we have an incredible 11 00:00:36,630 --> 00:00:39,930 Rob Simmelkjaer: medical team all along the course from start to finish, 12 00:00:40,290 --> 00:00:43,680 Rob Simmelkjaer: who is our partner in making sure that our runners 13 00:00:43,860 --> 00:00:47,850 Rob Simmelkjaer: make it from start to finish safely. That group is 14 00:00:47,850 --> 00:00:52,680 Rob Simmelkjaer: called CrowdRx. They, along with an incredible collection of medical 15 00:00:52,680 --> 00:00:56,700 Rob Simmelkjaer: volunteers that we have throughout the race, are really the 16 00:00:56,700 --> 00:01:00,120 Rob Simmelkjaer: heart and soul of our medical and safety operation at 17 00:01:00,120 --> 00:01:02,640 Rob Simmelkjaer: not just the marathon, but all of our races. And 18 00:01:03,000 --> 00:01:06,900 Rob Simmelkjaer: joining me to talk about that incredible team and the 19 00:01:06,900 --> 00:01:09,120 Rob Simmelkjaer: work we do as well as to give some tips 20 00:01:09,120 --> 00:01:11,130 Rob Simmelkjaer: to all of you out there on how to stay 21 00:01:11,130 --> 00:01:25,170 Rob Simmelkjaer: safe on marathon day is Dr. Matt Friedman. Matt, I'll 22 00:01:25,170 --> 00:01:27,750 Rob Simmelkjaer: call you Matt. I call you Dr. Friedman. Is Matt 23 00:01:27,750 --> 00:01:28,679 Rob Simmelkjaer: okay for this podcast? 24 00:01:28,680 --> 00:01:31,170 Matt Friedman: Matt is perfectly fine, please. Thank you. Let me just 25 00:01:31,170 --> 00:01:33,840 Matt Friedman: say hi. It's great to be here. I'm an emergency 26 00:01:33,840 --> 00:01:36,510 Matt Friedman: medicine physician based in Brooklyn, New York. I've been the 27 00:01:36,510 --> 00:01:40,170 Matt Friedman: National medical director for CrowdRx since 2013. 28 00:01:40,290 --> 00:01:43,259 Rob Simmelkjaer: It's great to have you here. So let me start 29 00:01:43,260 --> 00:01:46,260 Rob Simmelkjaer: with just a little bit about the behind the scenes 30 00:01:46,260 --> 00:01:50,460 Rob Simmelkjaer: that runners probably don't understand, the scale of the medical operation 31 00:01:50,460 --> 00:01:54,210 Rob Simmelkjaer: that we bring to bear on marathon day. How big 32 00:01:54,210 --> 00:01:57,210 Rob Simmelkjaer: is that medical operation? Dr. Friedman, 33 00:01:57,750 --> 00:02:00,660 Matt Friedman: The safety operation of marathon day, it's really a year 34 00:02:00,660 --> 00:02:02,670 Matt Friedman: long in planning for a single day. I guess that's 35 00:02:02,670 --> 00:02:05,910 Matt Friedman: not surprising to anyone involved. We have full- time staff, 36 00:02:05,970 --> 00:02:08,519 Matt Friedman: we have part- time staff, we have per diem staff, 37 00:02:08,580 --> 00:02:10,889 Matt Friedman: we have it all. And they're really coming from all 38 00:02:10,889 --> 00:02:15,720 Matt Friedman: over the metro region and farther. The medical operation is 39 00:02:15,720 --> 00:02:19,470 Matt Friedman: complex. We have four start tents, we have 25 horse 40 00:02:19,470 --> 00:02:22,919 Matt Friedman: tents, we have five finish line tents. We've got many, 41 00:02:22,919 --> 00:02:27,389 Matt Friedman: many bike EMTs, so EMTs on bikes responding with medical 42 00:02:27,389 --> 00:02:32,669 Matt Friedman: equipment. We have more than 15 gators, we like to 43 00:02:32,669 --> 00:02:35,970 Matt Friedman: call them. You may know them as ATVs or UTVs. 44 00:02:36,270 --> 00:02:39,240 Matt Friedman: They have a stretcher on them and can respond to 45 00:02:39,240 --> 00:02:44,340 Matt Friedman: a patient and move a runner around. We have finish 46 00:02:44,340 --> 00:02:48,930 Matt Friedman: line quick response teams. We have spotter towers. We have 47 00:02:49,169 --> 00:02:53,760 Matt Friedman: more than 70 ALS and BLS ambulances, so EMT or 48 00:02:53,760 --> 00:02:58,080 Matt Friedman: paramedic ambulances. But the most important driver obviously is our 49 00:02:58,080 --> 00:03:02,010 Matt Friedman: volunteers and we have 2, 500 volunteers on race day. 50 00:03:03,240 --> 00:03:06,360 Rob Simmelkjaer: And they play such a vital role in keeping our 51 00:03:06,360 --> 00:03:09,720 Rob Simmelkjaer: race safe. So Matt, let's talk about the journey of 52 00:03:09,720 --> 00:03:12,630 Rob Simmelkjaer: the runner and how they can stay safe throughout from 53 00:03:12,990 --> 00:03:16,770 Rob Simmelkjaer: before the race to of course, during the race. And 54 00:03:16,770 --> 00:03:20,610 Rob Simmelkjaer: let's start with just the basic question of should a 55 00:03:20,610 --> 00:03:25,918 Rob Simmelkjaer: runner run a marathon? And what conversations should someone have 56 00:03:25,919 --> 00:03:30,060 Rob Simmelkjaer: with a physician about whether it's safe for them to 57 00:03:30,060 --> 00:03:33,150 Rob Simmelkjaer: run a marathon? Are there certain conditions that if a 58 00:03:33,150 --> 00:03:36,570 Rob Simmelkjaer: runner has this condition, whatever it may be, a medical 59 00:03:36,570 --> 00:03:39,960 Rob Simmelkjaer: history of any kind, that it's especially important for someone 60 00:03:39,960 --> 00:03:43,080 Rob Simmelkjaer: to talk to their doctor first before they even take 61 00:03:43,080 --> 00:03:45,120 Rob Simmelkjaer: on the challenge of running a marathon? 62 00:03:45,330 --> 00:03:49,440 Matt Friedman: So obviously running a marathon puts physiologic stress in the 63 00:03:49,440 --> 00:03:51,810 Matt Friedman: body. I think we're all very comfortable with that idea. 64 00:03:52,080 --> 00:03:54,720 Matt Friedman: There are certain conditions that we do want to know 65 00:03:54,720 --> 00:03:57,150 Matt Friedman: if a runner has. And it's not to say that if 66 00:03:57,150 --> 00:04:00,180 Matt Friedman: they were to have them, they couldn't run, but they 67 00:04:00,180 --> 00:04:03,870 Matt Friedman: should moderate, they should moderate their risk. So we want 68 00:04:03,900 --> 00:04:06,510 Matt Friedman: runners to find out if they have coronary artery disease 69 00:04:06,510 --> 00:04:08,700 Matt Friedman: and what their risk factors are and what they should 70 00:04:08,700 --> 00:04:11,460 Matt Friedman: do about any coronary artery disease. We want them to 71 00:04:11,460 --> 00:04:13,830 Matt Friedman: know if they have a predisposition to seizures, if they 72 00:04:13,830 --> 00:04:16,380 Matt Friedman: have a predisposition to heat stroke or if there are 73 00:04:16,380 --> 00:04:19,799 Matt Friedman: any structural heart problems that should be diagnosed prior to 74 