References
Recipe for success: baking in Boston strong-observations on Boston's success
Abstract
On 15 April 2013 at 14:29 hours, two improvised explosive devices (IED) exploded within 15 seconds of each other in Boston. The explosions occurred approximately 200 yards apart at the Boston Marathon finish line.
In the follow on to the event it became quickly apparent that Boston EMS, in collaboration with the health community had achieved, by any standard, an effective response. One determining factor was the survival of victims; in Boston no victims died who survived the initial blast. This success did not happen by chance. In the wake and review of the events it became apparent that the successful response during the Boston Marathon was the result of decades of preparedness.
This article will not dwell on the actual response events as other reports and articles have done that well. The intent is to discuss the underlying principles that led to a successful response by Boston EMS and the other parts of the community response system. As will be discussed, the whole community of Boston participated in not only the response that day, but was integral parts of the recipe that created such a successful response.
On 15 April 2013 at 14:29 hours, two improvised explosive devices (IED) exploded within 15 seconds of each other in Boston. The devices were constructed within common pressure cookers concealed within two separate backpacks and built using low grade explosives, metal shards, and common BBs to create a field of shrapnel upon detonation. The explosions occurred approximately 200 yards apart at the Boston Marathon finish line. The devices were placed on the ground behind the metal barriers that kept spectators out of the street where the runners were arriving at the finish line. At the time of the event only two thirds of the runners had crossed the finish line (Serino, 2013).
The event caused three deaths, including an 8-year-old boy, all of whom died before reaching the hospital. Boston EMS triaged and transported 90 of the 264 injured people. Of those, 30 were triaged as red and were transported within 18 minutes of the explosions. The balance was transported within the first 30 minutes. The most critically injured suffered traumatic amputations, penetrating chest, and neck and head wounds. Patients were distributed in a manner that enabled the hospital community to manage patients effectively without any delay in care. Patients requiring specialty care arrived at specialty facilities directly without being transported to intermediary facilities.
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