(Elise Amendola/AP)

At the recent EMS World Expo and World Trauma Symposium in Las Vegas, experts discussed the emergency response to the bombings at the Boston Marathon. (Elise Amendola/AP)

Since April 15, when two bombs were detonated near the finish line of the Boston Marathon, the sports world has been on high alert. Events across the globe have tightened security, and even the NFL has responded; it now requires fans to use see-through bags for anything they’d like to bring into stadiums.

But changes are also being made to the way public safety officials plan for disasters at sporting events.

More than 6,000 trauma surgeons, emergency medical services administrators and paramedics have gathered at the Las Vegas Convention Center for the EMS World Expo and World Trauma Symposium. Here, they can compare half a dozen automated CPR machines or attend lectures on everything from using fake blood in training exercises to treating pediatric congenital heart defects.

“I’m normally very sarcastic, speak fast, I’m one of those kind of guys,” said Dr. Ricky Kue, the associate medical director for Boston EMS. “It’s going to be a bit different for this topic here.”

“Everybody who made it from the scene to a hospital survived.”
– Dr. Ricky Kue

When the bombs went off on Boylston Street in April, he was nearby in the marathon’s “Alpha” medical tent. When he felt the puff of air from the blast wave of the first explosion, he thought maybe someone had set off a cannon in a finish-line celebration.

“Thirteen seconds later, when that second one, that second explosion went off, there was this feeling inside me, like in my chest — I just felt like something sunk way down into my gut,” he recalled. “I could feel it sinking down, and I just had this sensation that you know, I’ve been through something like this before. I would have never thought of it happening here.”

Kue was deployed to Iraq with the U.S. Army Reserve in 2008. But not everyone in the “Alpha” tent was as prepared for what they were about to see.

“It wasn’t just EMS,” he explained. “It’s a lot of other medical volunteers, nurses, physical therapists, podiatrists. You name it, we had it.”

The “Alpha” tent treats the same sort of runners’ injuries year after year: dehydration, hypothermia and even chest pain and heart attacks. But nobody who showed up that day expected to treat shrapnel wounds and missing limbs. Kue looks back satisfied with the job that was done.

“Nobody from the scene who left alive died,” he said. “You know, everybody who made it from the scene to a hospital survived.”

The bombings at the Boston Marathon took three lives. More than 260 were injured. Thousands of runners were turned away before they reached the finish line.

While officials always try to anticipate every possible eventuality, it’s hard to know whether a plan will work until it’s actually put to the test. Kue says Boston’s plan was effective.

“We always take away some lesson and we’ve taken a lot of lessons away from this experience in terms of our infrastructure worked, so let’s make sure they continue to work,” he said. “And I think, if anything, the fact that something beyond what we’ve always prepared for can happen, well it has happened so now we have to think, always think, about how our plans will anticipate for a terror event or any event for that matter.”

Whether it’s a collapsed grandstand or sudden inclement weather, Kue says those who plan for major sporting events now have a heightened understanding that anything can happen. As the Boston Athletic Association plans for the 2014 marathon, preparing for a safe event won’t be the only thing on the minds of the medical professionals who were on scene on April 15.

“Like runners, I think they’re looking at it as a way to basically heal,” he said. “I don’t know everyone who was volunteering or on the medical staff. I don’t know if everyone’s going to come back. I can’t blame anyone who doesn’t want to come back because of the incident, but I think for many who do I think it’s gonna be part of the healing process.”

Kue says he’s not anticipating the 2014 Boston Marathon, scheduled for Monday, April 21, as a day of fear or a day of celebration. Instead, he says, he’s simply looking forward to seeing the event through until the last runner crosses the finish line.