Public Health

Surge Exercises: Bombings and Blast Injuries

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I’ve been watching some of the news coverage of the bombing incident in Boston, but have been focused on those aspects related to emergency response.  This event is a reality check for me because just a couple of years ago I was participating in the planning of an exercise scenario that included two bombs going off at a local 10k race.  In our scenario, the plan was to have the second bomb explode as emergency crews responded, rather than targeting the dispersing crowd.

I think a recap of what I have seen and remember from our surge exercise will serve as some lessons learned.

  • Events with large accumulations of people are an excellent opportunity to test preparations for surges.  In this case a medical tent was set up, staffed and supplies were available.  The level of preparedness seen probably contributed to a significant reduction in mortality.
  • Our new reality is that sometimes these resources will be needed for reasons beyond the additional scope.  Also having a stock of basic burn and trauma supplies available addresses this reality.  I’d also recommend having some supplies and/or equipment for chemical decontamination or at least a stand-by plan.
  • It was amazing to see so many patients in wheelchairs so quickly.  Equipment needs seem to have been well planned and probably helped expedite movement of patients from the medical tent to staging areas for transportation to hospitals.
  • Training – perhaps by instinct or because of training,  most volunteers seemed prepared to response.  Today’s reality makes conducting stimulated emergency response exercise with staff and volunteers a necessity – even if it is just a tabletop.
  • So far, I haven’t seen any pictures from inside the medical tent.  Hopefully, the lesson of having reporters inside tweeting what they were seeing in Joplin, MO was learned.
  • The hospitals shown in the various reports all seemed or were on lockdown as a result of this incident.

I’ve started receiving resources and want to share the CDCs on blast and boming injuries. It includes In A Moment’s Notice Surge Capacity for Terrorist Bombings. In the days that follow, we will probably start to see results of the emergency response debriefings by those involved.  I’ll add these resources as comments to these posts.

My closing thought is to recommend that everyone participate in community emergency planning activities or events.  If there is a CERT program in your area, join it and prepare.  Doing so honors those who were impacted by this act of evil.


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