![]() This report may serve as a template for other population centers to learn from what we have experienced and perhaps mitigate future morbidity and mortality as a result of multiple or MCIs through discussion, forethought, preparation, and above all training.ĮD LOS for patients admitted to OR, medianĮD LOS for patients admitted to ICU, medianĮD LOS for patients admitted to Ward, median The finish line for the race and the 2 blasts occurred in the geographic center of the surrounding trauma centers. ![]() The City of Boston, with its immediate population of approximately 636,479, 4 is unique in that it is supported by 5 adult level I trauma centers and 4 pediatric trauma centers. Boston EMS crews are stationed at the tent to transport those approximately 200 to 250 runners in need of further medical attention to the Boston area hospitals. The tent is staffed with paramedics, physicians, nurses, physical therapists, and others to provide for general heat- and overuse-related injuries. In preparation for the race, a temporary medical tent had been erected at the finish line to provide care for up to 2500 runners. The Boston Athletic Association, Boston Emergency Medical Services (EMS), and the Boston health care community have planned and drilled for mass casualty incidents (MCIs) for many years (personal communication, Chris Troyanos). 1– 3 Over the past decade, most Americans have become all too familiar with the impact of IEDs in East Africa, Spain, London, Israel, Iraq, and Afghanistan. Murrah building bombing in Oklahoma City in 1995, the United States had been mostly spared the volume and shock of terrorist attacks seen in other countries until the incendiary events of September 11, 2001. Now some 238 years later, Massachusetts was again under siege. ![]() There were 26,893 official entrants, and more than 500,000 people gathered along the marathon route to cheer on those runners and celebrate Patriot’s Day, the Massachusetts state holiday marking the “shot heard, round the world” and nationally recognized as the start of the American Revolution in 1775. The first detonation occurred at 2:50 pm and the second followed 10 seconds later. On April 15, 2013, 4 hours into the 117th running of the Boston Marathon, 2 improvised explosive devices (IEDs) were detonated among the spectators approximately 100 to 200 yards from the finish line.
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