00:04:19,800 --> 00:04:22,529 Matt Friedman: running. Again, if you are diagnosed with one of these 75 00:04:22,529 --> 00:04:24,660 Matt Friedman: things, this is by no means can you not run 76 00:04:24,660 --> 00:04:27,990 Matt Friedman: anymore. We just want you to moderate. There's different tests 77 00:04:27,990 --> 00:04:30,600 Matt Friedman: to diagnose all of those different conditions and we would 78 00:04:30,600 --> 00:04:33,420 Matt Friedman: leave it between you and your primary care physician to 79 00:04:33,450 --> 00:04:36,360 Matt Friedman: diagnose and run the tests that are necessary. But that's 80 00:04:36,360 --> 00:04:38,430 Matt Friedman: a question for you and your physician and we just 81 00:04:38,430 --> 00:04:40,110 Matt Friedman: encourage you to get checked out. 82 00:04:41,580 --> 00:04:44,849 Rob Simmelkjaer: And not every runner is necessarily going to have a 83 00:04:44,850 --> 00:04:49,950 Rob Simmelkjaer: full battery of tests. A EKG and all kinds of scans 84 00:04:49,950 --> 00:04:51,960 Rob Simmelkjaer: to make sure they're safe. If they haven't had a 85 00:04:51,960 --> 00:04:56,430 Rob Simmelkjaer: negative medical history, if they've generally been healthy throughout their 86 00:04:56,430 --> 00:05:01,200 Rob Simmelkjaer: lives, what do you recommend for those people? Is it 87 00:05:01,200 --> 00:05:04,260 Rob Simmelkjaer: simply just, Hey, you should be getting your regular checkups 88 00:05:04,260 --> 00:05:08,279 Rob Simmelkjaer: and maybe letting your doctor know you you're taking part in 89 00:05:08,279 --> 00:05:09,960 Rob Simmelkjaer: these kinds of endurance events? 90 00:05:10,890 --> 00:05:12,600 Matt Friedman: That's exactly what it is. We want you to get 91 00:05:12,600 --> 00:05:15,690 Matt Friedman: your annual checkup and when you get your annual checkups, like, " 92 00:05:15,750 --> 00:05:19,620 Matt Friedman: Hey Doc, I tend to run a marathon, tend to 93 00:05:19,620 --> 00:05:22,620 Matt Friedman: run races year to year. Anything I should be worried 94 00:05:22,620 --> 00:05:24,120 Matt Friedman: about or anything I should take note of?" 95 00:05:24,360 --> 00:05:27,540 Rob Simmelkjaer: What if you're feeling under the weather during the week 96 00:05:27,540 --> 00:05:31,229 Rob Simmelkjaer: of the race? Maybe you've got a cold. We are 97 00:05:31,320 --> 00:05:36,000 Rob Simmelkjaer: entering flu season, COVID is up as well. What do 98 00:05:36,000 --> 00:05:39,719 Rob Simmelkjaer: you recommend to runners if ... It's hard. You've put in 99 00:05:39,960 --> 00:05:43,200 Rob Simmelkjaer: months of training, you've got this date circled in your 100 00:05:43,200 --> 00:05:47,580 Rob Simmelkjaer: calendar and all of a sudden race week arrives and 101 00:05:47,580 --> 00:05:50,190 Rob Simmelkjaer: you're just not feeling your best. What advice do you 102 00:05:50,190 --> 00:05:52,500 Rob Simmelkjaer: give to folks in that situation? 103 00:05:53,760 --> 00:05:57,540 Matt Friedman: My answer to that would be to moderate, moderate, moderate. 104 00:05:57,630 --> 00:06:00,060 Matt Friedman: There isn't really a clear answer here about what you 105 00:06:00,060 --> 00:06:02,310 Matt Friedman: should do if you don't want to run because you're 106 00:06:02,310 --> 00:06:04,500 Matt Friedman: under the weather, come see me. I'll give you a 107 00:06:04,500 --> 00:06:07,440 Matt Friedman: doctor's note. There's no reason that you can or cannot 108 00:06:07,440 --> 00:06:09,450 Matt Friedman: run if you're under the weather, but if you have 109 00:06:09,450 --> 00:06:12,359 Matt Friedman: mild symptoms and you want to run, go for it. 110 00:06:12,810 --> 00:06:16,680 Matt Friedman: Just moderate. Don't aim for your PR that day, just 111 00:06:16,680 --> 00:06:17,279 Matt Friedman: take it easy. 112 00:06:17,640 --> 00:06:20,760 Rob Simmelkjaer: And Dr. Friedman. Another thing that's a little underrated when 113 00:06:20,760 --> 00:06:23,190 Rob Simmelkjaer: it comes to runner safety, but it ends up being 114 00:06:23,190 --> 00:06:25,860 Rob Simmelkjaer: a big issue for us and for you and your 115 00:06:25,860 --> 00:06:29,820 Rob Simmelkjaer: team when there's an incident, is to make sure that 116 00:06:29,820 --> 00:06:34,110 Rob Simmelkjaer: your emergency contacts are updated. We so often have runners 117 00:06:34,290 --> 00:06:38,039 Rob Simmelkjaer: who have a medical event of some kind, and of 118 00:06:38,040 --> 00:06:40,529 Rob Simmelkjaer: course the first thing we want to do is let 119 00:06:40,529 --> 00:06:45,300 Rob Simmelkjaer: your family or whoever your emergency contact is know about 120 00:06:45,300 --> 00:06:48,300 Rob Simmelkjaer: that so they can find you wherever you are and 121 00:06:48,300 --> 00:06:51,870 Rob Simmelkjaer: be there to help with whatever your situation is. And 122 00:06:51,870 --> 00:06:54,210 Rob Simmelkjaer: a lot of the time the contacts are not updated. 123 00:06:54,210 --> 00:06:57,240 Rob Simmelkjaer: So it's really important for people to update those emergency 124 00:06:57,240 --> 00:07:02,310 Rob Simmelkjaer: contacts. Another logistical side that we want to make sure 125 00:07:02,310 --> 00:07:06,089 Rob Simmelkjaer: people know about is our runner communication center that is 126 00:07:06,330 --> 00:07:09,510 Rob Simmelkjaer: on every single bib. If you look at the back 127 00:07:09,510 --> 00:07:15,660 Rob Simmelkjaer: of your bib, you'll see the number. It's 866-705-6626. Dr. 128 00:07:15,660 --> 00:07:18,720 Rob Simmelkjaer: Friedman. Why is it better for someone to call that 129 00:07:18,720 --> 00:07:22,860 Rob Simmelkjaer: number than call 911 if they see another runner in 130 00:07:22,860 --> 00:07:23,880 Rob Simmelkjaer: distress in the race? 131 00:07:24,090 --> 00:07:27,180 Matt Friedman: So you're getting trained personnel when you call that number. 132 00:07:27,180 --> 00:07:29,970 Matt Friedman: There's an emergency on the course, you should call that 133 00:07:29,970 --> 00:07:32,940 Matt Friedman: number. When you call that number, you're getting an emergency 134 00:07:32,940 --> 00:07:36,929 Matt Friedman: call receiving operator. Somebody who is incredibly familiar with the 135 00:07:36,930 --> 00:07:41,400 Matt Friedman: course and they're incredibly familiar with the closest responding asset, 136 00:07:41,640 --> 00:07:45,210 Matt Friedman: whether it's a bike team, a gator ATV team, an 137 00:07:45,210 --> 00:07:49,350 Matt Friedman: ambulance or a foot response team. Calling 911 on race 138 00:07:49,350 --> 00:07:52,530 Matt Friedman: day for an incident along the course would actually delay 139 00:07:52,530 --> 00:07:55,860 Matt Friedman: time because all of those calls get reworked to the 140 00:07:55,860 --> 00:07:59,520 Matt Friedman: race communication center. They all get reworked to the RCC. 141 00:07:59,790 --> 00:08:03,420 Matt Friedman: So the fastest thing to do is call the RCC. You'll get 142 00:08:03,420 --> 00:08:07,200 Matt Friedman: a timely response from our suitable responding assets. 