November 19, 2009
UW Medicine medical volunteers gear up to care for Seattle Marathon 2009 runners
More than 70 UW Medicine medical volunteers will be on hand the Sunday after Thanksgiving to assist runners who become ill or injured during the Amica Seattle Marathon 2009. UW faculty physicians will lead teams of nurses, physician assistants, fellows, residents, physical therapists, other health professionals and UW health science students. They will staff the main medical tent 20 yards from the finish line and on-course aid stations.
Describing UW Medicine volunteers for the Seattle Marathon as “an amazing group,” Dr. Mark A. Harrast, the medical director for the 2009 marathon and a UW Medicine physician, said the medical volunteer numbers this year are more than double that of the past two years.
“These UW Medicine faculty, staff and students see the marathon as a great community event to ‘give back to.’ It’s very telling that there is so much interest in volunteering even though it is a holiday weekend and the weather is usually cold and rainy,” he observed. Harrast is a UW clinical associate professor of rehabilitation and of orthopaedics and sports medicine who practices at UW Medicine Sports and Spine
Months of collaborative planning with many agencies have gone into designing a medical response system for Seattle Marathon participants.
“Creating medical coverage for a 26.2-mile course through the city has its own unique challenges that are very different from other sporting events,” Harrast noted. “Organizing medical care for a race this size requires a significant amount of preparation. We prepare for the worst, and hope for the best.”
Marathon medicine, Harrast explained, is becoming its own subspecialty in sports medicine. He gave a couple of reasons:
First, marathon running is becoming more popular each year. In 2008 more than 425,000 runners finished official marathons in the United States. The running boom of the 1970s witnessed about 100,000 finishers.
Second, running a marathon has the potential to cause ailments not usually seen in other sports. For example, some runners may overhydrate — drink too much fluid during the race — and dilute the salt levels in their bodies. The low sodium level can make them quite ill.
The 2009 Seattle Marathon medical team is ready to treat expected and unexpected problems. Most of the runners who will go to the medical tent will be fatigued, cold, or dizzy from low blood pressure. Some will have blisters or muscle, ligament, or bone injuries. A few may be in serious trouble. In the past the Seattle Marathon medical team has treated heat stroke, chest pain, and a runner who dropped near the finish line from a cardiac arrest. The team successfully resuscitated him.
Harrast provided an overview of how the 2009 Seattle Marathon medical response system will operate:
The main medical tent will be 20 yards from the finish line inside Seattle Center. This is where the medical team will treat the more acutely ill runners. In the tent, which Harrast calls a “mini-MASH unit,” the medical volunteers will have the capacity to triage, evaluate and treat most medical conditions. UW Medical Center will be supplying medical supplies and equipment like intravenous and blood draw set-ups, rapid electrolyte testers, electronic warmers for hypothermia or severe chilling, and ice for hyperthermia, or overheating. Harrast, who has treated severe heat stroke in previous damp Seattle Marathons, said runners can get overheated even in cold, wet weather.
A booth in the Victory Recovery Area near the Seattle Center Exhibition Hall also will have volunteers to direct or bring runners to medical assistance or post-race care. About 400 yards from the finish line, a separate medical station will typically care for sprains and other muscle or bone injuries, and blisters. Another four medical stations will be placed strategically throughout the 26 mile course to look out for and treat runners along the race. The stations also are visual reminders to the runners to assess themselves, stay in control, and not run beyond their limits. Wisely stopping or at least slowing down might prevent a more serious medical issue or collapse further down the course.
Through a new partnership this year with Medic One, three pairs of paramedics will roam the course on bicycles as mobile medical providers.
Because medical providers will be dispersed along the course, Harrast said a central command station will be located near the finish line. There, as the medical director, he will be in touch with all the medical stations, bike medics, and standby ambulances, as well as race officials, along the entire course. The central command will have representatives from Medic One and American Medical Response (AMR) to organize help for any medical issue, emergency or not, and dispatch appropriate aid as needed — a doctor from a nearby on-course medical station, a bike medic, Medic One, or an AMR ambulance. The command center will also be in communication with race officials in case situations — a water main break, building fire, car accident, icy roads — change the race or affect the runners.
Harrast pointed to marathon statistics showing that most medical problems arise in the last half of the race and even more so in last two miles. In the 2009 Seattle Marathon, runners will enter the last two miles on Boylston Ave. E. as they curve under Interstate 5 to Lakeview Blvd. E., and head toward Eastlake, Republican and Mercer.
In this final stretch, Harrast said, runners will likely get caught up in the excitement of being close to the finish. They may stop listening to their bodies and push beyond their limits.
“That is why we have enhanced the last half of the course with more medical personnel,” he explained. “The bike medics and scouts [people assigned to watch for runners in trouble] will be more heavily situated in the last six miles. Also new this year is a medical station with doctors and nurses at Mile 25 (the same as Mile 12 for the half marathon) near Republican and Terry.”
Along the course, half and full marathon participants should easily spot the UW Medicine medical team members in their bright red, long-sleeved jerseys, on-the-ready to provide help to runners.
Details on medical assistance for runners during the Sunday event are available on the Seattle Marathon 2009 Web site that also includes race information for the Saturday 5K Run/Walk — also accessible to wheelchairs, strollers and dogs on leash — and the final 1.2 mile of the Kids Marathon.
