A tough new stance on concussion management will be rolled out at this year's Crankworx - while Rotorua Hospital is preparing for increasing patient numbers.
Peak Safety co-director Mark Woods said this year they had introduced a "spectacular" concussion protocol to address the issue for competitors.
Used in the Enduro races over the weekend, it put more emphasis on making sure competitors were safe to get back on the track.
Volunteers had a set of criteria and riders who suffered concussion were now likely to be referred to doctors, who would determine if they could continue with the event.
He said the new protocols came about because of an increased awareness of concussion and the ongoing damage of repeated concussion.
Mr Woods said there were systems in place to make sure the event was as safe as it could be, including inspecting all the courses from a safety perspective and increased reporting of near misses.
"You hope for the best and plan for the worst."
Meanwhile, Rotorua Hospital is gearing up for more patients.
Lakes District Health Board communications officer Sue Willie said the emergency department experienced a higher than average volume of patient presentations during Crankworx week.
Miss Wilkie said an audit of patient numbers in 2015 revealed the hospital saw an extra 9.25 presentations a day from Crankworx, and an additional 1.75 daily presentations from non-event related injuries.
Miss Wilkie said that last year the hospital rostered additional emergency department staff on, but it hadn't done so this year.
The Rotorua Mountain Bike Club's First Response Unit will be operating all week to help those who get into trouble exploring the tracks in Whakarewarewa Forest.
While it won't deal directly with competitors the club decided to run the unit because of the influx of visitors.