For more than two decades Ricardo Martinez has coordinated medical care at America’s most popular sporting event. He can answer just about any question about stadium EMS . . . just don’t ask him for free tickets.
Ricardo Martinez, an emergency physician from New Orleans, has made some unusual medical supply purchases in his career. Once, in the 1990s, he purchased America’s entire supply of nerve gas Atropine pens that wasn’t on reserve for the U.S. military. Nowadays, he might be found planning for a different kind of disaster – most likely biological – but the job has remained the same: protect the attendees at America’s most beloved sporting event.
Dr. Martinez is the founder of Medical Sports Group, a company that provides medical services to the Super Bowl. Martinez has been basically writing the book on stadium medical care for the last 22 years, ever since he was first asked to consult on Super Bowl EMS services. But that’s getting ahead of the story. It all started with some abdominal pain.
“About 27 years ago, an overweight gentlemen came into my ER with right lower quadrant pain,” says Martinez. “As we talked, it became clear that he had a gall bladder attack. He was on his way up to work with the NFL for the Super Bowl. He asked me a lot of questions about the medical care.” About seven months later, Martinez was invited by the Stanford athletic department to come help them set up a system of medical care for their stadium. “I went over there and this tall, thin guy explained things to me and asked what I thought. He said, ‘you don’t remember me, do you.’ I said not really. He pulled up his shirt and showed me his gallbladder scar. It was the same guy, just 50 pounds lighter.”
The two men joined forces and established a sophisticated system to manage the Stanford stadium. They utilized computers, even in those early days, to log and track data. Some of the same people who worked at Stanford also happened to work for the NFL, so it wasn’t long until both men were pulled up to the big leagues. “In 1988, I was asked to work with the Super Bowl, to help them better understand EMS. At that time, EMS was kind of buried under security. What we found was that the EMS services were being staffed by a ‘friend-of-a-friend,’ some guy who knew somebody, but there was no real plan. So we started coming through and doing evaluations, making suggestions.”
This went on for a couple years, and then something changed the equation forever: The 1990 Gulf War, and the threat of a nerve gas attack. Coinciding with this new threat was the appointment of Paul Tagliabue, a lawyer, as NFL Commissioner. “All of a sudden the issues that I was dealing with came front and center,” says Martinez. “I found myself often being brought up to the commissioner’s office where they were concerned with how to protect the fans. They wanted to know what they could do to respond to the various threats.”
Thus what began as a two-man operation, involving duct tape and makeshift signage, quickly began to expand. Martinez added two other emergency physicians, and then in 2001 he asked the NFL if they could add additional staff to help focus more on disaster planning. “We did add another physician, and then two weeks later came September 11. At that point, everything ramped up tremendously. The game in New Orleans that followed the attacks on September 11 really had some of the most heightened security ever.” One particular planning session with secret service agents changed his perspective on disaster planning completely. “We met with the Secret Service to discuss ‘what-if’ scenarios. Then a man with a toothpick sticking out of his mouth said, Hey Doc, we don’t deal with ‘what-ifs. We deal with ‘when’.”
That year Martinez and his team helped stadium managers plan an 8,000 square foot hospital that was constructed beneath the stadium. There was a biological attack contingency plan that included a four-block stretch of overhead showers, to decontaminate people escaping from the stadium. In this scenario, the crowds would be instructed to strip down while running beneath the showers, placing their contaminated clothes in plastic bags. At the end of the shower area would be tens of thousands of blankets, and 14 municipal busses waiting to transport people to a nearby Army barracks for further care. Thankfully, none of these carefully scripted chess pieces needed to be deployed last year, and the crowds remained blissfully unaware of the labor going on behind the scenes.
Beyond the Big Show
The Medical Sports Group gets involved in the Super Bowl long before the big game kicks off. They orchestrate NFL family medical care, oversee team care – including their hotels, their families and practice sessions. “Really, the game day is the big finale,” said Martinez. “It’s only one part of a very long process.” Martinez and company do the credentialing and certification for the providers who are going to be at the game. They work with the architects to do risk management and install temporary first-aid stations. They even provide care for VIP guests and spectators. And that doesn’t even count the many ancillary events hosted in the stadium in the lead-up to the final game. “You may have over 100 events associated with the game,” said Martinez. “We require medical plans to be written for every major one.”
Increased Security Changed the Medical Process
Not surprisingly, since the threat of terrorist attacks has been heightened in recent years, Super Bowl security has been ramped up dramatically.
“During the games we have sensors for chemical, radiologic, biologic and nuclear hazards. We have pat-downs, magnetic detectors, bag searches. No vehicles can get in or near the stadium.” Those barriers and restrictions impact medical care, specifically the ability to maintain a certain emergency response time, says Martinez. “So now we have a lot of resources inside the barriers. Normally there are not physicians inside, but we upgrade to physicians. That does two things. It allows them to make decisions that would normally have to be made away from the facility – after a transport. Second, it allows us to maintain access to higher levels of medical care in the same time frame as before the barriers are put in place. It’s important to not have ambulances leaving because if they leave, you can’t be sure that they will get back on time. When an ambulance leaves, it has to be sanitized, X-rayed, sniffed for bombs, etc, before it can re-enter the perimeter. Getting a vehicle into the perimeter after the hard shutdown is a very impressive process.”
Nowadays, Martinez’s team consists of emergency physicians Jim Ellis, Til Jolly, Eric Ossmann and Randy Pilgrim, along with paramedic John Ritter and NASCAR firefighter Ed Klima.
So you Want to Get Involved
To other emergency physicians who might want to follow a similar path, Martinez suggests starting local. “Start by going to your local facilities, even your local high school. Ask them how you can help. What you’ll often find is that there’s a real gap. There are a lot of smaller colleges and high schools that are really hurting for the knowledge that we possess. It’s systems thinking, and it’s about doing the basics. I often find that people who run stadiums know plenty about marketing, and they know a little about finance and a little about security. But for some reason, they don’t know a thing about medicine, so they need us to help de-mystify it. If they don’t see a problem, they assume everything is fine. We know better than that. And just creating a plan creates huge opportunities, because now every employee, from vendors to ushers, is on the team trying to recognize emergencies.”
Being in charge of Super Bowl emergency medicine might be Dr. Martinez’s most glamorous title, but it’s only one of many hats he wears. Martinez is president of the Division East of the Schumacher Group, and also the executive vice president of their Medical Leadership Academy. Even so, he continues to find time every year to work on this yearly event, partly because of the relationships that have formed, and because of positive work being done in the community. “I’ve known many of the people who are senior execs for 20 years. They’re just good people,” says Martinez. “I never cease to be amazed at the things they do to help communities, children or veterans. So for me, it’s a lot of work, but it’s a great opportunity to contribute to a great event that does great things. I was there once when they had all of these severely-injured veterans in for the Pro Bowl practice session. They are always doing childrens programs and helping out schools. If they practice at a school, they’ll put a new field in for them. They really see this as a way to make a big difference. So for us, it’s about being a part of something that is doing a good thing.”
Oh, and getting to stand on the 30-yard line while your childhood team wins their first Super Bowl title? That’s not bad either.