143 00:08:07,350 --> 00:08:10,830 Rob Simmelkjaer: I really do recommend people put that number in their 144 00:08:10,830 --> 00:08:15,240 Rob Simmelkjaer: phones, save it just in case you ever are in 145 00:08:15,240 --> 00:08:17,700 Rob Simmelkjaer: a situation where you want to call for help for 146 00:08:17,700 --> 00:08:20,520 Rob Simmelkjaer: someone else you see or even for yourself. All right. 147 00:08:20,520 --> 00:08:23,760 Rob Simmelkjaer: Dr. Friedman, let's get into the race now. And running 148 00:08:23,760 --> 00:08:26,340 Rob Simmelkjaer: a marathon or maybe a half- marathon, whatever it is 149 00:08:26,340 --> 00:08:30,750 Rob Simmelkjaer: hard. You know that you're going to feel distress of 150 00:08:30,750 --> 00:08:35,040 Rob Simmelkjaer: various kinds. When you are running 26. 2 miles, you're 151 00:08:35,040 --> 00:08:36,660 Rob Simmelkjaer: going to get out of breath at times you're going 152 00:08:36,660 --> 00:08:40,170 Rob Simmelkjaer: to feel muscle fatigue. This is part of the deal. 153 00:08:40,440 --> 00:08:45,449 Rob Simmelkjaer: But when Dr. Friedman should a runner start to think, 154 00:08:45,690 --> 00:08:49,350 Rob Simmelkjaer: oh, this maybe is a little bit beyond what I 155 00:08:49,350 --> 00:08:51,840 Rob Simmelkjaer: should be feeling? What are the kinds of warning signs 156 00:08:52,200 --> 00:08:56,040 Rob Simmelkjaer: that should make a runner slow down, maybe stop and 157 00:08:56,040 --> 00:08:57,660 Rob Simmelkjaer: maybe even head to a medical tent? 158 00:08:58,260 --> 00:09:01,050 Matt Friedman: So it really shouldn't differ from your training all that 159 00:09:01,080 --> 00:09:03,660 Matt Friedman: much, but if you feel like you're about to collapse 160 00:09:03,660 --> 00:09:06,840 Matt Friedman: or feel like you're about to pass out, slow down, 161 00:09:07,440 --> 00:09:09,960 Matt Friedman: reassess yourself. Give yourself a few minutes at a slower 162 00:09:09,960 --> 00:09:13,980 Matt Friedman: pace and see. If you're having palpitations or heart racing 163 00:09:13,980 --> 00:09:18,179 Matt Friedman: faster than what you think is normal, slow down, reassess, 164 00:09:18,960 --> 00:09:23,309 Matt Friedman: take a breather for a couple of minutes. Obviously the trouble 165 00:09:23,309 --> 00:09:25,950 Matt Friedman: is it is tough to recognize, but if you're feeling 166 00:09:25,950 --> 00:09:30,030 Matt Friedman: more agitated than usual, if you're feeling irritable, delirious, if 167 00:09:30,030 --> 00:09:34,079 Matt Friedman: you're feeling incredibly hot or flush skin, please just take 168 00:09:34,080 --> 00:09:37,260 Matt Friedman: a breather, slow down, reassess after a couple of minutes. If 169 00:09:37,260 --> 00:09:40,260 Matt Friedman: you slow your rate and you're still feeling problems, you're 170 00:09:40,260 --> 00:09:42,839 Matt Friedman: still not feeling your normal self, then we would advise 171 00:09:42,840 --> 00:09:44,730 Matt Friedman: you to come to one of our medical tents and 172 00:09:44,730 --> 00:09:45,390 Matt Friedman: get checked out. 173 00:09:46,230 --> 00:09:48,960 Rob Simmelkjaer: I think that's so important. Think about how you did 174 00:09:48,960 --> 00:09:51,480 Rob Simmelkjaer: feel during your training runs. And yes, we know you're 175 00:09:51,480 --> 00:09:54,150 Rob Simmelkjaer: going to push harder in the race than you did 176 00:09:54,150 --> 00:09:57,929 Rob Simmelkjaer: in the training runs, but hopefully everybody out there can 177 00:09:57,929 --> 00:10:03,720 Rob Simmelkjaer: sense those key signs, dizziness, nausea. Those are the signs 178 00:10:03,720 --> 00:10:06,480 Rob Simmelkjaer: that, okay, my body's telling me something is not right 179 00:10:06,480 --> 00:10:08,220 Rob Simmelkjaer: here. I need to pull back. 180 00:10:10,050 --> 00:10:12,990 Matt Friedman: Absolutely. And just slow your pace down for a couple of 181 00:10:12,990 --> 00:10:17,100 Matt Friedman: minutes, reassess yourself. If you're still not feeling better, then 182 00:10:17,100 --> 00:10:19,620 Matt Friedman: bring it to a walk. Take another couple minutes. And 183 00:10:19,620 --> 00:10:22,140 Matt Friedman: if you're still not feeling better, get checked out. But 184 00:10:22,140 --> 00:10:23,460 Matt Friedman: if you start to feel better, if you start to 185 00:10:23,460 --> 00:10:27,390 Matt Friedman: feel improved, then slowly increase your pace again. Perfectly normal, 186 00:10:27,390 --> 00:10:28,920 Matt Friedman: a very rational approach. 187 00:10:29,370 --> 00:10:33,270 Rob Simmelkjaer: Peloton is leveling up. With the launch of their Peloton cross- 188 00:10:33,270 --> 00:10:37,080 Rob Simmelkjaer: training series they're redefining what race training can look like. 189 00:10:37,350 --> 00:10:40,920 Rob Simmelkjaer: Personalized cardio and strength, it makes it easier than ever 190 00:10:41,100 --> 00:10:44,820 Rob Simmelkjaer: to achieve real results. Whether runners are building a base 191 00:10:44,820 --> 00:10:47,850 Rob Simmelkjaer: or pushing for a PR, Peloton meets them where they 192 00:10:47,850 --> 00:10:52,380 Rob Simmelkjaer: are then helps them go further. Smarter training, stronger outcomes, 193 00:10:52,559 --> 00:10:57,090 Rob Simmelkjaer: all backed by expert instruction and performance insights. Ready to 194 00:10:57,090 --> 00:11:00,330 Rob Simmelkjaer: elevate your race game with Peloton? Head to onepeloton. com 195 00:11:01,740 --> 00:11:07,140 Rob Simmelkjaer: to learn more. Peloton an official partner of the 2025 TCS 196 00:11:07,140 --> 00:11:10,559 Rob Simmelkjaer: New York City Marathon. The medical tents are there along 197 00:11:10,559 --> 00:11:13,500 Rob Simmelkjaer: the course and they're not just for serious medical issues. 