This story was originally published in June 2012:
When it comes to medical care at Shelter Island’s annual 10k race, everything begins with the finish line.
That’s where doctors and nurses are stationed should a racer or spectator need help, and nobody knows the drill better than Dr. Frank Adipietro, head of the race’s medical response team.
“The finish line tent has to have all the ingredients an emergency room has,” said Dr. Adipietro. “It needs doctors, nurses and equipment as necessary, so we can handle anything from the simplest orthopedic problem to a full cardiac arrest.”
Dr. Adipietro and registered nurse Linda Kraus have organized and run the race’s medical support system for more than a decade.
“My husband started running the race 30 years ago,” said Ms. Kraus, “And I followed suit soon after. I became an RN in 1989 and since then, I’ve been involved in the medical tent.”
Dr. Adipietro wrote the race’s medical operations protocol 12 years ago.
“We staff the race every year, always have, and because we’ve improved it to the level we have, I think it will continue the way it has without a glitch,” he said. “When the protocol was first designed, we sat down with police officers, doctors and nurses to formulate it. Linda improved it from a nurse’s perspective and, the truth is, everybody has an important role in this operation, down to the people who deliver ice to the finish line to treat hyperthermia or heat stroke.”
Dr. Adipietro said the staffing model is quite simple. “Linda is basically in charge of the tent and I’m the medical doctor who supervises the nurses. We have two, sometimes three doctors at the finish line.”
The doctor said he’s joined by Dr. Fred Carter, an orthopedic surgeon. Sometimes there’s an ER physician, depending on availability, supported by at least a dozen nurses. Police officers and several emergency medical technicians will also stand by.
Dr. Adipietro said in addition to personnel, there are also four ambulances stationed around the race course, with a vehicle from Stony Brook Volunteer Ambulance Corps at the finish line. That way any of the island ambulances can respond to an emergency without compromising runner safety.
“If a runner goes down on the course, the Shelter Island ambulance will pick them up and treat them,” the doctor said. “If they need more advanced medical care, they’ll be transported to the finish line. We’ll decide if we can discharge them or whether they need to be transported to Eastern Long Island Hospital.”
All race personnel are in direct communication by both radio and cellphone.
“If something happens, the police will frequently be at the site of the incident before the ambulance. Because we’re all in direct communication, we’ll know from the second it happens what needs to be done,” Dr. Adipietro said.
“We had one gal a couple years ago who collapsed on the side of the road just before the final stretch,” he added. “The police department started to administer care to the girl, who was in her early 20s. We knew she was on her way, so we put on the air conditioning in the back of the Stony Brook ambulance so it would be cooled down by the time she arrived. She was ultimately fine within 15 minutes of arriving to the finish line. We put in an IV and applied ice packs to her arms and groin while she cooled down in the back of the ambulance.”
Ms. Kraus said the most challenging part of the race is the final 400 meters, during which runners have to race on grass.
“It’s a tough 400 meters,” she said. “That’s when we see people have difficulty. We had an elite runner collapse around that field once from dehydration. We brought her to the medical tent and checked her sugars. But I think we’ve had a pretty good record of nothing really serious happening.”
Ms. Kraus said medical professionals closely watch at the race clock for the hour mark.
“People want to make it in under an hour, so you have to watch that,” she said.
“As runners start to finish the race, about 45 minutes in, we begin to get busier and busier with orthopedic problems, exhaustion, dehydration and sometimes heat stroke or worse,” Dr. Adipietro said.
If someone has heat stroke, they could be disoriented or unconscious, the doctor said.
“If someone is not sweating anymore, that’s a very bad sign,” said Dr. Adipietro. “Another thing we’ll notice is people shivering because their body is not physiologically working right anymore. Other things that could occur with heat stroke are shortness of breath, chest pains and even seizures.”
Last year a spectator with an underlying medical condition had either a stroke or seizure near the finish line and was taken to ELIH.
Both the doctor and Ms. Kraus advise runners to avoid medical surprises or problems with staying hydrated as the top precautionary measure.
“There a lot of different ways to handle dehydration but the key is prevention,” Dr. Adipietro said. “Drink adequate fluids up until race time and supplement with fluids with electrolytes, like Gatorade. If the runner stays hydrated up until race time then during the race there’s a water station at every mile mark.”
Both professionals said drinking water even if you’re not thirsty is also key and if someone feels dizzy while running their advice is to stop.
As part of the protocol, police will advise runners who don’t look well to stop running, Dr. Adipietro said.
Ms. Kraus said a big tip for young runners is making sure they don’t drink too much alcohol the night before a race.
“Running a race, even a 10K, is all about the night before, so you don’t want to party,” she said. “That’s why we have the pasta night. It brings people together the night before to prepare for the race in a healthy way. It’s also important not to sit in the sun all day or eat directly before the race. Watch how much sun you get because a lot of races are run early in the morning and this one is at 4 or 4:30 in the afternoon, so people tend to go down to the beach beforehand.”
She said this year’s race is the 33rd.
“This is a great give-back and community event,” Ms. Kraus said. “When you love something, you just kind of ask, ‘What can I do to give back?’ ”
The race, started by South Ferry owner Cliff Clark, has donated over half a million dollars to various charities.