Each year on the third Saturday of October, hundreds of thrill-seekers and thousands of tourists gather in the tiny village of Fayetteville, West Virginia, to celebrate what has become the state’s most recognizable icon, the New River Gorge Bridge.
On this day, the bridge is closed to vehicular traffic and opened to pedestrians who can stroll casually along the span, take in the breathtaking panoramic views and purchase keepsakes from a variety of local vendors. There is an element of adventure, too: zip-lining and rappelling are favorite activities, and toward the middle of the bridge, BASE jumpers leap one after another, freefalling a few agonizing seconds before finally deploying their parachutes.
For all of the fun and excitement of Bridge Day, the event does present a unique set of challenges for Jan-Care Ambulance Service, the company that provides all medical services for the event. At any given time, the population along the 3,030-ft.-long bridge can range anywhere from 60,000 to 100,000 people, making it by far the largest “city” in the state. With all those people, medical emergencies are not only possible, they are likely. And because all those people are occupying a relatively small surface area, locating, treating and transporting patients can be difficult.
While all of this action is happening on the bridge, BASE jumpers are attempting to negotiate a favorable landing on the jagged, rock-filled clearing next to the New River 876 feet below. Apart from the occasional errant jumper who comes down in a remote area of the forest, it is easier to locate patients down here. Yet, due to the nature of their injuries, it is often more difficult to treat them. Transports are long and slow at best, as the tiny, treacherous road that snakes up the gorge contains numerous hairpin turns that tax even the best drivers.
To confront these challenges, Jan-Care personnel at Bridge Day rely on a strategic plan developed over decades and refined by experience. Consequently, they are prepared to meet any emergency head on—even multiple, simultaneous ones—and still ensure proper patient care, personnel safety and adequate EMS coverage.
Essentially, Jan-Care operates four zones of coverage—three on the bridge itself, and one at the bottom. On the south side of the bridge, three ALS ambulances stand ready to transport patients to one of two area hospitals—one in nearby Oak Hill, the other 10 miles south in Beckley. These transport units are supported by one stationary ALS unit, the crew of which is responsible for providing basic first aid necessities (band aids and bacitracin, for example) and offering free on-site blood pressure screenings to the public. If necessary, this unit can also administer more critical treatment and transport patients. The entire zone is under the direct command of the south side medical reconnaissance supervisor, who liaises directly with the bridge-top EMS command supervisor.
Toward the middle of the bridge, Jan-Care posts another fully stocked ALS ambulance unit in close proximity to the BASE jump pad. The bridge-top EMS command, which includes the command supervisor, communications and IT crews, and a law enforcement liaison, is stationed here, as well. From this vantage point, the command supervisor has a good view of what’s occurring at the landing zone below. He can also coordinate and support the units on the north and south sides of the bridge and, if necessary, suspend the BASE jumps while EMS personnel treat injuries below.
On the bridge’s north side, three more ALS transport units and one stationary unit mirror those on the south. They are commanded by the north side medical reconnaissance supervisor, who—like his south side counterpart—communicates directly with the EMS command supervisor. In addition, another ALS unit is stationed a few hundred yards away at the nearby visitor center. Because the bridge is filled with pedestrians, and travel time across the gorge via alternate routes can take up to an hour, emergency transports from the north side almost always go north to hospitals in either Summersville or Charleston.
Though hospital transports from the top of the bridge do occasionally happen, the vast majority of transports come from the BASE landing zone on the south bank at the bottom of the gorge. It’s not uncommon to see a full range of medical issues, from bumps and abrasions to bone fractures and even life-threatening injuries. To ensure the best care possible, Jan-Care deploys a host of first responders under the direction of the bridge-bottom EMS command supervisor.
No fewer than 10 paramedics are stationed down here, backed up by five ALS ambulance units and another unit stocked solely with medical supplies. In addition, Jan-Care hosts a triage center staffed by two MDs where patients are treated and stabilized before transport. A rescue coordinator communicates with water and tree rescuers for patients who come down in the river or remote parts of the Gorge, while a medical safety officer works to ensure Jan-Care personnel remain safe in the frantic, seemingly-chaotic scenes of emergency situations. In the event of an extreme emergency, bridge-bottom EMS command can also pull the ALS units from the south side top zone for transports, backup or unit replacement.
All of this adds up to a safe and efficient experience for people who find themselves in need of medical care at Bridge Day. Naturally, the BASE jumpers plunging from the bridge must certainly recognize that it is a distinct possibility they will need medical services. And yet, the fact that they still jump, year after year, decade after decade, is testament not only to the spirit of accomplishment and adventure Bridge Day commemorates, but also to the professionalism and effectiveness of Jan-Care personnel. Munire morem, non stare.