198 00:11:13,500 --> 00:11:15,660 Rob Simmelkjaer: We have lots of people who go in there because 199 00:11:15,929 --> 00:11:19,200 Rob Simmelkjaer: maybe they need a Tylenol or a Band- Aid, maybe 200 00:11:19,200 --> 00:11:22,709 Rob Simmelkjaer: they're cramping and want to a little Icy Hot or 201 00:11:22,710 --> 00:11:25,890 Rob Simmelkjaer: something to put on their muscles. So we got a 202 00:11:25,890 --> 00:11:28,440 Rob Simmelkjaer: lot of different things that you can get if you 203 00:11:28,440 --> 00:11:30,059 Rob Simmelkjaer: go into one of those medical tents. 204 00:11:30,570 --> 00:11:34,559 Matt Friedman: Absolutely. And we also have physical therapists and podiatrists who 205 00:11:34,559 --> 00:11:38,010 Matt Friedman: really will rehab you and hopefully get you good and 206 00:11:38,010 --> 00:11:38,760 Matt Friedman: running again. 207 00:11:39,450 --> 00:11:43,679 Rob Simmelkjaer: We are having this conversation, Dr. Friedman on October the 208 00:11:43,679 --> 00:11:46,950 Rob Simmelkjaer: ninth so we do not know what the weather will 209 00:11:46,950 --> 00:11:50,010 Rob Simmelkjaer: be on marathon day, but can you talk a little 210 00:11:50,010 --> 00:11:52,679 Rob Simmelkjaer: bit about the impact of heat in case we do 211 00:11:52,679 --> 00:11:55,020 Rob Simmelkjaer: happen, have another warm day like the one we had 212 00:11:55,020 --> 00:11:59,370 Rob Simmelkjaer: say in 2022. And if you've got a warm, humid 213 00:11:59,370 --> 00:12:02,730 Rob Simmelkjaer: day, what kind of an effect should that have on 214 00:12:02,730 --> 00:12:06,420 Rob Simmelkjaer: the way that most runners approach running that day? 215 00:12:07,710 --> 00:12:11,339 Matt Friedman: I'm just going to say moderate, moderate, moderate. Just like 216 00:12:11,340 --> 00:12:13,950 Matt Friedman: we all used to say hydrate, hydrate, hydrate. It's the 217 00:12:13,950 --> 00:12:17,370 Matt Friedman: same. Heat obviously, we all feel the effects of the 218 00:12:17,370 --> 00:12:20,220 Matt Friedman: heat. We feel the muscle weakness, we feel the fatigue. 219 00:12:20,550 --> 00:12:23,670 Matt Friedman: But the risk is real. When it gets hotter and 220 00:12:23,670 --> 00:12:28,080 Matt Friedman: hotter, moderate yourself. Maybe don't push for the PR on 221 00:12:28,080 --> 00:12:32,969 Matt Friedman: a hot day. Go slowly, be persistent, finish the course, 222 00:12:33,210 --> 00:12:35,160 Matt Friedman: but just take it easy that day. That is by 223 00:12:35,160 --> 00:12:37,290 Matt Friedman: no means a day to stretch yourself beyond what you're 224 00:12:37,290 --> 00:12:37,800 Matt Friedman: used to. 225 00:12:38,340 --> 00:12:42,209 Rob Simmelkjaer: You mentioned hydration and there's of course a golden rule 226 00:12:42,210 --> 00:12:44,880 Rob Simmelkjaer: that runners know nothing new on race day. You don't 227 00:12:44,880 --> 00:12:47,130 Rob Simmelkjaer: want to try anything new. What are some of the 228 00:12:47,130 --> 00:12:51,300 Rob Simmelkjaer: mistakes that you've seen runners make when it comes to 229 00:12:51,330 --> 00:12:54,540 Rob Simmelkjaer: hydration or nutrition on race day? 230 00:12:56,910 --> 00:12:59,670 Matt Friedman: As you said, changing up your routine would be first 231 00:12:59,670 --> 00:13:02,429 Matt Friedman: and foremost. We want people to run like they train, 232 00:13:02,429 --> 00:13:04,620 Matt Friedman: run like you train. So if you're used to training 233 00:13:04,620 --> 00:13:07,350 Matt Friedman: a certain way, switching anything up on a race day is 234 00:13:07,350 --> 00:13:10,260 Matt Friedman: not recommended. But we want you to pay attention to 235 00:13:10,260 --> 00:13:13,740 Matt Friedman: your body. You know your body. You know when something's 236 00:13:13,740 --> 00:13:18,330 Matt Friedman: wrong. Something is bugging you, slow the pace, get assessed, 237 00:13:18,390 --> 00:13:22,920 Matt Friedman: get checked out. Too much hydration and too little hydration 238 00:13:22,920 --> 00:13:26,099 Matt Friedman: is both bad. We want you to drink to thirst. 239 00:13:26,309 --> 00:13:29,819 Matt Friedman: We used to give the wrong mantra in the 1980s, 1990s that 240 00:13:29,820 --> 00:13:32,730 Matt Friedman: people would over drink and we saw some very deleterious 241 00:13:32,730 --> 00:13:37,710 Matt Friedman: effects from that. Another big no- no is caffeinating too 242 00:13:37,710 --> 00:13:41,040 Matt Friedman: much. If you don't normally caffeinate, please try and avoid 243 00:13:41,070 --> 00:13:43,679 Matt Friedman: caffeinating on a race day, we want you to run like 244 00:13:43,679 --> 00:13:46,830 Matt Friedman: you train. Also be mindful of what you ingest. A 245 00:13:46,830 --> 00:13:49,260 Matt Friedman: lot of things are caffeinated nowadays. There's a lot of 246 00:13:49,260 --> 00:13:52,080 Matt Friedman: energy drinks out there. You think it may give you 247 00:13:52,080 --> 00:13:54,030 Matt Friedman: an edge, but it actually is probably a little bit 248 00:13:54,030 --> 00:13:57,630 Matt Friedman: harmful. It will dehydrate you and worse, it'll make your 249 00:13:57,630 --> 00:14:01,170 Matt Friedman: heart speed up, it'll give you excess palpitations. It'll do 250 00:14:01,170 --> 00:14:02,880 Matt Friedman: things to you that you really don't want to be 251 00:14:02,880 --> 00:14:06,720 Matt Friedman: effective. So we would really avoid doing anything on race 252 00:14:06,720 --> 00:14:09,210 Matt Friedman: day that you're not used to or that you haven't trained with. 253 00:14:09,570 --> 00:14:14,700 Rob Simmelkjaer: That's interesting. Your point about drinking to thirst. And I've 254 00:14:14,850 --> 00:14:19,050 Rob Simmelkjaer: heard in the past people say if you're thirsty, you 255 00:14:19,050 --> 00:14:21,780 Rob Simmelkjaer: waited too long to drink, you should have been drinking 256 00:14:21,780 --> 00:14:26,880 Rob Simmelkjaer: to avoid thirst. Should people think differently? Is it really 257 00:14:26,880 --> 00:14:30,000 Rob Simmelkjaer: just as you would during your normal day when you're 258 00:14:30,000 --> 00:14:32,730 Rob Simmelkjaer: thirsty, drink. But if you're not particularly thirsty, if your 259 00:14:32,730 --> 00:14:35,880 Rob Simmelkjaer: body's feeling good, you don't need to drink and drink 260 00:14:35,880 --> 00:14:39,630 Rob Simmelkjaer: and drink just because someone told you never to get 261 00:14:39,630 --> 00:14:41,940 Rob Simmelkjaer: thirsty. And what are the dangers in drinking too much? 262 00:14:42,510 --> 00:14:45,810 Matt Friedman: There's a couple of variables at play. Mainly how hot 263 00:14:45,810 --> 00:14:49,320 Matt Friedman: it is or what you're used to. I wouldn't recommend stopping 264 00:14:49,320 --> 00:14:54,030 Matt Friedman: it every single water station if you don't normally do 265 00:14:54,030 --> 00:14:56,700 Matt Friedman: that. We want you to drink just to up your 266 00:14:56,700 --> 00:15:00,450 Matt Friedman: thirst. When you over hydrate, it does drop your sodium 267 00:15:00,480 --> 00:15:03,000 Matt Friedman: levels a little bit. So we don't want you to 268 00:15:03,000 --> 00:15:06,600 Matt Friedman: drink to over hydrate. Drink to thirst has been the 269 00:15:06,600 --> 00:15:12,270 Matt Friedman: recommended guidance for the last 10 or 12 years now, and we've 270 00:15:12,540 --> 00:15:16,890 Matt Friedman: seen the number of low sodium levels really drop dramatically. 