Leading with Digital at a Top Ten Marathon

How for more than 20 years 140+ Minnesota Radio Amateurs have led the emergency and medical communications at the Medtronic® Twin Cities Marathon

Erik Westgard, NY9D

9/19/13 ewestgard@att.netVolunteer Medical Communications Coordinator,

Medtronic Twin Cites Marathon

Red White and Boom Half Marathon

http://www.14567.org

1. New York City Marathon 47,000 registered participants in 2012 2. Chicago Marathon 37,455 finishers in 2012 3. Honolulu Marathon 24,413 finishers in 2012 4. Marine Corps Marathon 23,515 finishers in 2012 5. Boston Marathon 21,544 finishers in 2012 6. LA Marathon 18,729 finishers in 2012 7. Walt Disney World Marathon 13,467 finishers in 2012 8. Philadelphia Marathon 11,553 finishers in 2012 9. Twin Cities Marathon 8781 finishers in 2012 10. Houston Marathon 7637 finishers in 2012

https://everymove.org/blog/the-10-largest-marathons-in-united accessed 9/19/13

The Most Beautiful Urban Marathon in America®

12,000 Marathon starters, 10,000 10 Mile starters, 200,000 spectators

Medical Personnel on the CourseThe marathon has one of the best medical teams in the industry and is led by Medical Director, Dr. Bill Roberts.  On average, one to three percent of every 1,000 entrants will seek medical assistance along the course or at the finish line. With that in mind, 300 medical personnel are positioned along the course and at the finish line. All medical personnel can be identified by their orange vests and all are trained to assist in medical care. A medical team will be assigned to each aid station along the course. There are also medical volunteers stationed at many of the mile and half-mile marks of the race course.  Communications personnel in yellow shirts are paired with the medical volunteers to provide access to mobile medical teams and ambulance services. Seriously injured or ill runners will be transported to the nearest hospital from any of the Medical Aid Stations on the course, and well runners who drop out of the race will be taken to the finish area. Medical volunteers will have first aid supplies at every medical location. 

What is our Job?

https://www.tcmevents.org/events/medtronic_twin_cities_marathon_weekend/marathon/medical_information/ Accessed 8/13/2013

Simplified Event Communication Structure

Race Director Incident

Commander

Race Operations

Medical Director

Medical EMS

Course MarshalsOther race officials

Med VolunteersAmateurRadio

EMSFireEtc.

EventCommunicationsCenter

NormalReporting

In a declared emergencythe Incident Commandertakes over

Under normal operations, the event communications center provides radio and other channelsto support the event. In an emergency, all resources are available to the Incident Commander

Best practice:An IncidentAction Plan(IAP) is on file

Marathon Patient Flow

Chest Pain

Ice pack, etc

All other

911+ Location tracking(+MNTRAC etc.)

Location Tracking(admit/discharge)Personal HealthRecord download

Hams as third backup system

SAG wagon dispatching

Injured runner tracking- packet

Vehicle position reporting (APRS(r))

Family Medical DatabaseMed Tent Admit/Discharge

MTCM Medical Team Amateur Radio Project Evolution

1985 1995 2005 2015

D-Star and 802.11 for scale >

Personal Health Record

Physician Order Entry

TabletsHam dispatchers

Hospital tracking >

NIMS/ICS

www.14567.org 7/7/2013

AidStations

Net1 Data +

22 WaterStops/120 YellowShirts

5 + 4 voice5+1 D-Star Repeaters911 serviceRented UHF5G Mesh backbone

Net Controls- distributedNets 1-3 D-Star data entry/queryOn-Course Med Director

Finish Line EMS Dispatch Database Net 4 (course inter-tie)Medical Ch.1 ControlMedical Director

Family Medical/Med TentBus Drop-off iPadsIP phones

Marathon Course Medical Communications 2012

Race Weekend General Principles:Yellow shirts (hams) backstop medical operations - report and notifyInjured /dropped out runner location data flows to the serverCourse tactical operations are autonomous (ICS)

Finish Line802.11g/n protocol

2-3 D-Star Uplinks802.11n/OLSR mesh link (Finish line to St Paul EOC)

Net2 Net3 Medical Tent

Family Medical

News for 2010- iPads for check in – hospital tent New for 2011 – IP PhonesNew for 2012- Mobile apps Family Medical Information

Runner tracking and situation reports – TrivnetDB in the main Comm Center at “Course Medical” Net Control – note rented UHF radios + Ham “Dispatchers” on Course and Finish medical channels

2003-2012 Medtronic Twin Cities Marathon

Finish Line Comm Ctr Net 4 Control TCM Ch1/Ch 6 (UHF) Finish area dispatch

Med Tent Med Info Tent (x6)

