Optimizing Clinical Risk Management Through Motorcycle Emergency Response: A Three-Year Retrospective Study of the Khon Kaen International Marathon in Thailand.

Purpose: This study evaluates the effectiveness of motorcycle ambulances (motorlances) in delivering emergency medical response at the Khon Kaen International Marathon (KKIM), Thailand, over a three-year period (2023-2025).

Patients and methods: We conducted a retrospective analysis of emergency medical service (EMS) data from three consecutive annual Khon Kaen International Marathons held on January 28-29, 2023; January 13-14, 2024; and January 11-12, 2025. Data including EMS operation intervals, clinical interventions carried out, and patient outcomes were collected from EMS patient care documents, organized by Srinagarind Hospital, Khon Kaen University, Thailand during the marathon events. A comparative analysis was carried out to evaluate year-over-year operational improvements utilizing IBM SPSS version 27.0, with continuous data expressed as means ± standard deviations, categorical data as frequencies and percentages, chi-square tests employed for associations among categorical variables, and p<0.05 considered statistically significant.

Results: Among 20,681 marathon participants, 132 cases (6.38%) required emergency intervention with motorlance support. The use of motorlances significantly increased from 25 cases in 2023 to 65 in 2025 (p=0.011), with consistently rapid mean response times (5.3-5.6 minutes each year). Clinical capabilities improved over the study period, evidenced by a rise in advanced interventions such as intravenous glucose administration and pain management (from 0% to 23.1%, p=0.010). Scene time increased in parallel with this expanded clinical scope (from 8.2 to 18.6 minutes, p<0.001). Importantly, over 90% of patients treated by motorlance were able to continue the race following on-scene care.

Conclusion: Motorcycle ambulances significantly enhance the efficiency of emergency medical responses during large marathon events. Notable results indicate a constant increase in motorlance utilization, consistently rapid response times, and enhanced clinical competencies with advanced interventions. Extended scene duration indicated enhanced on-site treatment delivery. Significantly, over 90% of patients treated by motorlance resumed to racing after treatment, indicating the efficacy of prehospital intervention.