271 00:15:17,250 --> 00:15:20,850 Rob Simmelkjaer: Is there anything you recommend Dr. Friedman in terms of 272 00:15:20,850 --> 00:15:26,370 Rob Simmelkjaer: a mix of water versus electrolytes and how much ... By 273 00:15:26,370 --> 00:15:29,250 Rob Simmelkjaer: electrolytes I mean Gatorade, which is what we serve on 274 00:15:29,250 --> 00:15:32,489 Rob Simmelkjaer: course or whatever electrolyte happens to be available. Do you 275 00:15:32,490 --> 00:15:36,900 Rob Simmelkjaer: have a recommended mix? Is it one- to- one? How 276 00:15:36,900 --> 00:15:39,840 Rob Simmelkjaer: do you think about how much water versus electrolyte sport 277 00:15:39,840 --> 00:15:40,920 Rob Simmelkjaer: drink that someone should drink? 278 00:15:41,370 --> 00:15:43,380 Matt Friedman: It's a tough question to answer in general because it 279 00:15:43,380 --> 00:15:46,080 Matt Friedman: really does depend on your body mass. Smaller people versus 280 00:15:46,080 --> 00:15:50,310 Matt Friedman: larger people need different amount of solute or salt. We 281 00:15:50,310 --> 00:15:54,000 Matt Friedman: would recommend that you run like you train. So if 282 00:15:54,000 --> 00:15:57,210 Matt Friedman: you're used to having solute with water and not drinking 283 00:15:57,210 --> 00:15:59,910 Matt Friedman: any Gatorade, keep on doing that. But we definitely do 284 00:15:59,910 --> 00:16:02,820 Matt Friedman: want you to take some solutes or salt in with 285 00:16:03,060 --> 00:16:07,200 Matt Friedman: the water. Drinking too much water by itself without any 286 00:16:07,200 --> 00:16:11,760 Matt Friedman: salt concentration can be harmful as well. So some electrolytes 287 00:16:11,760 --> 00:16:14,250 Matt Friedman: should be ingested along the course, but you should train 288 00:16:14,250 --> 00:16:16,859 Matt Friedman: like this too. You feel like your training has really 289 00:16:16,860 --> 00:16:19,080 Matt Friedman: gotten you to this point and you shouldn't differ from 290 00:16:19,080 --> 00:16:20,070 Matt Friedman: it all that much. 291 00:16:20,940 --> 00:16:25,740 Rob Simmelkjaer: And Dr. Friedman, so many of the serious medical events 292 00:16:25,740 --> 00:16:29,250 Rob Simmelkjaer: that we have dealt with at Roadrunners and that happened 293 00:16:29,250 --> 00:16:33,150 Rob Simmelkjaer: in the industry tend to be in that last stretch 294 00:16:33,480 --> 00:16:36,720 Rob Simmelkjaer: leading up to the finish line and sometimes at the 295 00:16:36,720 --> 00:16:39,359 Rob Simmelkjaer: finish line. And I guess in a way that's not 296 00:16:39,360 --> 00:16:44,700 Rob Simmelkjaer: surprising. The fatigue has built up, your body has been 297 00:16:44,700 --> 00:16:47,850 Rob Simmelkjaer: strained now for a while. And then also people are 298 00:16:47,850 --> 00:16:51,270 Rob Simmelkjaer: oftentimes going for those PRs, they're going for those BQs. 299 00:16:51,540 --> 00:16:54,120 Rob Simmelkjaer: That's when they're conscious of the time they're trying to 300 00:16:54,120 --> 00:16:57,210 Rob Simmelkjaer: hit and they are going all out at that time. 301 00:16:57,630 --> 00:17:01,110 Rob Simmelkjaer: And that's part of running. That makes sense. But I 302 00:17:01,110 --> 00:17:03,150 Rob Simmelkjaer: guess it goes back to the question I asked before 303 00:17:03,150 --> 00:17:05,760 Rob Simmelkjaer: and it's probably the same answer, but when do you 304 00:17:05,760 --> 00:17:08,939 Rob Simmelkjaer: say, you know what? Today's not the day to make 305 00:17:08,940 --> 00:17:11,520 Rob Simmelkjaer: that all out push for the finish line. Today's the 306 00:17:11,520 --> 00:17:15,210 Rob Simmelkjaer: day to cruise in and enjoy it and maybe there'll 307 00:17:15,210 --> 00:17:17,490 Rob Simmelkjaer: be another day where I can go for that PR. 308 00:17:18,720 --> 00:17:22,170 Matt Friedman: So as an emergency physician what you're describing to me 309 00:17:22,170 --> 00:17:26,190 Matt Friedman: sounds like a tachydysrhythmia, which is when you get overexcited and 310 00:17:26,190 --> 00:17:29,400 Matt Friedman: you really push yourself to finish, that's when your heart 311 00:17:29,400 --> 00:17:33,119 Matt Friedman: can race really fast. And God forbid you can go 312 00:17:33,119 --> 00:17:36,390 Matt Friedman: into a dangerous arrhythmia. We don't want you to do 313 00:17:36,390 --> 00:17:38,850 Matt Friedman: that. We don't want you to push yourself beyond what 314 00:17:38,850 --> 00:17:42,330 Matt Friedman: you normally push yourself for. That is really the chance 315 00:17:42,330 --> 00:17:44,850 Matt Friedman: that your heart speeds up too much and it takes 316 00:17:44,850 --> 00:17:47,310 Matt Friedman: a really long time to slow down. So if you're 317 00:17:47,310 --> 00:17:53,040 Matt Friedman: feeling that moderate, moderate, moderate. Sub PRs is just as 318 00:17:53,040 --> 00:17:56,310 Matt Friedman: good, it's a beautiful day, finish it strong, but no 319 00:17:56,310 --> 00:17:59,850 Matt Friedman: need to overstress yourself and overstress your heart because there's 320 00:17:59,850 --> 00:18:04,320 Matt Friedman: always a concern of these tachydysrhythmias and pushing yourself in excess. 321 00:18:05,130 --> 00:18:09,000 Rob Simmelkjaer: Yeah. That's really important advice. So if a runner is 322 00:18:09,000 --> 00:18:11,700 Rob Simmelkjaer: on the course and they see another runner that seems 323 00:18:11,700 --> 00:18:14,880 Rob Simmelkjaer: to need help, what's the best way for them to 324 00:18:15,060 --> 00:18:19,140 Rob Simmelkjaer: signal that they want to get medical attention for someone 325 00:18:19,140 --> 00:18:22,109 Rob Simmelkjaer: or get a runner to a tent without blocking the course? 