Case Study: Medical Coverage for a Large-Scale Cycling Event

A medical operation built on an established partnership

REDSTAFF Medical’s relationship with NTU Sports Club was already well established before Bike Rally 2024. We had worked alongside NTUSC for multiple prior events such as National Vertical Marathon and Surf N Sweat and this helped us both develop a mutual understanding of the events and our respective teams worked. Most importantly, we understand the scale of the club’s activities and the practical demands of supporting student-led sporting events. So, by the time planning for Bike Rally 2024 began, we were not approaching it as an unfamiliar medical vendor receiving a manpower/support request. We were able to work with NTUSC as an operational partner.

Bike Rally was particularly challenging because there was no single event site or route to cover. Cyclists were distributed across three distances — 58 km, 108 km and 178 km, with the signups projecting hundreds of cyclists across each route.

One of the most significant changes for 2024 came from examining how previous Bike Rallies had operated.

Previously, Safety Cars performed both safety and emergency-response functions, which meant that while medical personnel were spread across a substantial number of vehicles, they may be called away for non-medical related callouts such as flat tires or participant issues. Only one medic was onboard each Safety Car, limiting the interventions a solo medic can perform – especially if you consider the kind of medical and trauma presentations associated with long distance cycling.

For 2024 we separated those responsibilities: Safety Cars concentrated on cyclist safety and accident prevention, while dedicated Medical Cars became rapid-response assets whose sole purpose was responding to medical callouts and emergencies. This change was more than just a staffing or platform adjustment as we were designing a distinct and deliberate medical response system.

So four Medical Cars were deployed, each carrying a Paramedic, First Aider, and driver. Three were assigned as primary responders to the individual routes, while the fourth performed a medical command function dispatching the other vehicles to incidents and covering their route when they were committed to a casualty (while also serving as a backup medical responder).

Instead of waiting at a static first aid post, the Medical Cars travelled with the event. They remained behind the cycling groups, moved between predetermined standby points and responded to incidents occurring along the route.

Why not just use ambulances eh?

A more conventional approach to an event like this would be “ambulance coverage”. After all, they’re a prevalent request. Let’s think about it.

At one extreme, an organiser could deploy just one ambulance to cover the entire event. While “budget friendly”, a single ambulance cannot be everywhere at once with three separate cycling routes operating over large geographical areas. If it is positioned on one route, it may be far away from an incident occurring on another.

There is another problem – if that solo ambulance evacuates a patient to hospital, it is no longer available to the event. If a second casualty occurs (regardless of severity) during that evacuation, the event temporarily loses its dedicated medical capability altogether.

At the other extreme, an organiser could assign one ambulance to each route.

That would provide three dedicated evacuation platforms, but at significant cost, and much of that cost could be spent on ambulances sitting unused for long periods simply because they had been allocated to a route. At $130/hr industry rate, that’s $390 per hour. At 12 hours, that’s $4,680 burnt.

REDSTAFF Medical took a different approach.

Rather than using ambulances as the primary means of reaching casualties, we separated rapid medical response from patient evacuation.

Not every medical callout needs an ambulance. The four Medical Cars provided mobile clinical response across the routes, serving as triage and stabilisation, while an ambulance was reserved for patients who actually required evacuation. This allowed medical personnel to reach incidents without tying every response to a costly ambulance platform.

Such an arrangement also provided greater resilience:

• A medical car attending to one casualty did not remove the event's evacuation capability,

• and an ambulance leaving for a hospital did not abandon the entire event's medical capability.

Building the response around where help was actually needed

The same principle was applied to ambulance coverage, i.e. their physical location.

Our medical plan considered where Singapore’s public emergency ambulance response was readily available and where geographical coverage was comparatively weaker. The operational plan identified most of the 58 km,108 km, and much of the 178km routes fall within the prevailing SCDF ambulance-response coverage area. A hired private ambulance was therefore concentrated on two portions of the route where that response coverage was less favourable: the NTU–Kranji sector (Lim Chu Kang Road and Neo Tiew Road) and the Changi Beach - National Sailing Centre sector (Tanah Merah Coastal Road)

The ambulance itself was repositioned during the night, first covering the western portion of the course and subsequently relocating to Changi as the progress of the cycling group shifted eastwards. No point covering the west when all the cyclists cycled east, resources should move with the risk.

An integrated event operation

Medical coverage was also designed to work with the rest of the event rather than operate as an isolated service.

The wider vehicular operation supporting all three routes included four Medical Cars, three Safety Cars, three Sweeper Buses, an ambulance, multiple operations and logistics vehicles, and outriders.

Medical vehicles were location-tracked, assigned individual radio callsigns and coordinated through a defined communications structure.

The response pathway was also written, and we brought the event organisers onboard with this too for understanding. If an incident was reported, information  would be relayed to medical command, the nearest Medical Car dispatched, and the relevant Safety Car sent to support the scene. Once assessed, riders requiring higher care could be escalated for ambulance evacuation, while those unable to continue cycling but not requiring hospital care could be transferred to the Sweeper Bus.

For an event occurring on public roads, even the positioning of response vehicles was planned. Our medical briefing covered traffic protection, high-visibility PPE, maintaining ambulance ingress and egress, vehicle placement and traffic marshalling around a casualty.

More than providing medics

Bike Rally 2024 is a good example of what our longstanding relationship with NTU Sports Club allowed us to do, and how deep medical planning for events can get.

The requirement was not reduced to: “How many first aiders should we send?”, nor was it reduced to: “How many ambulances should we engage?”

Instead, a strong relationship allowed us to answer:

• How should medical incidents be reported?

• Which vehicle should respond?

• Who is responsible for medical dispatch and command?

• What happens to the route when a Medical Car is committed?

• Where should ambulance capability be positioned?

• How does a casualty get evacuated without leaving the rest of the event uncovered?

As much as they are medical, they are also event-operations related.

That is where REDSTAFF Medical’s approach differs from the competition of simply providing personnel or ambulances on standby. An ambulance is a transport platform. It is not, by itself, an event medical system. Neither do we just throw personnel in and call it a day. Event medical services aren't a separate line/service item like equipment rental or transportation services.

Events are what REDSTAFF Medical was built for.

REDSTAFF Medical was built for Keeping Events Uneventful.