EMS Personnel Deliver Gold Medal Care at 2010 Winter Olympics

      In the last 56 years of Winter Olympic history, there have only been five deaths recorded and Bob Alexander, the point man for all EMS care for the 2010 event, had the unenviable distinction of having one occur on his watch.

   With the world watching, literally on television, EMS personnel in Whistler, B.C., Canada, tried in vain to revive Nodar Kumaritashvilli, a 21-year-old luge runner from the Republic of Georgia who suffered injuries in a horrific 90-mph crash into a concrete buttress. He perished from those blunt force traumatic injuries, but it wasn't for the lack of immediate care by highly trained people.

   "We had our crews on the scene within seconds," Alexander says, noting paramedics witnessed the crash from just feet away. Alexander was the EMS coordinator for the 2010 Winter Olympic Games and the 2010 Paralympic Winter Games in Vancouver and the secondary venue site in Whistler. He is a paramedic and supervisor of the British Columbia Ambulance Service (BCAS), the provincial government-operated emergency medical service for the entire province.

   Four paramedics were involved with the young luger's care, and a host of support staff. A helicopter was readied and flight notifications were made to medevac Kumaritashvilli, but the young man perished at the venue's "polyclinic"—a temporary medical facility outfitted better than many rural hospitals in the province.

   "That was one of two calls we had that hit the press," Alexander says, noting that a woman in the cross-country sprint competition suffered serious injuries in a practice run as well.

   Petra Majdic, a cross-country skier from Slovenia, suffered four broken ribs and a pneumothorax in a disastrous fall before competing for a medal in the 1.4km individual classic sprint. She went on to win a bronze medal and collapsed in extreme pain at the finish line.

   Alexander said his paramedics treated her with a chest tube and recommended immediate medical airlift for definitive care, but Majdic, 31, refused to leave before getting her medal, a first for her in Olympic games.

   A paramedic escorted the obviously in-pain woman to the podium, with a chest tube in place, for the medal award ceremony, Alexander said.

   "She got her medal and then we loaded her into the helicopter," he notes.

Call Volume Spikes

   Not all the calls and requests for treatment were as high profile as those, but they were numerous and kept Alexander's staff on the go for the duration of the games.

   "It was busy," Alexander says, adding that BCAS crews transported 181 patients, athletes, spectators and staff for care.

   "We saw about a 23% increase in call volume during the games and 10% ofthat was from the game venues," he says, noting that call volumes throughout the area were up because of the influx of spectators in the cities around the games.

   Surprisingly, Alexander said there were only about 25 hospitalizations for the 2010 Winter Olympics compared to 1,200 during the 2006 Torino Winter Olympics in Turin, Italy. He attributes the dramatic decline in hospitalizations from the Torino games to the medical system in place in Vancouver for spectators and athletes. Two polyclinics staffed with physicians and nurses, one in Vancouver and the other in Whistler, provided a wide range of medical care. Each was equipped with MRIs and CT scanners, as well as laboratories, x-ray equipment, and dental and ophthalmology services.

   "The only time a person was taken to the hospital was for advanced care or medically appropriate overnight stays, which was not part of what the polyclinics were designed to do," Alexander says. The concept of the polyclinics was to reduce the burden on the local hospitals and medical centers in Vancouver. And it worked, he said.

   Alexander credits the success of the EMS care provided for the Olympics to venue commanders assigned to sectors and games within the facilities.

   "Each commander took ownership of their venue," Alexander says. "It was like a family."

   It was a lot of work, not only at the venues themselves, but in the cities and towns, particularly Vancouver, where every night was a party with 100,000 revelers celebrating the games.

   "We had very few issues because everyone worked together," he says, noting he had key people in key places who performed superbly. Years of planning and months of intense training proved valuable.

   Everyone who provided EMS signed up for the shifts and venues on a voluntary basis, and everyone lived up to the task —even the paramedics faced with the reality of a fatal accident at the very start of the games.

   Those involved with the care of Kumaritashvilli, the luger from Georgia, received critical incident stress debriefing within 45 minutes of the accident, Alexander said, and that helped get everyone back on board.

   As the overall supervisor for the entire games, Alexander said he didn't have much of a chance to see the events themselves, spending most of his time in the command center. Nevertheless, it was a once in a lifetime event and he's pleased he did it. He now must pass along his knowledge to those who are organizing the 2014 Winter Olympics in Sochi, Russia.

   "My high point is my paramedic commanders," Alexander says. "They all stepped up to the plate and did their jobs and did them well. We had a major event here and everything went really well."

   Ed Ballam is a firefighter and NREMT-B with the Haverhill Corner (NH) Fire Department. He is a staff writer for EMSResponder.com, Firehouse.com and Officer.com.