326 00:18:22,619 --> 00:18:26,129 Matt Friedman: So we pride ourselves in having resources throughout the course 327 00:18:26,400 --> 00:18:29,760 Matt Friedman: at a very frequent clip. If somebody needs help, I 328 00:18:29,760 --> 00:18:32,129 Matt Friedman: would stop. I would raise your hands. There should be 329 00:18:32,130 --> 00:18:36,840 Matt Friedman: somebody within 25 yards at the most, whether it's a 330 00:18:36,869 --> 00:18:41,550 Matt Friedman: NYRR staff member, whether it's a New York City official, 331 00:18:41,700 --> 00:18:44,399 Matt Friedman: there will be somebody to stop and notice. Somebody with 332 00:18:44,400 --> 00:18:48,720 Matt Friedman: a radio who can call you. Ideally if the patient's 333 00:18:48,720 --> 00:18:51,300 Matt Friedman: able to walk, you should walk them to the medical 334 00:18:51,300 --> 00:18:53,369 Matt Friedman: tent to get checked out. They just need a little bit 335 00:18:53,369 --> 00:18:57,090 Matt Friedman: of assistance. We have a medical tent every single mile. 336 00:18:57,270 --> 00:19:00,000 Matt Friedman: They should ideally walk into that medical tent. If they 337 00:19:00,000 --> 00:19:02,699 Matt Friedman: can't walk, we will come to you, be it a 338 00:19:02,700 --> 00:19:06,750 Matt Friedman: bike on foot, in a gator, in an ambulance, we 339 00:19:06,750 --> 00:19:08,879 Matt Friedman: will get to you. But the first thing first is 340 00:19:08,880 --> 00:19:12,450 Matt Friedman: to find somebody who can help. Stopping raising your hands, 341 00:19:12,660 --> 00:19:14,879 Matt Friedman: flagging people down does the trick. 342 00:19:15,210 --> 00:19:18,210 Rob Simmelkjaer: And I always say at the starting line of a 343 00:19:18,210 --> 00:19:20,429 Rob Simmelkjaer: lot of our races when I speak, I tell the 344 00:19:20,430 --> 00:19:23,129 Rob Simmelkjaer: runners, I really hope to not see them in a 345 00:19:23,130 --> 00:19:25,290 Rob Simmelkjaer: medical tent. We don't want them in a medical tent. 346 00:19:25,290 --> 00:19:27,930 Rob Simmelkjaer: But if someone does end up having to go to 347 00:19:27,930 --> 00:19:31,050 Rob Simmelkjaer: a medical tent, Dr. Friedman, what can they expect to 348 00:19:31,050 --> 00:19:35,639 Rob Simmelkjaer: see? How is that set up? How are they evaluated? How are 349 00:19:35,640 --> 00:19:38,609 Rob Simmelkjaer: they cared for? What is the protocol that they'll go 350 00:19:38,609 --> 00:19:40,200 Rob Simmelkjaer: through if they do end up having to go to 351 00:19:40,200 --> 00:19:41,220 Rob Simmelkjaer: one of our medical tents? 352 00:19:41,520 --> 00:19:43,530 Matt Friedman: So I like to say that we have the most 353 00:19:43,530 --> 00:19:47,760 Matt Friedman: multidisciplinary team probably in the entire city at that point. 354 00:19:47,940 --> 00:19:51,359 Matt Friedman: We have physical therapists, we have nurses, we have occupational 355 00:19:51,359 --> 00:19:55,050 Matt Friedman: therapists, we have emergentologists, which is just a funny name 356 00:19:55,050 --> 00:19:59,550 Matt Friedman: for emergency medicine physicians. We have neurosurgeons, we have rheumatologists, 357 00:19:59,550 --> 00:20:03,210 Matt Friedman: we have endocrinologists. We have a full team set to 358 00:20:03,210 --> 00:20:06,450 Matt Friedman: assist you. We have mental health workers, we have paramedics. 359 00:20:07,170 --> 00:20:09,240 Matt Friedman: First thing first we're going to come into the tents 360 00:20:09,240 --> 00:20:10,830 Matt Friedman: and we're going to assess you. We may take your 361 00:20:10,830 --> 00:20:13,740 Matt Friedman: vital signs, we may set you down in a chair, 362 00:20:13,740 --> 00:20:15,840 Matt Friedman: we may lie you down into bed. We're going to 363 00:20:15,840 --> 00:20:18,600 Matt Friedman: assess every runner who comes in there. We're going to 364 00:20:18,600 --> 00:20:21,780 Matt Friedman: determine what they need and make recommendations based on that. 365 00:20:22,350 --> 00:20:25,020 Rob Simmelkjaer: And then from there you got a lot of different 366 00:20:25,020 --> 00:20:28,619 Rob Simmelkjaer: types of treatment. I've seen people in ice baths, I've 367 00:20:28,619 --> 00:20:33,840 Rob Simmelkjaer: seen people getting all manner of treatments. Obviously fluids and 368 00:20:34,050 --> 00:20:36,000 Rob Simmelkjaer: things like that are often a big part of it. 369 00:20:36,000 --> 00:20:41,159 Rob Simmelkjaer: But at what point Dr. Friedman in that process do 370 00:20:41,160 --> 00:20:44,430 Rob Simmelkjaer: you and the medical tent decide, okay, we need to move 371 00:20:44,430 --> 00:20:48,150 Rob Simmelkjaer: someone to another facility if they need more serious medical attention? 372 00:20:48,480 --> 00:20:52,380 Matt Friedman: So we're better equipped with more nurses and more staff 373 00:20:52,380 --> 00:20:55,199 Matt Friedman: than most local facilities. We really do our best to 374 00:20:55,230 --> 00:20:58,710 Matt Friedman: treat and stabilize you on site. We really would try 375 00:20:58,710 --> 00:21:01,020 Matt Friedman: and avoid sending anybody to the hospital should it be 376 00:21:01,020 --> 00:21:05,970 Matt Friedman: needed. Sometimes somebody falls and it sustains a laceration. They 377 00:21:05,970 --> 00:21:07,830 Matt Friedman: may have to go to urgent care to get sutured 378 00:21:07,830 --> 00:21:12,180 Matt Friedman: up. That's pretty rare though. Most things we have on 379 00:21:12,180 --> 00:21:15,000 Matt Friedman: site in one of those medical tents to treat somebody 380 00:21:15,000 --> 00:21:19,560 Matt Friedman: and prevent any further transport to any definitive facility like 381 00:21:19,560 --> 00:21:22,290 Matt Friedman: a hospital. We'll treat you we'll get you back into 382 00:21:22,290 --> 00:21:25,440 Matt Friedman: shape and most people just need time. I would say 383 00:21:25,440 --> 00:21:27,540 Matt Friedman: that's the number one treatment we offer people is we 384 00:21:27,540 --> 00:21:29,790 Matt Friedman: offer them time just to get back to their normal 385 00:21:29,790 --> 00:21:32,190 Matt Friedman: self. And then most people walk on out of there. 