Editorial: All Emergency Care Should Aspire To Be Like Boston

Police clear the area at the finish line of the 2013 Boston Marathon as medical workers help injured following the explosions. (Charles Krupa/AP)

Police clear the area at the finish line of the 2013 Boston Marathon as medical workers help injured following the explosions. (Charles Krupa/AP)

An editorial in the medical journal The Lancet today sums up the communal gratitude much of Boston is now feeling toward the emergency doctors, nurses and other hospital staff who have been caring for victims of the Marathon bombing over the past week: they rock.

Not only will all of the patients who have been or continue to be treated in area hospitals survive, according to reports, but the institutions were amazingly prepared for the harrowing disaster.

After the two explosions at the Marathon finish line, which killed three people and injured more than 200, doctors and hospitals mobilized with “a rapid, exceedingly well-orchestrated, and inspiring response,” the Lancet notes:

Immediately, medical and emergency personnel who were staffing the event swept in to treat the wounded and to secure the area, and the first wave of the injured were quickly transported to the network of hospitals nearby. In the context of such an emergency, the city of Boston is an unparalleled setting because of its great number of top-tier medical facilities and teaching hospitals. Ten hospitals, including Brigham and Women’s Hospital, Tufts Medical Center, and Massachusetts General Hospital, received and treated the injured. Importantly, they were at the ready. Upon being alerted of the explosions, local hospitals initiated a cascade of actions: emergency rooms were cleared, patients in less critical condition were diverted to increase capacity, and clinical teams were mobilised to aid in the triage of victims. All of the routine disaster rehearsals, coordinated training, and special awareness of the types of injuries they would be treating meant that clinical staff were poised to act. These well-practised plans undoubtedly served to minimise injuries and loss of life.

The editorial concludes that, indeed, Boston’s response should serve as a model for the global medical community. “Boston has set an excellent example that response efficacy and strength is built on planning and preparation. Emergency systems everywhere should aspire to be Boston strong.”

Meanwhile, The Boston Globe reports that only two patients hurt in last Monday’s bombings remain in critical condition, but that the tally of injuries has jumped to over 280, with some people not seeking treatment immediately after the blasts. Many of those with less serious injuries are dealing with hearing loss and ear injuries, as WBUR’s Sacha Pfeiffer reported last week.

And The New York Times today reports that attention is now turning to the cost of caring for the wounded, and how charitable funds for bombing victims will be doled out:

Kenneth R. Feinberg, the lawyer who has overseen compensation funds for victims of the Sept. 11 terrorist attacks, the shootings at Virginia Tech and other disasters, arrived in Boston on Monday to start the difficult work of deciding who will be eligible for payouts from a new compensation fund and how much each person wounded in the bombings and family of the dead deserves.

The One Fund Boston, which Mayor Thomas M. Menino of Boston and Gov. Deval Patrick of Massachusetts created a day after the bombings, has already raised more than $10 million for victims and their families. At the same time, friends and relatives have set up dozens of smaller funds for individual victims.

For at least 13 victims who lost limbs, including William White of Bolton, Mass., expenses may also include renovations to their homes that make it easier for them to get around.

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