Checklist for Trail Race Aid Station Preparedness

In an effort to provide medical awareness guidelines for trail race directors, Frank D. Dumont, MD, FACP, Internal Medicine, Estes Park Health, has devised the following aid station checklists. With the acronym, ESTES (Estes Park Standards for Trail Running Emergency Aid Stations), consider the following as support tools to ensure a successful trail running event.

Note: event directors should develop, with the support of medical professionals, an aid station medical action plan to address the full range of activities from the stocking of aid stations to emergency evacuations.

Krissy Moehl at the 2015 Trail World Championships in France.

For Participants:
Provide education on race website as well as in direct emails to participants and include:

  • Specific challenges/dangers of the specific race environment that a participant may face during the event (altitude, cold, heat, terrain, lightning, animals).
  • Location and number of aid station(s) on the course and whether drop bags can be checked by participants to retrieve at aid stations.
  • Fuel – list what will be provided at aid stations – carbohydrate containing food (for example: chips/pretzels, potatoes, soup, M&Ms, candy, sandwiches), and specify the brand of energy bars, drinks, or gels.
  • Other items – sunscreen, petroleum jelly.
  • Provide information on cleanliness guidelines at aid stations, and handling food (these guidelines may vary state by state). Indicate steps you have for pre-cycling as well as recycling and/or teracycling at your aid stations.
  • Hydration – indicate whether aid stations are cupless, and suggest participants bring hydration pack or hand-held water bottles – note the importance of electrolyte replacement for events over two hours in duration.
  • NSAID avoidance – provide information about dos and don’ts of NSAIDs.
  • Provide a medical form for participants to list medical problems, medications and supplements, and any allergies and keep on file for all registered participants. Implement a procedure whereby aid station captains can access this information if necessary.
  • Provide participants guidance on what to do if they come across an injured or ill runner on the course. Remind runners that, as race participants, they should watch out for each other.

Aid station at the Rocky Raccoon 100 Mile in Huntsville, TX.

For Race Directors:
Nutrition supplies for aid stations

  • Hot water/beverages.
  • Cold water/beverages.
  • Energy gels.
  • Energy bars.
  • Electrolyte tabs or caps.

Note to Race Directors: Provide adequate quantities to supply all items to all participants.

Matt Flaherty fueling up at the Cayuga Trails 50 Mile in Ithaca, NY.

Number of medical personnel/aid station:

  • There should be at least one individual certified as an EMT, and/or trained as a Wilderness First Responder.
  • One additional medical volunteer should be on staff thus allowing one to perform tasks and function as a caregiver while the other is able to observe and assess and think.

Skills required for medical aid station personnel:

  • Ability to help apply basic dressings.
  • Ability to take temperature, blood pressure, pulse, and pulse ox level.
  • Ability to perform orthostatic vital signs.
  • Ability to perform limited Neuro exam.
    • Orientation to person, place, and time.
    • Cincinnati Stroke Scale.

David Laney at Robinson Flat aid station at the Western States 100 Mile Endurance Run.

Communication equipment – Must provide ability to support communication to on-course personnel, other aid stations, start and finish – could be different communication methods depending on race location. Modalities to consider include radio, cell phone, and ham radio with operator support. For more remote locations, may need to consider relaying communication.

  • Communication Network and Links.
  • From Aid Station to Medical Director at start/finish.
  • Ability to communicate with emergency aid stations (relay if needed).
  • Adopt communication protocol, and a plan for medical evacuation.
  • Pre-race planning with local emergency responders.
  • Race personnel responsibilities for responding.
  • Map nearest points to vehicle access from all points on course.
  • Map potential helicopter landing locations (if applicable).

Mile 8 aid station at the Flagline 50K in Bend, OR.

Medical Kit for Aid Stations – consider scaling up the number of supplies for races with greater than 500 participants, e.g. 4 sheets of Moleskin per 500 participants.

  • Blood pressure cuff (automated) (1)
  • Thermometer (tympanic membrane) (1)
  • Pulse oximeter (1)
  • Scale (1)
  • Antiseptic swabs (4)
  • Antibiotic ointment (4)
  • Bandaids (4 each of 3 sizes)
  • Moleskin (4 small sheets)
  • 4X4 dressing pads (8)
  • Coban (2 rolls)
  • ACE wrap, 3 and 4 inch (1 of each)
  • Medical tape (2 rolls)
  • Scissors (1)
  • Non latex gloves (8 of each size)
  • Vaseline
  • Sunscreen
  • Emergency blanket
  • Headlamps/light source for events held at dawn, dusk, or at night
  • Aspirin tablets (baby chewable) (8)
  • Loratidine 10mg tablets (2)
  • Diphenhydramine 25mg tablets (4)

Zach Miller at the 2018 Trail World Championships in Spain.

Interested in what other races are doing with their aid station preparedness and crew information? Check out the following race web pages:


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