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Boston Marathon Bombing Creates War Zone Scene for Local Hospitals

Update Date: Apr 16, 2013 01:09 PM EDT
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Boston hospitals treated hundreds of patients after two bomb explosions at the Boston Marathon left three dead and 170 were wounded.

The dead included an 8-year-old boy, The Boston Globe reported, citing law enforcement sources briefed on the investigation. Among the injured, 17 were reported to be in critical condition.

Victims were rushed into local hospitals with limbs blown off, shrapnel wounds, burns, gruesome fractures and perforated eardrums following the shock wave of the twin explosions near the Boston Marathon finish line just before 3 p.m. on Monday.

 "For many, many people in emergency medicine who are practicing domestically and not in the military, these are once-in-a-lifetime events," said Dr. Ron Walls, chairman of the Department of Emergency Medicine at Brigham and Women's Hospital.

Both marathon runners and spectators made up an unprecedented volume of patients rushed to eight different hospitals. Hospitals reported treating a minimum of 144 patients all together, at least 10 of whom were children.

Many hospitals activated emergency plans in response to the high volume of injuries, some calling in extra staff, while other facilities called a temporary lock-down, not permitting any guests and searching anyone who entered as a precaution following the explosion.

Hospitals were surrounded by local, state and federal law enforcement officials who interviewed patients, families and friends about what they had seen.

The hospital at Brigham treated 31 patients, ranging from age 16 to 62. The broad spectrum of injuries included people who had broken bones in multiple places and others who lost large amounts of tissue from their legs.

 "The two things that struck me the most were the incredible calm of the victims, even though they were obviously ­experiencing something no ­human being should ever have to experience," Walls said. ­"Incredibly calm and able to help us take care of them."

A medical tent near the finish line traditionally set up to treat running injuries, such as dehydration and hypothermia, became the first to treat the wounded at the scene.

Dr. Sushrut Jangi, an internist at Beth Israel Deaconess Medical Center, was shaken by what he witnessed. "There were victims coming in with both legs blown off," Jangi said. "I had never seen anything like that."

Doctors had to improvise, arranging an area in the back of the tent for the critically wounded while treating runners with more routine ailments up front. The tent was equipped with intravenous fluid bags, tourniquets, and defibrillators.

"Obviously we were not anti­cipating a scene of trauma," said Jangi. "I just held hands and talked to patients to try to bring down their anxieties," he said. "The patients who were severely injured didn't stay in the tent too long; the priority was to stabilize them and get them to hospitals."

Beth Israel ­Deaconess treated at least 21 injured victims with the assistance of 100 additional physicians, nurses, and other personnel descended on emergency rooms to help out the 25 or so typically there during a Monday afternoon.

Of the 21 people brought into the emergency room, at least seven had life-threatening injuries. Dr. Richard Wolfe, chief of the emergency department, said that in his 14 years at the hospital, "nothing comes close" to what he witnessed Monday. One patient had both legs amputated and one person had one leg removed in the operating room. One or two patients were in a very "dicey" situation, Wolfe said, in their ability to survive their injuries.

Injuries also included patients with eye damage, deep flesh wounds, and ruptured internal organs.

The ER staff at the hospital are trained to handle the kinds of critical injuries they treated on Monday, as many were similar to the trauma seen in serious car accidents, but by the time most patients had been transferred out of the emergency room and into ­other parts of the hospital, many staff members could not contain their suppressed emotions any longer. Several openly wept at memories of the initial hours of the blast, Wolfe told The Boston Globe.

"Some people were quite traumatized," he said.

Hospital staff across the city dealt with heightened tensions due to the potential of more explosions. Wolfe said police directed his hospital to go into lock-down because they worried that additional bombs might have been placed at other locations where police and crowds were expected, including hospitals.

Heavily armed SWAT-team officers arrived at Boston Medical Center, where 23 patients were treated. Officers held the peri­meter for about 15 minutes around 5:30 p.m. and then moved into the hospital to secure the grounds. Officials wearing FBI jackets and jackets from the Bureau of Alcohol, Tobacco, and Firearms were also seen at the ­facility.

Massachusetts General Hospital treated 29 patients, including at least four who lost limbs, Dr. Peter J. Fagenholz said, "We had three in the first five or 10 minutes. . . . I've never seen this volume come this quickly."

Hospital administrators realized the need to upgrade disaster-response training about five years ago and called in Israeli disaster-response teams to provide additional training at the facility.

"We ­obviously have a limited experience with explosions in an ­urban area," said Dr. Alasdair Conn, Mass. General's chief of emergency services.

"The Israelis, unfortunately, have this several times a year, and we asked their disaster-response teams to come and help us upgrade our disaster response," Conn said. "And I'm very pleased that we went through that orientation and additional training."

Seven children were treated at Boston Children's Hospital, including one parent. The children range in age from a 2-year-old with a head injury to a 12-year-old with a broken leg.

Investigators are urging members of the public to aid the investigation by providing any amateur photos or videos they may have from the Boston Marathon. 

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