Nurse Katie Powers, a volunteer in the medical tent at last year’s Boston Marathon, was checking the blood pressure of a runner when, through her stethoscope, she heard an odd thud.
She looked at her patient, a young woman, and thought, “There’s something wrong with this girl’s blood pressure.”
Then, another thud. Powers looked up at the large-screen TV monitoring the race and saw a plume of smoke.
Two bombs had exploded near the finish line, killing three people and injuring 265, some in life-altering ways.
At her day job in Bradenton, Fla., Powers works with new mothers, advising them about breast feeding. But on that day, she was among medical tent volunteers who were told to get ready for “incoming wounded.”
“So,” she recalled this week, “we went from a well-managed first-aid station to a field hospital in the course of a minute.
“It was a life-changing event.”
Powers has volunteered at more than a dozen marathons in recent years, including the Cowtown, where she will work again this weekend.
The event is expected to be the biggest ever, with an estimated 30,000 runners. Many were entered in the Dallas Marathon in early December, but an ice storm canceled that event. The Cowtown is a chance to gain qualifying points to run in the spring in Boston.
With so many participants, Dr. Darrin D’Agostino, the Cowtown’s medical director, knows his team will be busy treating people for the usual dehydration and abrasions, as well as the occasional cut that needs a suture.
In case something more serious happens, D’Agostino said, his staff will be ready.
D’Agostino chairs the department of internal medicine at the University of North Texas Health Science Center at Fort Worth. This is his second year as the Cowtown’s medical director.
His counterparts in Boston are longtime friends of his, and he has talked to them about the bombing. They had photos of casualties far more gruesome than what appeared in the media, he said.
“These were wartime injuries at a peaceful sporting event,” D’Agostino said. “There was a picture of one guy who would never walk again — a horrendous injury for no good reason.”
But D’Agostino credited volunteers such as Powers, who worked closely with police and other first responders, for saving numerous lives.
A similar framework will be in place in Fort Worth, D’Agostino said.
In Boston, he said, medical personnel were clearly identified with credentials and white jackets, allowing police to get help to the victims because everyone else was kept away. The area had become a crime scene.
“One of the things we learned from that is we’ll need to identify our personnel with different-colored vests and ID badges — those people who are allowed in certain areas,” D’Agostino said.
On Wednesday, D’Agostino unpacked red vests with white medical crosses for volunteers such as Powers to wear in the medical tent. Only medical personnel with special yellow vests will be allowed at the finish line.
D’Agostino will also wear a special jacket, either orange or bright green.
He’ll be shadowed by a shortwave radio operator who will keep him connected to first-aid stations along the route and emergency medical technicians and medics on bicycles.
D’Agostino met with police and firefighters Monday to discuss security, which will include an increased public safety presence. He said there was information from federal law enforcement groups, although an FBI spokeswoman referred all questions to local police.
“Walking out of that meeting, I was very confident this will be a safe and secure race,” D’Agostino said.
Fort Worth police will deploy “additional uniformed and undercover officers to supplement those already assigned to festivals, races and events,” Cpl. Tracey Knight, a police spokeswoman, said Thursday.
“In addition to the officers, bomb-detecting K-9 units will be sweeping the area.”
People should “remain vigilant and report anything suspicious to the nearest police officer or call 911,” she said.
A MedStar Mobile Healthcare official said the ambulance service has been working closely with public safety officials preparing for the Cowtown.
“When you combine spectators, participants, staff and the length of the route, it poses many different challenges,” said Michael Potts, MedStar’s special-operations supervisor. “We will staff a command post with Fort Worth [police], Fort Worth [Fire Department] and Cowtown Marathon to monitor and coordinate responses.”
The command post, he said, “will unify the responders with the event to allow for seamless communication and response efforts for all stakeholders involved.”
Heidi Swartz, the marathon’s executive director, said Wednesday that about 30 active-duty soldiers from local Army recruiting offices will enhance the uniformed presence.
Runners won’t be allowed to have friends or relatives stand with them at the starting line, Swartz said. Nonparticipants must stay behind barriers.
Runners can’t bring personal backpacks or duffel bags to the gear-check areas but can use clear plastic bags provided by the marathon, Swartz said.
No backpacks will be allowed along the course, but runners may use hydration packs, Swartz said.
The suspects in the Boston attack, Tamerlan and Dzhokhar Tsarnaev, used backpacks to tote their bombs, officials have said.
“The banning of backpacks on the course, that’s because of Boston,” Swartz said. “We’ve always had really good security at the Cowtown, but people may not have noticed it before.
“This year, we want people to see [security] a little more to make them feel comfortable.”