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Prepared for Trauma, Overwhelmed by Carnage
Date:4/18/2013

By Barbara Bronson Gray
HealthDay Reporter

WEDNESDAY, April 17 (HealthDay News) -- It was an uneventful early afternoon on Monday in the emergency departments at Boston area hospitals. Staffs were working purposefully, efficiently through routine caseloads.

Suddenly, the city's emergency management system burst alive: bombs had exploded shortly before 3 p.m. near the finish line of the fabled Boston Marathon in the city's fashionable Back Bay section. There were unknown numbers of wounded with still-unknown injuries.

Instantly, the hospitals spun into action, putting carefully crafted, detailed disaster plans into gear.

Interviews with emergency management experts suggest that's just how the situation unfolded at eight Boston hospitals during the first minutes after the twin bombings that killed three people and injured more than 170 others.

But miraculously, countless lives were saved in a city famed for its world-class medical centers. And any success that staffs had in assessing and treating the large number of severely injured wasn't due to chance. Hospitals are required to routinely plan and prepare for a wide range of disasters, conducting practice drills and developing partnerships within the local health-care community.

"All hospitals have emergency operation plans to be able to respond to any disaster that may come at them. They're developed by thinking about the hazards and risks the hospitals face in their communities," said Roslyne Schulman, director of policy development at the American Hospital Association.

Most of the Boston bombing victims suffered traumatic injuries to their lower extremities. Many were pierced by sharp objects -- nails, BBs, ball bearings -- that had been planted in two crude "pressure-cooker" bombs. The bombs were designed to cause maximum damage to a human body. Some patients had as many as 40 pieces of shrapnel inside of them -- the types of injuries t
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