Keeping an Eye on 20,000 Hearts at Twin Cities Marathon

Oct. 02--Chuck Bergen is a lucky guy.

Last year, while running the Medtronic Twin Cities Marathon, the 62-year-old Apple Valley man collapsed near the 11-mile mark of the race. An artery to his heart was blocked and his heart had stopped.

"I didn't have any symptoms," Bergen said. "I actually had one or two seconds where I felt like I was getting dizzy."

Then he fell face down on the pavement. Running behind Bergen was Ross Olson, a nurse with experience dealing with cardiac arrests.

Olson, 32, of North St. Paul, knew exactly what was happening when he rolled Bergen over and saw Bergen's lips were blue and his eyes were rolled back in his head. Within a minute, Olson and a race volunteer who also arrived on the scene were performing CPR on Bergen.

And within about two minutes, volunteer mountain bike patrollers came along. They were carrying a portable defibrillator that they used to shock Bergen's heart and get it started again.

The next thing Bergen knew, he was waking up in the back of an ambulance on the way to the hospital where he would get a stent put in a heart artery.

"I'm doing really well now," said Bergen, who is still running. "I feel like I'm really close to normal."

RESPONDERS WILL BE READY

Sudden cardiac arrests are rare but potentially deadly occurrences at marathons. But for the more than 20,000 runners hitting the roads Sunday in St. Paul and Minneapolis for the Twin Cities Marathon and the Medtronic TC 10 Mile, race organizers have set up a largely unseen umbrella of responders ready to help if a racer's heart stops.

Up to seven two-person teams of mountain bike patrollers, each equipped with portable defibrillators, will be cruising among the runners, ready to respond to people who have collapsed. The race was among the first marathons to use mountain bike patrollers with defibrillators when it started doing that more than 10 years ago.

"Our primary responsibility is to bring an AED (automated external difibrillator) to a downed runner," said Michael Randall, assistant director of the Backcountry Trail Patrol Association, the volunteer mountain bike group at the marathon.

Volunteers working at aid stations and as course marshals are also trained in CPR. Ambulances will shadow the race course and be located at key parts of the race.

Motorized carts will be ready at places along the course where a full-sized vehicle might be difficult to maneuver. Volunteers will be stationed on scissor lifts above the finish line, looking to spot racers struggling at the end of the event.

The medical personnel are linked with a HIPAA-compliant smartphone app that can be used at the scene of an emergency to access health and family contact information provided by runners.

"The EMT guy told me that really helped them," Bergen said. "All they had to do was pull out their smartphone and plug in my bib number."

If there's a failure of the cellphone system during the race, there's a backup radio communication plan.

Marathon medical director William Roberts said the race will probably have a total of about 50 automated external defibrillators available on race day. The total race day medical team, including doctors, nurses, EMTs, paramedics, athletic trainers, physical therapists, National Ski Patrol members, medical students and medical residents will number about 300.

But Roberts said he also wants the 5,000 race-day volunteers to all consider themselves part of the medical team, keeping an eye out for runners and calling 911 and the team's medical emergency number if something happens.

In addition to being prepared for sudden cardiac arrest, the medical team is also keyed to respond to potential cases of heatstroke and hyponatremia, a condition caused if a runner drinks too much water resulting in a blood-sodium level that's too low.

"All three (conditions) can kill you," Roberts said.

"The way they prepare for emergencies at the Twin Cities Marathon is amazing," said Olson, the runner who stopped for Bergen. "It worked exactly like it should."

Runners should consider themselves part of the effort, according to Roberts.

"As many volunteers that we have, they're not shoulder to shoulder," he said. "The first person who comes upon a runner who is down is likely to be another runner."

He encourages runners to learn CPR and be willing to sacrifice a race goal if someone needs help.

"If you stop to help another runner and it interferes with your race, we'll give you a complimentary entry to next year's race," Roberts said.

'ETERNALLY GRATEFUL'

Olson estimated that in last year's race, Bergen collapsed about half a block ahead of him. But he said there were so many runners on the course that several dozen runners likely passed Bergen before he stopped.

"I think when you see someone like that, your natural tendency is, 'Well, someone else is going to help,' " Olson said. "Not everyone is comfortable doing that.

"I encourage people, even if they're not in the medical field, to get their BLS (Basic Life Support) certification," Olson said. And then if you see someone in trouble, "be confident to take action. Be vigilant."

"Somebody stopped for me. I'm eternally grateful for that," Bergen said.

In the case of cardiac arrests, the time that elapses before CPR and defibrillation is critical, according to Roberts.

"The CPR starts usually right away because there's always somebody around," he said. He estimated that most of the cardiac arrests at the race have had defibrillation within five minutes.

There have been seven cardiac arrests in the 34-year history of the marathon. Two of those seven runners died. There have been two cardiac arrests in the 16 years of the TC 10 Mile. Both of those runners lived.

That works out to about one sudden cardiac death per 100,000 finishers in the history of the marathon.

According to a 2012 study co-authored by Roberts, the risk of sudden cardiac deaths in a marathon is higher for men, up to one in 50,000 finishes in recent years based on records from the Twin Cities Marathon and the Marine Corps Marathon. Women marathoners, who now make up about 45 percent of Twin Cities Marathon runners, have tended to be younger than men, and the rate of sudden cardiac arrests for women racers is one in 200,000 finishers, according to the study.

Roberts said the survival rate of the Twin Cities Marathon runners who had a cardiac arrest -- five out of seven incidents -- is better odds than living through a cardiac arrest in other settings. He said that typically, only about 5 percent to 10 percent of people who have sudden cardiac arrests survive.

"One of the nurses said to me probably the only better place for this to happen was in the hospital," Bergen said of his cardiac arrest last year. "I think I probably survived because I was a runner."

Richard Chin can be reached at 651-228-5560. Follow him at twitter.com/RRChin.

Copyright 2015 - Pioneer Press, St. Paul, Minn.