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Army Ten-Miler Called for Excessive Heat

A group of runners in mid stride as they start the race. A wave of runners cross the start line in the Army Ten-Miler Oct. 8, 2017.  (Photo Credit:  U.S. Army photo by Joseph Lacdan)
USU Faculty, Fellows and Students Lead Medical Team, Treat Casualties

By Sharon Holland

Tens of thousands of runners converged on Washington, D.C., Sunday, Oct. 8, for the 33rd annual Army Ten-Miler race, but as the temperatures rose, so did the number of the heat casualties, leading to the race being shortened and reclassified as a “recreational run” at 10:08 a.m.

A team of personnel from the Uniformed Services University of the Health Sciences (USU) provided medical support for the second-largest 10-mile race in the U.S.

Two runners get splashed with water by military volunteers on the sidelines
Runners get splashed by volunteers in an attempt to cool down during this year’s Army Ten-Miler. Record temperatures and high humidity forced race officials to call the race and reclassify it as a recreational run on the recommendation of USU faculty overseeing medical operations for the race. (Image credit: John Sonderman/Flickr)

Conditions were relatively warm and humid as the race began at 8 a.m., with temperatures in the 70s, but only 45 minutes into the event, as the thermometer rose into the 80s and the humidity levels climbed, runners began suffering from a variety of heat-related illnesses. According to the National Weather Service, it was the warmest low temperature in Washington, DC, in the last 145 years.

At 10:00 a.m., the medical team recommended that race officials call a halt to the competition to keep things from getting worse.

Infographic: Title: Race Stats. 8:00 start time > 35k runners > 1,500 lbs of ice > 264 heat illnesses > 34 ambulance transports > 10:08 race called
"The safety of our runners is paramount. The Military District of Washington is committed to providing a world-class road race in a safe and secure environment," Jim Vandak, Army Ten-Miler race director, said in a statement posted on the race website. "The decision to downgrade the road race was made in coordination with medical, safety and race operations personnel."

Exertional heat illness occurs with prolonged intense activity, most frequently in hot-humid conditions. There are many types of heat illness, including cramps and exhaustion, which can be the result of fatigue, body water or electrolyte depletion and other factors. Exertional Heat Stroke (EHS) is the most severe form of exertional heat illness and is a medical emergency that is lethal up to 90% of the time if not rapidly recognized and appropriately treated.

More than 264 patients were treated by USU faculty, medical students, and National Capital Consortium Primary Care Sports Medicine fellows, along with staff from several National Capital Region military treatment facilities, in four medical tents on race day. Thirty-four patients were transported to area hospitals by ambulance. Thirty runners were treated for EHS in one of four ice baths running almost continuously for much of the race.  More than 1,500 pounds of ice was used to provide life-saving treatment for runners with EHS.

USU protocol officer Joshua Barricklow was one of this year’s race participants.  “It was unpleasant and warm for this time of year and very humid. It rained some early on, which helped a little, but then you're soaked and still having to run five to six miles. It felt like all I heard for the last two miles were sirens. Runners were dropping all over the place. I was in the first wave and seeing that...I can only imagine what it was like for the later waves,” he said.

A group of volunteers pose for a photo outside of a medical tent
USU faculty, medical students and NCC Primary Care Sports Medicine
fellows, along with healthcare providers from other National Capital Area
military treatment facilities were responsible for the care of more than
35,000 runners at the 2017 Army Ten-Miler, Oct. 8.  (Image credit:
courtesy of Dr. Christopher Jonas)
As patients continued to pour in, USU team members were key in recognizing and treating them,  including medical students Army 2nd Lts. David Ediger, Taylor Reffett, and Paige White, Navy Ensigns  Vivek Abraham, Ingrid Carnevale, and Paolo Rigo, Air Force 2nd Lts. Sydney Giblin, Nate Ford, Brett Rasmussen, and Connor Kelly, who worked with deliberate efficiency under the supervision of Fort Belvoir Sports Medicine physicians Army Maj. (Dr.) Chad Hulsopple, Air Force Maj. (Dr.) Cole Taylor, and Army Maj. (Dr.) Jesse Deluca as they took care of the runners.

And they were prepared.  On Tuesday October 3rd, prior to the race, USU hosted the first ever Army Ten-Miler Medical Symposium in preparation for the race.  Symposium topics included management of EHS, mass event coverage, collapsed athletes, stress fractures, running injuries and many other race-related subjects taught by sports medicine experts from USU, Fort Belvoir, the U.S. Naval Academy, Johns Hopkins University, and Walter Reed National Military Medical Center.

“I think we were definitely ready to handle the casualty load,” said 2nd Lt White.  “Each medical student was paired with an attending and the ‘heat teams’ were formed from there. A ‘heat team’ was basically an attending, a medical student, and extra staff like a resident, corpsmen, medics, etc. In the hours before the race began we did practice runs so each team was prepared to take a patient, carry the litter, and move them into an ice bath when it was time. This structure ensured the safety and smooth flow of patients and allowed for an organized hand-off to the EMTs. The staff of the race and the medical tent noted that we were hit with more heat casualties than they had seen for a long time, however, everybody still worked like a well-oiled machine even when it felt like we were bombarded with casualties.”
Four runners (three male, one female) pose for a group photo in their running gear with their numbers on their clothes
USU medical students Army 2nd Lts. Tim Zerhusen. Eric Adams. Air Force 2nd Lt. Tora Cobb, and Public Health Service Ensign Quinn Bott braved the rephoto)cord temps and humidity to run the 2017 Army Ten-Miler, Oct. 8.  (Image credit: courtesy photo)

“This felt almost exactly like providing care during mass casualty situations while deployed. This dedicated and totally unified joint service medical unit prepared and performed in a truly extraordinary way,” said USU assistant professor of Family Medicine Lt. Col. (Dr.) Christopher E. Jonas, who served as Chief Medical Officer of the race and director of the medical symposium.  “This was a total team effort and every member provided tireless, coordinated, and efficient expertise.”