Amateur Radio Medical Communications Support System

PDA 802.11n(Security, MDs)

Ipad 802.11nCheck-In

Ipad 802.11nDischarge

Laptops 802.11aWin XP

Bus Drop-offStation802.11n Laptops

Trailer Linux /MySQLTrivnetdb 2.0

802.11nWeb

D-Star

Net 3+4/VoiceRamsey Cty EOC

D-Star

Net 2+4/VoiceHennepin Van

D-Star

Net 1+4/VoiceNorth Memorial

D-Star

D-Star DD IP was primary in 2008+ Com Ctr x3

Laptop 802.11gWin XP

Laptop 802.11nRecords

Mile1-19

Mile23-26

Mile20-22

Net Control

+ 6-8 carts

Six overlapping DD mode systems provide reliable, web app friendly high speed data (TCP/IP) coverage for the core Twin Cities Metro

www.14567.org D-STAR MSP 8/13 DD Mode

Ham Radio Trailers, County/State VansTrivnetdb Database +web front endID-1 Radios – data /application uplinks

ID-1 RadioUsers (remote)links to trailer

Mining ARC (Ramsey)@280 feet

90kbps 90kbps

LocalLaptopsVia 802.11g

Erik Westgard. NY9D

Linux SystemCitadel, DNAT

DSTAR Controller and Data Repeater

MinneapolisSouth (MSP, MOA)@200 feet

DSTAR Controller and Data Repeater

Linux SystemCitadel. DNAT

DSTAR Controller and Data Repeater

Linux SystemCitadel, DNAT,

St. PaulOne (State EOC, MDH)@260 feet

Linux SystemCitadel, DNAT,

DSTAR Controller and Data Repeater

MinneapolisEast (Hennepin)@260 feet

ID-1

Gateway

DSTAR Controller and Data Repeater

MPLS N @290 feet

Linux SystemCitadel, DNAT,

Packet

DSTAR Controller and Data Repeater

MNWash *Bayport @600’

ID-1

ID-1 ID-1

Icom D-Star DD Mode + DNAT

RP-1/2D

ID-1

LinuxAppliance

DNAT Other servicesPacketWebsite CitadelLinksOLSR

ID-1

Fields not in order: DCall Rcall1 G Rcall2 G SCall Payload

TrivnetdbServer

ID-1

ID-1

Ethernet

Database and or Internet

Stock DD RP unit is a simplex Ethernet bridge using callsign encapsulation. It supports oneto one for ID-1s, but multiple connects to the repeater Ethernet. If you run multiple subnets,and DNAT on the back end appliance, multiple ID-1-ID-1 user (TCP/IP) sessions are possible

With DNAT, all ID-1 users (L3) can reach the server, and each other

“G”

New Web Interface- Trivnetdb

Missing /dropped out/ill runner web runner lookup and update

Runner location only- non HIPAA

Racesafe Proposed Integration 1.0

irunsafe.com trivnetdb in

the TCM data trailer

API

Amateur Family Medical Information Tent agents (6-8)

Either a singleintegratedview or windows to both/all apps

TCM Race Timing Web

MDsMedical\admissions

Command centersQuery + updates

Events +Timestamps

Part 97 Requirements:Non HIPAA event view,API feed to trivnetdb

EMRPHRdata

Mobiledevices

MNSTPMNAUGMPLS-N

MNWASH

MPLSS

MPLSE STPONED-Star DD Mode Disaster Nodes100kb no InternetCitadel / trivnetdb

MinneapolisRed Cross

MNEOCMDH

5G Mesh 802.11aOpen WRT

ColorsBlue- DD ModeOrange 5GPurple- both

oror

ISP

MNRAM

TwinsLAN 2.0 – 802.11a Mesh NetworkingAugsburg is the hub OLSR routing protocol Some D-Star sites may join the backbone

3mb/sec

Mesh/OLSR 2013

Explorer 8DefaultTimeout

Ubiquity 5G 2 mile path NanoStation >NanoStation

Case Study

• Pandemic Flu or Anthrax • Need a vaccination/treatment station in two

hours for 20,000 people in a public building• Need to track who got vaccinated, adverse

reactions and vaccine supplies/delivery out of region

• Massive “buzz” going on- infrastructure and transportation disrupted

Cellular Jamming

http://www.bomb-jammers.net/?m=201305 Accessed 9/19/13

Lessons Learned

• Served agency alignment is key- wear their badges – “embedded”

• Focus on the mission

• Data is the coin of the realm

• There is an app for that

• Think scale and pre staged infrastructure

• Being prepared for the last conflict is unhelpful- shadows, go kits, slow data modes, etc.