For Baltimore's emergency workers, the Baltimore Grand Prix Festival of Speed is more than a three-day party surrounded by shrieking Indy cars.
It's 40,000 to 80,000 people a day — many with medical issues, bad judgment or evil intent — jammed in by closed streets and barricades, surrounded by speeding cars and volatile fuel, all just a week before the anniversary of the Sept. 11 attacks.
Planning how to keep fans and participants safe, treat the sick or injured at the race site, and move them quickly to area hospitals if necessary — while keeping the rest of the city's emergency medical network working — has taken months. It's also demanded the cooperation of the U.S. Department of Homeland Security and a dozen other agencies, public and private.
"Given the proximity of downtown, and the number of stakeholders it affects, logistics and pre-planning, it's the biggest thing we've ever tackled," said Robert Maloney, director of the Mayor's Office of Emergency Preparedness.
The only other Baltimore events that might compare, said Fire Department spokesman Chief Kevin Cartwright, are the two-day visit of Pope John Paul II in 1995, this summer's July 4 crowd and President-elect Barack Obama's stop just before his inauguration in January 2009.
Police will be out in force this weekend. Officials wouldn't provide a specific number, but said hundreds of officers from the city and neighboring localities will be both inside and outside the track.
"You'll see a very large number of uniformed police officers on the corners," said city police spokesman Anthony Guglielmi. "What you're not going to see is several hundred — literally — plainclothes officers. They'll be wearing Orioles shirts or Ravens jerseys. You might think they're a regular spectator, but they're there to make sure the fans are safe."
There will also be a private security firm working the race. And the increased police presence will continue at night, after the races, when tourists are enjoying Baltimore's night life.
Guglielmi said the rest of the city won't be left short of officers. "It's going to be an all-hands-on-deck approach."
Some 175 Baltimore firefighters and medics will be on the job, too, according to the International Association of Firefighters Local 734. They'll include 30 "pit groups" along Pit Lane, and a team ready to respond to any collapsed stages or grandstands.
Planners have also prepared for the possibility of mass casualties, either because of a race-related accident or a terrorist incident.
There have been no terrorist threats, officials said, but race planners and Homeland Security officials recognized that a huge, tightly packed crowd, gathered just a week before the 10th anniversary of the 9-11 attacks, might be an attractive target.
"We're utilizing this as an opportunity to integrate all the closed-circuit TV — 300 cameras, private, state and city — into one platform we can watch and manipulate," Maloney said. "We've also done a tremendous amount of additional planning with Homeland Security."
Without disclosing specifics, Maloney said race planners have worked with the FBI; the Bureau of Alcohol Tobacco, Firearms and Explosives; the Maryland State Police and the U.S. Marshal's Office, to prepare. They've established unified command centers in several positions around the harbor area, including the 17th floor of the World Trade Center, which offers a panoramic view of the area.
The command centers began operating at 5 p.m. Sunday, and will continue until 5 p.m. Wednesday, he said.
A key issue was the recognition that spectators and race crews — not to mention guests in three hotels — will be inside the race course, cut off by speeding cars and barricades from easy access to the city's hospitals.
Here's how a medical emergency might play out if a spectator is struck by crash debris, or if someone within the track perimeter begins to have chest pains:
A call to 911 would be relayed through the city call center to the Fire Department's Mobile Command Center. It's a large van parked near the main entrance to Oriole Park on Russell Street, said Alex Perricone, deputy chief for emergency medical services.
Commanders there will dispatch one of five, two-person paramedic bike teams.
"They carry advanced life-support equipment, medications, blood-pressure cuffs, cardiac medications," he said. "They have the capability to fully resuscitate that person. … The only thing they can't do is transport on a bicycle."
Transport would be assigned to one of six paramedic carts — all-terrain vehicles called Gators, equipped like miniature ambulances, Cartwright said.
"They look like mini medic units, with a stretcher and one person in the back," Cartwright said. They can carry patients directly to the nearest of three First Aid stations inside the track or, scooting across pedestrian bridges or through an underground tunnel, to the nearest ambulance outside the track.
Decisions on whether to send patients to an aid station, or directly to an ambulance for the ride to a hospital, will be made in the command center by the Fire Department's medical director, Dr. Wade Gaasch.
The aid stations are 10-by-20-foot tents, to be staffed by Johns Hopkins Hospital with seven to 10 medical professionals each, including two emergency physicians, several nurses and paramedics, Perricone said. The stations will be located between Oriole Park and the Hilton; near Howard and Pratt streets (inside the track), and near the police booth north of the Maryland Science Center.
Working out of headquarters in the 600 block of W. Pratt St., and a race command post alongside the warehouse at Camden Yards, Maryland Institute for Emergency Medical Services Systems personnel will be tracking patient traffic through the Grand Prix aid stations. And, using the state's emergency database, the staff will send computer alerts to area hospitals.
"If we needed to know how many patients a hospital could handle at that moment, they can enter that data for us," said John Donohue, chief of field operations for MIEMSS. The agency could then direct patients to the nearest emergency department that's best situated to help.
The closest hospital is the University of Maryland Medical Center, just blocks from the race.
UMMC "is always available 24/7 to receive and treat transported patients, and we will be staffed for emergencies and care of the critically injured or ill in both our Emergency Department and in Shock Trauma," said Mary Lynn Carver, senior vice president for communications. Outpatient offices normally open on Friday or Monday may be closed or on reduced hours because of the holiday weekend and low patient volumes, not the race.
A UMMC physician and nurses will also be the "on-track providers" for the Grand Prix drivers, pit crews and other race personnel. Any injured race participants will be moved to a mobile race hospital staffed by UMMC caregivers.
Cartwright said Fire Department medic units will be positioned around the track. "There are gates and fences positioned where … God forbid, if a car flips over, we will be able to get one of the entryways open for a medic unit to pull inside."
Perricone said there is a gate at Turn 12 near the Hilton, where an ambulance can exit the track to reach University Hospital and the Shock Trauma Center.
Donohue reminded spectators to do their part for safety, too. "If it's hot, make sure you've eaten well before you leave the house. Make sure to drink plenty of fluids — not alcohol or caffeine. Those fluids [are dehydrating, and] will not help a lot."
While the Grand Prix is a big and very unusual event for Baltimore's medical and fire services, those in charge are confident their planning will keep things running smoothly, both inside the track and beyond.
"It's very unique and exciting opportunity to display what the city can provide," said Perricone. "We're really excited to be a part of it. We're going to do our best to make sure everybody has a fun, safe time."
Baltimore Sun reporter Justin Fenton contributed to this article.
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