Disaster response

June 01, 2013
by Loren Bonner, DOTmed News Online Editor
It seems like only yesterday I was writing about how New York City hospitals reacted to Hurricane Sandy. Recently, another tragedy struck. This time in Boston when two pressure cooker bombs exploded at the finish line of the Boston Marathon on April 15th. The blasts killed three people, injured hundreds, and put all medical personnel in the city on active duty. Although the events in Boston and New York City are quite different, they showed a lot of people how important it is for hospitals to be prepared when disaster strikes.

As you may know, Boston houses some of the most elite hospitals in the nation, and how they dealt with the disaster is a true testament of their strength. Atul Gawande, a surgeon at Brigham and Women's Hospital in Boston and regular contributor to the New Yorker magazine, is one of my favorite writers. If you are in health care, you probably have read his books and articles. A few days after the bombings, he wrote a fantastic piece about "Why Boston's Hospitals Were Ready." (You can find the article online at the New Yorker).

While it was certainly one of the most chaotic days in history for these hospitals, he writes that every individual working there knew what to do. They prepared for the worst in the few moments they had before the victims came through the doors - a direct result of what has infiltrated our cultural mindset after the September 11th attacks, notes Gawande.

"Ten years of war have brought details of attacks like these to our towns through news, images, and the soldiers who saw and encountered them. Almost every hospital has a surgeon or nurse or medic with battlefield experience, sometimes several. Many also had trauma personnel who deployed to Haiti after the earthquake, Banda Aceh after the tsunami, and elsewhere," writes Gawande.
Like many major cities, Boston had conducted disaster drills and it paid off. They knew how to mobilize before being told to do so, set up command posts in the hospitals, and recognized that the bombs had been packed with ball bearings and nails when they found them in the wounds of the victims.

And because it was a marathon, medical personnel and doctors were near the finish line. Since the historic race began, it's common for Boston doctors to take the day off and volunteer their time in the first-aid tents. Having the triage process begin there certainly contributed to the rapid response and the lives saved.

Every single one of wounded victims is expected to survive. This may be partly due to living in an age of advanced medicine, but more than anything, I think it's a direct result of human beings doing their jobs well.