The crew should monitor the swimmer in the hours after the swim is over to provide support if needed and watch for possible health issues as their body starts the process of recovering. ​Our swimmer packing list instructed them to have their hotel room key card, passport, medical information, and insurance card in a ziplock bag and placed in their "after bag". The crew chief should take possession of it during or immediately after the swim is over or know where it’s located and have access to it in case it’s needed to seek medical care for the swimmer.

 

The crew can use the spare hotel room key card to access the swimmer’s room every couple of hours or so to check on the swimmer’s condition. Make sure the swimmer knows you'll be doing this if that's the plan, but even then you can fully expect to be scaring the daylights out of them when you first come in - they're tired, they might not be expecting to see a dark figure looming in the doorway. If the crew have concerns, they can wake the swimmer up and ask questions or ask them to take their temperature.

 

How do you know when a swimmer needs to be taken to the hospital for medical care? Great question, and not one I'm qualified to answer. And unless the crew are medical professionals, the crew won't have a clear answer to that question either. But here are some things to look for and consider...

 

• Is the swimmer breathing normally, or is their breathing loud, raspy or laboured?

• Are they feeding and drinking fluids normally, or are they nauseas and unable/unwilling to ingest anything?

• Are they ingesting food and fluids and vomiting afterwards, or abstaining from ingesting anything in order to avoid vomiting?

• Are they able to carry a conversation that has complex thought or explanation with relative clarity and precision?

• Are they experiencing any loss of muscle control or muscle tremors, muscle cramps, abnormal heart rhythm?

• Learn about some of the medical conditions that can affect marathon swimmers, Section 13 Monitoring the swimmer's body.​

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​Where does the support crew role end in these situations? Another great question, and something you should talk about with your swimmer beforehand. If it's understood that the crew will be monitoring the swimmer for an extended period after the swim is done, then check, challenge and push as needed. If you're on the fence about whether to seek medical care for the swimmer and have doubts as to their well-being, then don't give it further thought and just take them to a hospital emergency room. The best case outcome is you made a move that got the swimmer the care they needed to be well again, the worst case outcome is that you were over-cautious and wasted part of everyone's day - the latter still guarantees a positive outcome, rather than risk the alternative. Same goes for any crew members that become unwell as a result of the swim.

 

What if the swimmer won't willingly go? If the situation is serious enough that the crew feel medical care is necessary, they have the swimmer's emergency contacts who are usually loved ones, give them a ring and enlist their support in convincing the swimmer to go. Your swimmer might be unhappy with you at the time, but taking action is better than not, and they are supposed to trust your judgement to act on their behalf. You can't force the swimmer to do anything they don't want to, but you can push pretty hard.

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Once at the hospital, the swimmer will need to explain that they have undertaken a marathon swim and describe whatever issues transpired during or after the swim. If the swimmer is not able to communicate clearly or hasn't really pieced together what's happening to them, the crew may need to help by communicating on their behalf where needed. Consider the following:

 

• It's unlikely the doctor will know what a marathon swim involves, it would be helpful to explain the following:

  • Total time in water, weather conditions (ie, cold winds, hot sun), level of physical effort​

  • Feed and fluid volume consumed, and urination throughout

  • Concerns or issues with the swimmer's well-being before, during or after the swim

 

• This crew guide has a Swimmer/Crew Contacts, Insurance and Medical Information form that can be filled as part of the swim's planning. The form was created with the help of a medical doctor with plenty of emergency room experience and is designed so you can just hand the completed document over to hospital admissions intake (section 1) or a doctor (section 2), to give them quick access to key information about the person seeking treatment. Note that medications are purposefully separated from conditions/ailments, apparently many people don't know or have a hard time explaining exactly why they are on specific medications, it's easiest for the doctor to ask questions and make those connections directly with the person. 

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Think bad shit can't go down? Give Charlotte Brynn's raw account of her 2011 Lake Memphremagog crossing a good read...

• Memphre Battlewounds

• The Aftermath continues...

• The 3 Rs: Rest, Recovery, & Repair

• Evaluating the Swim​