Off-site cross-country in winter: risk assessment or overreaction?
A school PE department plans a 5 km cross-country run in January on public footpaths and farmland for 120 students aged 12–16. The forecast is 3 °C, 35 km·h−1 wind and persistent rain; the route crosses a stream and a road, and mobile phone signal is poor in the valley. Four staff will supervise, one of whom is first-aid trained. Two students are on the register with medical needs: one has well-controlled asthma and uses a reliever inhaler before exercise; one has a peanut allergy and carries an adrenaline auto-injector. The department has no minibus and the nearest hospital is 25 minutes away. A parent has offered to drive a car as a sweep vehicle. The head of PE wants to run the event as planned because it is the only date available before the district championships.
1. Carry out a risk assessment for this event using the hierarchy of control. Identify the three highest risks and the controls you would put in place before consent is sought.
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Hierarchy: eliminate, substitute, engineering controls, administrative controls, PPE. Highest risks: (1) cold stress or hypothermia from 3 °C, rain and 35 km·h−1 wind, especially if students stop or get wet; (2) a medical emergency (asthma or anaphylaxis) in an area with poor mobile signal; (3) traffic on the road crossing, plus the stream.
Controls: eliminate or substitute the route - use a school loop or a shorter, sheltered route, avoid the road and stream, or postpone. If the route remains, use marshals at the road, a signed crossing, radios and a signal check, a first-aider at the front and back, a sweep vehicle, warm shelter and dry clothing, and a clear emergency plan with grid references. Before consent: send medical forms, check inhalers and auto-injectors are carried, brief staff, set a staff–student ratio, obtain parental consent and inform parents of the plan. PPE includes waterproof clothing and footwear. The parent sweep driver should not be relied on as medical cover.
2. Write the emergency action plan for a student who collapses with wheeze and does not respond to their inhaler, and for a suspected anaphylaxis.
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For the asthmatic student: stop exercise, sit upright, give 10 puffs of reliever via a spacer (one puff at a time, 30 seconds apart), and call 999 if there is no improvement after 10 puffs or if lips are blue, or the student is drowsy or exhausted. Keep warm and monitor breathing.
For suspected anaphylaxis: call 999 immediately, lay the student flat with legs raised (or sitting if breathing difficulty), give the adrenaline auto-injector into the outer thigh, note the time, and repeat after 5 minutes if there is no improvement and a second injector is available. Do not stand them up or give oral food. Be ready for CPR.
Communicate the exact location, access point and what has been given. Record times, doses and observations. The poor signal means a runner must be sent to a known signal point; the plan must identify that point before the event.
3. The head wants to proceed. Give a reasoned decision and alternatives. Include what you would tell the parent sweep driver.
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The decision should be evidence-based, not based on the district championships. If the controls cannot be met - no reliable communication, only one first-aider for 120 students, a road and stream, and cold wet weather - the event should not run as planned. The risk of a delayed emergency response outweighs the fixture. Alternatives: postpone to a better forecast; move to a school site loop with multiple laps, shelter and signal; shorten to 2–3 km; reduce numbers and increase staff; or use a nearby venue with vehicle access.
Tell the parent sweep driver: thank them, explain that their role is limited to sweeping and reporting, not medical care or transport of an injured student, and that they must not move a collapsed student. They should carry a radio or phone, know the emergency meeting point and follow staff instructions. If the event proceeds, provide a written brief and check insurance and consent.