The Runner Who Went Down at Mile 6
You are assigned to traffic control at a 10K road race on a July morning. The temperature is 88°F with 70% humidity. At the 6-mile mark, a 41-year-old male runner collapses. Bystanders tell you he became dizzy, then went stiff and fell. He is unresponsive. He is making occasional gasping sounds, and you cannot feel a definite pulse at the carotid within 10 seconds. His skin is hot and dry. An AED is in your cruiser about 200 yards away; a bike medic is three minutes out; EMS is eight minutes out. A crowd of runners is gathering, and one bystander is already kneeling over him, shaking his shoulders and asking if he is okay. You are in uniform with a duty belt, radio, and trauma kit; your partner is 100 yards away directing traffic.
1. What is your immediate assessment, and what is the first priority?
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Your first priority is your own safety and the patient's airway, breathing, and circulation. Put on gloves, have a bystander stop shaking him, and check responsiveness, breathing, and pulse for no more than 10 seconds. Occasional gasping is not normal breathing; it is agonal and signals cardiac arrest until proven otherwise. With no definite pulse, start CPR immediately and send someone for the AED. The heat is a second emergency, not the first: heat stroke can cause collapse, but you cannot cool a patient who is in cardiac arrest without also providing CPR and defibrillation. Direct the crowd back, assign someone to meet EMS, and keep your radio open. Do not spend time trying to give him water or sit him up. The first five minutes are about high-quality compressions and getting the AED.
2. Describe your CPR, AED, and heat-illness management sequence.
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Begin 30 compressions to 2 rescue breaths at 100–120 per minute, about 2 to 2.4 inches deep, allowing full recoil; if you are alone, use compression-only CPR. Apply the AED as soon as it arrives: bare and dry the chest, attach pads, clear everyone, and follow the prompts. If a shock is advised, deliver it and resume CPR immediately. In parallel, treat heat stroke: move him to shade if you can do so without interrupting CPR, remove excess clothing, apply ice packs to the neck, armpits, and groin, fan him, and pour cool water over him. Cooling should not delay compressions or defibrillation. If ROSC occurs, continue cooling and monitor breathing. The bike medic and EMS should be updated with the arrest time, AED shocks, and cooling measures.
3. What legal protections and limits apply to the care you provide?
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Ohio's Good Samaritan law (O.R.C. 2305.23) generally provides civil immunity for emergency care rendered voluntarily and in good faith, but it does not protect reckless conduct or care outside your training. As an on-duty officer, you also have a policy-based duty to act and cannot abandon the patient once care begins. Work within your certification: CPR, AED, and basic first aid, not advanced airway or medications. Document the times, interventions, and responses. Do not discuss the patient's condition with the crowd or on social media. If you are relieved by EMS, give a clear handoff. The legal protection is strongest when you act within training, in good faith, and with a complete record.