Responding to Disaster: Boston 2013
The Boston Marathon bombing occurred on April 15th, 2013 when two homemade pressure cooker bombs exploded near the finish line just 12 seconds apart, ultimately killing 3 individuals and injuring 264 others. The winners of the marathon had crossed the finish line two hours prior, but 5,700 runners remained on the course and hundreds of thousands of spectators were still in the surrounding areas.
The Boston Emergency Medical Services, Boston Police Department, and Boston Fire Department were all on site and were able to quickly dispatch additional responders to the scene. First responders near the finish line quickly converted the runner’s first aid tent to an emergency triage unit. From there patients were triaged and transported to trauma centers throughout Boston.
Maureen Hemingway, a nurse at Massachusetts General Hospital (MGH), wrote an account detailing the response of the level 1 trauma unit to the disaster. According to Hemingway, staff first learned of the bombing moments after it occurred through their personal cell phones and social media accounts. The Boston emergency medical system had notified hospital leaders of the bombing but it took time for this information to be disseminated through the hospital emergency notification system. Although social media accounts may not provide completely accurate information, they allowed perioperative staff to prepare for an influx of wounded patients prior to receiving official information from the hospital leaders. By the time individuals arrived at the trauma center, all necessary ORs were staffed and ready.
In terms of emergency preparedness, the timing of the disaster was fortunate. A major shift change was to occur at MGH at 3pm. With the news of the bombings the hospital was able to retain the day shift staff, boosting the 88 scheduled nursing team members to 180. This increased staffing was essential for assisting with patient identification, obtaining blood products, count procedures, and procuring supplies that weren’t readily available.
Overall it seems that emergency services and trauma centers in Boston were very well prepared to handle this disaster. It was fortunate that due to the nature of the event, there were many enforcement agencies and healthcare providers already on site. Being in a well developed metropolitan area helped get people off the streets and out of immediate danger. As for those that were injured, there were adequate volunteers available with the knowledge and skills necessary to properly triage. Once triaged, Boston had the resources and infrastructure necessary to promptly get individuals to appropriate trauma centers for treatment.
I think the environment this disaster occurred in played a very large role in how well it was handled. Had this disaster occurred in a similarly dense area without proper resources or infrastructure, I think there would have been more injuries with worse outcomes.
Hemingway, M., & Ferguson, J. (2014). Boston Bombings: Response to Disaster. AORN Journal, 277-288. doi: http://dx.doi.org/10.1016/j.aorn.2013.07.019.