386 00:21:32,910 --> 00:21:37,560 Matt Friedman: It's really amazing. Some people come in quite tired, fatigued, altered, 387 00:21:37,590 --> 00:21:41,760 Matt Friedman: obtunded and give them about half an hour and they're 388 00:21:41,760 --> 00:21:44,490 Matt Friedman: back to themselves. They don't feel like a million bucks 389 00:21:44,520 --> 00:21:45,480 Matt Friedman: but they feel pretty good. 390 00:21:46,170 --> 00:21:50,490 Rob Simmelkjaer: Yeah, absolutely. And we know that nobody shows up at 391 00:21:50,490 --> 00:21:53,040 Rob Simmelkjaer: the starting line planning to end up in the medical 392 00:21:53,040 --> 00:21:56,670 Rob Simmelkjaer: tent, but if you need it, there is absolutely no 393 00:21:56,670 --> 00:21:59,340 Rob Simmelkjaer: reason to avoid it. We have incredible professionals in those 394 00:21:59,340 --> 00:22:03,510 Rob Simmelkjaer: tents and take advantage of those opportunities. Take advantage of 395 00:22:03,510 --> 00:22:06,810 Rob Simmelkjaer: the resources they're there for you if you get to 396 00:22:06,810 --> 00:22:09,389 Rob Simmelkjaer: a point where you need them. So please don't feel 397 00:22:09,630 --> 00:22:11,970 Rob Simmelkjaer: any shame in going to a medical tent if you 398 00:22:11,970 --> 00:22:15,000 Rob Simmelkjaer: need one. Dr. Friedman, I want to talk about CPR 399 00:22:15,180 --> 00:22:20,070 Rob Simmelkjaer: and we have clearly seen in our events that when 400 00:22:20,070 --> 00:22:25,440 Rob Simmelkjaer: there are serious events, cardiac events in our races, the 401 00:22:25,680 --> 00:22:31,050 Rob Simmelkjaer: biggest determiner of success or a tragic outcome is whether 402 00:22:31,050 --> 00:22:35,220 Rob Simmelkjaer: there was someone nearby who was able to perform CPR. 403 00:22:35,220 --> 00:22:41,040 Rob Simmelkjaer: And in most cases the first person available to perform 404 00:22:41,040 --> 00:22:43,530 Rob Simmelkjaer: CPR will be a fellow runner because the runners are 405 00:22:43,530 --> 00:22:47,400 Rob Simmelkjaer: everywhere and they'll be able to perform up until that 406 00:22:47,400 --> 00:22:50,580 Rob Simmelkjaer: time that one of your medical professionals is able to 407 00:22:50,940 --> 00:22:56,010 Rob Simmelkjaer: arrive. And so we talk about learning hands- only CPR, 408 00:22:56,220 --> 00:22:58,560 Rob Simmelkjaer: what is that and why is that so important? 409 00:22:58,890 --> 00:23:02,130 Matt Friedman: So there is good data which shows that you don't 410 00:23:02,130 --> 00:23:05,430 Matt Friedman: need to provide the rescue breathing or the mouth- to- 411 00:23:05,430 --> 00:23:11,400 Matt Friedman: mouth CPR to get desired results. Hands- only CPR takes 412 00:23:11,400 --> 00:23:15,510 Matt Friedman: out the rescue breathing. You really just do the compressions, 413 00:23:15,690 --> 00:23:19,440 Matt Friedman: which for the first five minutes is fairly effective or 414 00:23:19,500 --> 00:23:22,380 Matt Friedman: I should say very effective at getting blood flow to 415 00:23:22,380 --> 00:23:25,410 Matt Friedman: the patient's body until we get there. The first five 416 00:23:25,410 --> 00:23:27,869 Matt Friedman: minutes are key. There is no need to do the 417 00:23:27,869 --> 00:23:31,950 Matt Friedman: rescue breathing if you are not trained in it. Do only hands- 418 00:23:31,980 --> 00:23:35,730 Matt Friedman: only compressions. And that's simply you take your hands ... And 419 00:23:35,730 --> 00:23:38,310 Matt Friedman: we can have a video of this at the expo 420 00:23:38,760 --> 00:23:41,969 Matt Friedman: presented by New Balance. You take your hands and you're 421 00:23:41,970 --> 00:23:44,040 Matt Friedman: going to compress their chest at a rate of about 422 00:23:44,040 --> 00:23:48,210 Matt Friedman: a hundred per minute at a depth of about one 423 00:23:48,210 --> 00:23:50,670 Matt Friedman: to two inches. So you're going to compress their chest 424 00:23:50,670 --> 00:23:53,820 Matt Friedman: for one to two inches at a rate of a 425 00:23:53,820 --> 00:23:56,189 Matt Friedman: hundred compressions per minute. 426 00:23:56,460 --> 00:24:00,150 Rob Simmelkjaer: That's about one compression, almost two per second, a little 427 00:24:00,150 --> 00:24:03,450 Rob Simmelkjaer: less than two compressions per second. So you're going really, 428 00:24:03,660 --> 00:24:05,311 Rob Simmelkjaer: really fast there with those compressions. 429 00:24:05,311 --> 00:24:08,760 Matt Friedman: It's a clip. It's a fast clip. We also want people 430 00:24:08,760 --> 00:24:12,840 Matt Friedman: to change out. It's physically enduring. You really have to 431 00:24:13,109 --> 00:24:14,520 Matt Friedman: work hard at it. So we do want people to 432 00:24:14,520 --> 00:24:17,430 Matt Friedman: change every couple of minutes. We'll be there within five minutes, 433 00:24:17,670 --> 00:24:19,590 Matt Friedman: but we really do want people to change out hands- 434 00:24:19,590 --> 00:24:23,580 Matt Friedman: only compressions. But hands- only compressions is perfectly effective for 435 00:24:23,580 --> 00:24:26,130 Matt Friedman: the first five minutes. There's no need to do rescue 436 00:24:26,130 --> 00:24:28,950 Matt Friedman: breathing. Just compress their chest to the best of your 437 00:24:28,950 --> 00:24:31,830 Matt Friedman: ability and that will provide time for us to get 438 00:24:31,830 --> 00:24:33,810 Matt Friedman: there and before life- saving treatment. 439 00:24:34,740 --> 00:24:36,750 Rob Simmelkjaer: And Dr. Friedman, you mentioned we are going to be 440 00:24:36,750 --> 00:24:41,550 Rob Simmelkjaer: doing demos of hands- only CPR at the expo. What 441 00:24:41,550 --> 00:24:44,699 Rob Simmelkjaer: can a runner expect to learn if they stop by 442 00:24:45,240 --> 00:24:47,340 Rob Simmelkjaer: that demonstration at the expo of CPR? 443 00:24:48,119 --> 00:24:50,340 Matt Friedman: So they'll see the exact placement for where you should 444 00:24:50,340 --> 00:24:53,340 Matt Friedman: place your hands on the sternum. They'll get practice doing 445 00:24:53,340 --> 00:24:55,980 Matt Friedman: it with a mannequin so you really understand the force 446 00:24:55,980 --> 00:24:59,790 Matt Friedman: that's necessary. I hate to be graphic, but you are 447 00:24:59,790 --> 00:25:03,480 Matt Friedman: expected to break some ribs in the hands- only compressions. 