Audrey Fraizer

Audrey Fraizer

Best Practices

By Audrey Fraizer

There are some things that response just won’t do, no matter who calls the shots.

For example, would you send one of your responders into a marsh to retrieve a microphone on the green that an alligator decided was a “must-have” item in its nest?

The answer depends on your perspective, according to Don Lundy, director, Charleston County EMS, S.C.

If you’re the technician concerned about losing a $1,400 piece of equipment or a spectator worrying about a close encounter of the wildlife kind, maybe.

If you’re the person in charge of handling emergency medical services for the six days the PGA is in town, not necessarily. Your priorities might not be on par with event hosts’.

“We knew the gators were there,” Lundy said. “But we weren’t going to get the microphone just because the technician wanted it back.”

Lundy was in charge of EMS operations during the 94th PGA Championship held on Ocean Course, Kiawah Island, in South Carolina. Reasons that PGA officials chose Kiawah Island are much the same reasons the island’s a popular destination for thousands of visitors: golf courses, natural beauty, and protected natural habitat for viewing wildlife; gazing at the 600 to 700 gators on the island from a respectable distance is spectacular.

While Charleston County EMS is no stranger to large-scale events, the PGA is unique wherever it’s held because of the way the game is played and the PGA rules. Charleston County officials were told to anticipate 35,000 tourists daily plus the media and golfers. PGA rules restrict portable toilets and water stations to areas outside of where camera crews film.

Unlike a foot race or national political convention, play is going on at several locations at the same time, with crowds following players of their choosing.

“Staging units for response time [without a major event] is a hair-pulling experience,” Lundy said. “I can’t say we expected a nightmare, but we knew it was going to be a challenge.”

Never without a new challenge

The 13.5-square-mile Kiawah Island is a private, exclusive resort and residential area. It is considered one of the East Coast’s premier golf destinations. The island has two medical centers—urgent care and family medicine—and the closest hospitals are 22 miles away in downtown Charleston. A single two-lane road connects the island to the mainland.

Charleston County EMS runs 16 ambulances and in 2011 they responded to more than 139,450 calls for assistance resulting in nearly 50,000 responses. During the same year, the county had just started construction of its $26 million consolidated communication center and emergency operations center. The facility was scheduled for opening the following year (before the PGA was scheduled to arrive).

The six-day tournament—two days of practice, two days of elimination, and two days of final play—brings in an estimated $100 million for the host city. In return, PGA officials don’t welcome the potential of something going wrong, and they do put their money where the championship goes.

“They spared no expense, and gave us a long lead time to prepare,” Lundy said. “Something bad happening on the island would have been ugly for everyone.”

Planning started 26 months in advance with EMS and PGA officials holding one meeting per week up until the tournament. The PGA regulates “every square inch” of the golf course selected, including spectator-viewing areas, Lundy said. The PGA also works with municipalities to help plan for traffic control.

The first step for EMS was an Incident Action Plan (IAP), which included the process emergency communications would follow and where to locate the trailer in relation to the command post at Cougar Point Clubhouse.

“It had to be the safest place possible,” Lundy said.

They borrowed XL radios from state police and brought in maps of the Ocean Course and surrounding area in the event the Geographic Information System (GIS) went down. They planned on extensive use of FirstWatch, a software surveillance system that allowed them to analyze the clustering of calls.

“FirstWatch kept us ahead of the curve to allocate resources,” he said.

There was also the matter of staff convenience.

“We brought dispatchers in early in the process,” he said. “Personal comfort was important.”

The communication center was set up a fair distance from parking lots, which meant dispatchers, working 10-hour shifts, had to walk more than a mile in hot and humid weather. Shifts were arranged to avoid peak traffic times. Food was purchased from the clubhouse at lower prices compared to meals sold to spectators, and dispatchers were advised to bring in ample water for drinking. Upon request, the PGA brought in a 47-inch TV for a visual tracking of the players.

The PGA covered all overtime costs.

As the time clock clicked, bleachers were going up along with luxury boxes; a 32,000-square-foot golf shop was built in just three days and a 40,000-square-foot tent was dubbed the largest-ever PGA sports bar.

During the event, temperatures were in the high 80s, with humidity values above 60 percent, exacerbating concerns of dehydration. Spectator water rules were modified to allow entrance with one sealed water bottle.

Police officers were posted at key intersections along the routes. Charleston County Sheriff’s Office air support and motorcycle units monitored the single route continuously. Parking was monitored to maintain corridors for emergency transport. Ambulances were given the right-of-way even when the noise might interfere with the concentration of a golfer in play.

“They understood that,” Lundy said. “Once someone gets in the back of the truck, we’re the player.”

There are some things, however, that happen outside the control of the best-laid plans.

Cars broke down on the way in and buses broke down on the way out. The number of sports broadcasters arriving from around the world for the last two days of the championship interrupted emergency radio systems. These “microwave wars” overrode signals at the receiver and blocked emergency radio transmissions.

“Be forewarned,” Lundy said. “On the last day, we had nothing but digital.”

Lundy said the two “burn downs” to discuss what went right and wrong revealed the success of the event.

“We never had a bad day because we respected each other’s mission,” he said. “The PGA said they’d love to come back, although I’m not sure the islanders would say the same.”

Lundy also offered the following recommendations:

•Preplanning is key—get everybody around the table as soon as possible.

•Set up a predeployment plan—Charleston County EMS established two: one for the PGA and the other for a 20-mile radius of the island.

•Come prepared—don’t assume residents will welcome you.

•Make friends with key people—how else do you buy meals at reduced costs?

•Plan for the unplanned—no matter how ridiculous someone’s suggestion might be, it could turn out to be a game changer.

•Maintain perspective—it's not the place for people with short tempers.

•Flexibility is key—not everything goes exactly as planned.

Facts and figures from the 94th PGA Championship

•Medical staff treated 180 attendees, with the common medical problems being abrasions, lacerations, abdominal pains, and heat-related symptoms such as dizziness and chest pain.

•Only three patients required transport to the hospital; all other patients were treated on-site at the numerous medical stations staged throughout the Ocean Course.

•Figures from the Charleston Convention and Visitors Bureau show that hotel occupancy in Charleston County was about 86 percent.

•More than 91,000 room nights were booked in the county and the average daily rate was almost $149.

•College of Charleston researchers earlier projected that the championship at the Ocean Course would mean about $92 million in direct tourism impact.