Imagine an EMS system that covers a distance of 1,000 miles with a response time of four to five hours (or up to 12 hours at night). Now imagine there isn’t any ALS monitoring equipment, and mutual aid might comprise a couple caballeros on horses. These are some of the challenges the Short Course Off-Road Enterprises (SCORE) medical team faces each year in a remote area in Mexico. “This channel is code red. We’ve got an emergency at race mile 243. Checkpoint 2, go ahead,” says “the Weatherman” as he breaks into the airwaves.