448 00:25:03,660 --> 00:25:06,090 Matt Friedman: That means you're doing the right thing. And it can 449 00:25:06,090 --> 00:25:09,000 Matt Friedman: be jarring to people. But if you understand that and 450 00:25:09,150 --> 00:25:12,780 Matt Friedman: you're doing the right thing, that is the biggest determinant 451 00:25:12,810 --> 00:25:16,770 Matt Friedman: to see if the patient lives or dies. And so many 452 00:25:16,770 --> 00:25:21,030 Matt Friedman: runners are so salvageable and able to be saved with 453 00:25:21,030 --> 00:25:23,910 Matt Friedman: a runner who performs CPR and we get there with 454 00:25:23,910 --> 00:25:26,939 Matt Friedman: our AED and trying to fibrillate their heart. 455 00:25:27,570 --> 00:25:31,410 Rob Simmelkjaer: Absolutely. It's something that I think every runner needs to 456 00:25:31,410 --> 00:25:34,440 Rob Simmelkjaer: know every single person listening to this can be a 457 00:25:34,440 --> 00:25:37,890 Rob Simmelkjaer: part of saving a life if we happen to have 458 00:25:37,890 --> 00:25:41,399 Rob Simmelkjaer: a runner who unfortunately has a cardiac event during a 459 00:25:41,400 --> 00:25:44,160 Rob Simmelkjaer: race. So we really encourage everybody to check that out 460 00:25:44,430 --> 00:25:47,520 Rob Simmelkjaer: at the expo. Dr. Friedman, there are videos as well 461 00:25:47,520 --> 00:25:51,060 Rob Simmelkjaer: online that people can watch to see how to perform this. 462 00:25:51,810 --> 00:25:55,260 Matt Friedman: Absolutely. Hands- only CPR. Feel free to Google that. You'll 463 00:25:55,260 --> 00:25:58,440 Matt Friedman: see a short video. It really is a very short 464 00:25:58,440 --> 00:26:01,199 Matt Friedman: training period. You can also reach out to the local 465 00:26:01,200 --> 00:26:04,830 Matt Friedman: American Heart Association or American Red Cross to get fully 466 00:26:04,830 --> 00:26:06,840 Matt Friedman: certified and get an official certification. 467 00:26:07,800 --> 00:26:11,129 Rob Simmelkjaer: All right. So Dr. Friedman as we wrap up, what's 468 00:26:11,130 --> 00:26:15,330 Rob Simmelkjaer: your best overall piece of advice to runners as they 469 00:26:15,990 --> 00:26:19,800 Rob Simmelkjaer: get ready to take on this day and this challenge? 470 00:26:19,800 --> 00:26:20,909 Rob Simmelkjaer: And we know it's going to be one of the 471 00:26:20,910 --> 00:26:25,859 Rob Simmelkjaer: best days of most runners lives. But on the medical 472 00:26:25,859 --> 00:26:28,560 Rob Simmelkjaer: side, what's the best advice to make sure that they finish 473 00:26:28,560 --> 00:26:29,730 Rob Simmelkjaer: strong and stay safe? 474 00:26:30,150 --> 00:26:32,880 Matt Friedman: We want you to run like you train. We ideally 475 00:26:32,880 --> 00:26:35,220 Matt Friedman: want you to run in a group or with friends 476 00:26:35,670 --> 00:26:39,780 Matt Friedman: and just have a good day. Enjoy yourself. No need 477 00:26:39,780 --> 00:26:43,980 Matt Friedman: to push yourself in excess, moderate, moderate, moderate. It'll be 478 00:26:43,980 --> 00:26:47,280 Matt Friedman: a wonderful day in a thriving community and it'll be 479 00:26:47,280 --> 00:26:48,090 Matt Friedman: fun for all. 480 00:26:48,840 --> 00:26:51,840 Rob Simmelkjaer: All right. And we've got a lot more information by 481 00:26:51,840 --> 00:26:54,659 Rob Simmelkjaer: the way out there about this topic. So if anyone 482 00:26:54,660 --> 00:27:00,240 Rob Simmelkjaer: wants to learn more, they can go to our website nyrr.org/ 483 00:27:00,270 --> 00:27:08,760 Rob Simmelkjaer: marathonrunnersafety, that's nyrr.org/ marathonrunnersafety. Dr. Friedman we also have a 484 00:27:08,760 --> 00:27:12,990 Rob Simmelkjaer: system that we use to give runners a sense of 485 00:27:13,260 --> 00:27:16,470 Rob Simmelkjaer: what the conditions are like on a given race day 486 00:27:16,470 --> 00:27:18,960 Rob Simmelkjaer: and how hard they should be pushing ourselves. We call 487 00:27:18,960 --> 00:27:22,230 Rob Simmelkjaer: it the EAS system, flags of different colors. Can you 488 00:27:22,230 --> 00:27:25,680 Rob Simmelkjaer: talk about that system a bit and how runners should 489 00:27:26,010 --> 00:27:28,050 Rob Simmelkjaer: pay attention to that? What it means if we have 490 00:27:28,050 --> 00:27:30,689 Rob Simmelkjaer: a flag that's a yellow or different color than green? 491 00:27:31,080 --> 00:27:35,130 Matt Friedman: Yeah. So green means go. Green is good. Take no 492 00:27:35,130 --> 00:27:38,189 Matt Friedman: caution When you do see a green flag. Yellow would 493 00:27:38,190 --> 00:27:40,830 Matt Friedman: be our next flag up and that means take some 494 00:27:40,830 --> 00:27:44,550 Matt Friedman: caution as conditions are less than ideal. Slow down your 495 00:27:44,550 --> 00:27:48,899 Matt Friedman: pace a bit. Drink to thirst again, moderate, moderate, moderate. 496 00:27:49,440 --> 00:27:53,460 Matt Friedman: After yellow we would encounter a red flag and red 497 00:27:53,460 --> 00:27:55,290 Matt Friedman: means that there is some risk, there is some high 498 00:27:55,290 --> 00:27:59,820 Matt Friedman: risk and it's potentially dangerous. Runners should exercise caution and 499 00:27:59,820 --> 00:28:03,000 Matt Friedman: slow your pace significantly and you should look for further 500 00:28:03,000 --> 00:28:06,750 Matt Friedman: instructions from race officials. And after red is a black 501 00:28:06,750 --> 00:28:09,780 Matt Friedman: flag and that means there is an extreme risk and the race is 502 00:28:09,780 --> 00:28:14,399 Matt Friedman: canceled. Participants should stop running. We use the wet bulb 503 00:28:14,400 --> 00:28:17,340 Matt Friedman: globe thermometer to assess this. This is a standard device 504 00:28:17,340 --> 00:28:22,350 Matt Friedman: across the running industry really worldwide. I'm going to explain 505 00:28:22,350 --> 00:28:25,500 Matt Friedman: the specifics of that in a whole other podcast. But 506 00:28:25,650 --> 00:28:30,090 Matt Friedman: green is go, yellow is exercise some caution, red means 507 00:28:30,210 --> 00:28:33,480 Matt Friedman: extreme risk and really exercise a lot of caution and 508 00:28:33,480 --> 00:28:35,129 Matt Friedman: black means stop running 509 00:28:35,520 --> 00:28:38,430 Rob Simmelkjaer: Dr. Matt Friedman, thank you so much for being with 510 00:28:38,430 --> 00:28:41,640 Rob Simmelkjaer: us for this great information. We will see you at 511 00:28:41,640 --> 00:28:44,910 Rob Simmelkjaer: the expo for that CPR training and obviously we will 512 00:28:44,910 --> 00:28:46,620 Rob Simmelkjaer: see you on race day. Thank you very much. 513 00:28:47,130 --> 00:28:48,300 Matt Friedman: Nice talking with you Rob. Thank you.