The Lancet Salutes Boston's Readiness, Response

"Emergency systems everywhere should aspire to be Boston strong," the magazine's editorial states.

An editorial from the staff of The Lancet titled "Boston's first-in-class response" urges cities to model Boston’s performance in response to the mass casualties after two bombs exploded April 15 during the Boston Marathon.

"What followed [the explosions] was a rapid, exceedingly well-orchestrated, and inspiring response," it states. "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.

"We commend the commitment, bravery, and tireless efforts of Boston's first responders. Moving forward, it is vital that the lessons learned here are shared within the global medical community. It is a sad truth that such horrific events happen all over the world and all too frequently, but 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."

The Boston Marathon's emergency medical response program is well prepared and involves more than a thousand medical personnel. During an April 2011 interview just prior to that year's marathon, the race's longtime medical coordinator, Chris Troyanos, said his team is in constant contact during it with the 10 hospitals that are ready to accept patients when the medical teams bring them in. He said cities' and towns' fire and police personnel, ambulance support, and additional hospitals in the area also assist, swelling the numbers of emergency medical professionals who take part.

"Up until 2004, I always looked at it as a sporting event. I no longer look at it as a sporting event," he said. "I look at it now as a planned mass casualty event."

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