Monday, April 15, 2013, was a day the people of Boston and citizens around the United States would prefer not to remember, but will not soon forget. A day usually dedicated to celebrations of the Boston Marathon turned to tragedy because of a terrible act.
This was the 26th year working the Boston Marathon for Larry Venis, MEd, ATC, Head Athletic Trainer (AT) at Boston University. In previous years, he had provided more typical athletic training services: assisting runners at the finish line and getting patients into the medical tent when needed. The events of this year’s marathon, however, required Venis to use his emergency response skills in an unexpected way.
Venis was assigned to a section 30-50 yards away from the bombing. His initial thought was that the sound was the subway or a manhole. Then he smelled gun powder, and the second bomb went off. He remembered looking over at the scene, then looking at Ray Castle, ATC, Athletic Trainer at LSU, Jon Dana, ATC, Head Athletic Trainer at the University of New Hampshire and Jack Foley, ATC, Head Athletic Trainer at Lehigh. They ran to where people needed help.
The time was 2:50pm. The elite runners had already crossed the finish line and about 6,000 people were left on the race course.
In the medical tents, ATs, physicians, nurses and EMTs treated runners and bombing victims. Surprisingly, the tents cleared earlier than usual – by 5:00pm.
“This was a huge testament to the quick care of the victims,” Venis said, “The cooperation was unbelievable among the police, emergency medical teams and fire department.”
For ATs, it is the essence of the job to work in the background, so initially the news featured police, firefighters and doctors in the news.
“As an AT, knowing what to do was fundamental. Just being prepared and knowing what we had available was important,” Venis said. “ATs directly helped physicians such as pediatricians and others who were not used to dealing with trauma and emergency care. “
He added, “As an AT understanding acute care, the setting and rehab and counseling experience helped immensely.”
All these elements reflect the five domains of athletic training.
Boston Marathon Medical Director Chris Troyanos, ATC, is the Head Athletic Trainer at Lasell College in Newton, Massachusetts. He works with FEMA, MEMA and Massachusetts Medical Society to coordinate all medical staffing and planning needs for the marathon.
The Boston Marathon has expanded the last 4-5 years, bringing volunteer ATs together from Louisiana State University, South Carolina, North Carolina, Southern Nazarene, Indiana Wesleyan University and Marist College. The volunteers are dedicated; they pay for their own travel and accommodations. Some of the athletic training students receive assistance from Boston University for rooming.
In preparation for the Boston Marathon, ATs receive communications from Troyanos, the Boston Athletic Association and Brian FitzGerald, BSN, ATC, with Boston Childrens Hospital one to two months in advance. Emails or articles are shared with volunteers to inform them about weather and what to expect. Volunteers continue their professional development when they get to the Boston event, as Boston University provides an educational conference the day before the race for AT students and AT volunteers.
The typical day for an AT working the Boston Marathon starts at 7:00am and goes until 7:00pm. The public and runners could spot an AT by a white coat and red hat. There was a group of about 15 AT students with wheelchairs at the finish line, a group that went throughout the streets between the medical tents and another group working at the finish line.
At the Boston Marathon, ATs usually work with dehydration, fatigue, blisters and hyponatremia. Casualties are uncommon and, when they have occurred, have been traced to problems like cardiac arrest.
There were three casualties the day of the April 2013 race. Some of the more than 250 who were injured are still receiving treatment and rehabilitation. In the past 26 years Venis worked a race, he could recall only two casualties.
A few weeks ago, after the bombing, there was a video conference meeting with the medical director and AT leadership of the Boston Marathon and ATs from various universities.
“The support from the Boston Athletic Association and the Red Cross has been and continues to be phenomenal as far as emotional and physical support,” Venis said.
More experienced ATs were concerned with their students. Based on the trauma students saw, it was a quick triage learning experience. Psychological counseling has been available to help with the tragedy and because one of the victims was a student at Boston University.
The finish line was about 1 ½ miles away from campus – very close to where students and ATs were located. None of the ATs were injured, and Venis was proud that everyone on the medical team was accounted for.
“A good amount of healing is still needed to continue,” Venis said. “All the ATs who were there this year as well as students did say they would continue to go back, which is a huge testament to our profession.”