Coastal Medical Transportation Systems Provides EMS Support to 128th Boston Marathon

With temperatures in the 70s, the 128th Boston Marathon on April 15, 2024, was a hot grueling race for its nearly 30,000 runners. Add the estimated 500,000 spectators that lined its 26.2-mile route from Hopkinton, Massachusetts to downtown Boston, plus security concerns after the 2013 Boston Marathon bombing, and the importance of on-scene EMS was more pressing than ever. 

Fortunately, Coastal Medical Transportation Systems (CMTS) was there to help. For the second consecutive year, this privately owned and operated EMS company supported the Boston Marathon Medical Deployment in partnership with state public safety agencies, the Boston Athletic Association (BAA), and the Massachusetts Emergency Management Agency (MEMA) Ambulance Strike Team. 

“Our deployment was sizable with 48 ambulances along the route,” said Kevin Mont, CMTS’ Vice President of Emergency Services & Public Health. “We had about 110 staff deployed in multiple communities throughout the course.” CMTS also had personnel on bikes and small Gator ATVs on site, plus EMS personnel embedded with tactical teams.

CMTS Supporting Towns in Boston

For CMTS, providing EMS support to the Boston Marathon makes sound logistical sense.

“After all, we are the contracted 911 EMS provider in Wellesley, the City of Newton, and the Town of Brookline all along the route, so we are providing service here anyway,” Mont explained. “We also are subcontracted to staff the BAA’s five medical tents, plus support MEMA’s Strike with five ambulances in case a mass casualty event occurs. Add our three EMTs on the SWAT teams assigned to the Boston Marathon, and you can appreciate how deeply committed we are to this event.” 

To put it mildly, a running race with more than half a million athletes and spectators on site is a very challenging environment to work in. This is why CMTS supplemented its ambulance crews with EMS ATVs and bikes.  

“The roads are closed, and there's barricades up and along the course — so if somebody goes down, how do you get in and out of there without driving an ambulance down a race course?” said Mont. “Well, that’s why we had Gator ATVs equipped with EMTs and medical gear. They could drive through the available space to reach people, treat them in place, or transport them to medical tents or ambulances for transport. Meanwhile, our bicycle teams were deployed to do triage and initiate treatment when needed. They're the way to get to the patients quick and efficiently and to determine if transport is needed or not. That way ambulances can be staged outside the barricades and wait to provide transport as needed.”

Preparing for the Marathon

Now preparing for such a massive event requires lots of planning. That’s why “over the past three months the Boston Athletic Association has worked side by side with our valued partner Coastal Medical Transportation Systems, to ensure that we have the proper level of boots on the ground EMS resources in place within the community to prepare for any and every scenario,” said Chris Troyanos, the BAA’s Medical Coordinator. 

This being said, no one could have expected 70s-level temperatures in April. As a result, heat-related medical issues were front and center during the 128th Boston Marathon.  

“We had some folks that presented at some of the medical tents along the way with core temps very high,” Mont said. “The medical staff at the BAA tents did a great job in managing those alongside some of our paramedics and transporting those individuals. Other than that, we wound up with respiratory cases. You also have spectators along the way that get injured. There were a lot of trips and falls, a lot of respiratory-type issues, and disorientated people; dizzy, nauseous, all those kinds of things. It really ran the gamut, the types of ailments that we had.” 

Nevertheless, the 128th Boston Marathon went really well as far as CMTS was concerned, even though the company had to maintain regular EMS coverage in the communities that it serves. 

“In the middle of the day, the three communities that we service were extremely busy,” said Mont. “I think we had 37 ambulances responding to calls at the exact same time. So that was the high watermark as far as that goes. But still, the Boston Marathon plan came together. Everybody worked as a team, and at the end of the day, people who required medical attention got it, and the transport to the hospital that they needed. Yes, it was challenging with the weather being into the 70s — which a lot of the runners around here aren't used to — but our staff did a great job and the plan worked. It absolutely worked.”