In Spanish and English: Staying safe in super hot weather

Probably won’t wear long sleeves but…

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MGH surgeon, who treated #bombing victims in Afghanistan and #Boston, brings #tourniquet campaign to area schools

How sad is it that teachers are learning how to use tourniquets?  Dr. David King, a Mass General surgeon tells the Globe that he thinks some of the students at Newtown might have survived if teachers had those skills.

After a stint in Afghanistan, where he responded to a truck bomb, and hours the Mass General OR working on the those injured in the marathon bombing,  King is familiar with lower limb injuries.

The lay people, the volunteers, the teachers: Those are the people who are truly the first who can respond to these kinds of incidents,” he said.

To prepare for such unforeseen events, King and other doctors are calling for greater access to commercially manufactured tourniquets and for training in their proper use.

In this story from Health Leaders Media, he explains why the marathon bombing made this clear.

His experiences here and overseas where 75 percent of all injuries were caused by explosions— have made King a huge promoter of the tourniquet. The bystanders at the finish line did their best with t-shirts, belts, and other makeshift tourniquets, he said. But, it takes a medical-quality device to stop arterial hemorrhaging and prevent blood loss that can make a leg wound fatal.

Here he talks about his own experience that day, when he was called in MGH after finishing the marathon himself.

Dr King’s Marathon from Tinker Ready on Vimeo.

Health Leaders Media: What hospitals learned from the Boston Marathon Bombing

From Health Leaders Media

A year after the two bombs went off near the finish line of the Boston Marathon, killing three and injuring scores, the city is making final preparations for the 2014 marathon on Monday, April 21. 

First responders and healthcare workers in particular have learned a number of lessons from the events of April 15, 2013. For example, since the bombing, Boston hospitals have changed the way they receive unidentified trauma patients in the emergency department. Members of the city’s police force are now equipped with military-quality tourniquets.

More lessons, perhaps further-reaching, will come as researchers begin to analyze data on the injuries, surgeries, and outcomes for each of the more than 240 people injured.

Dr King’s Marathon from Tinker Ready on Vimeo.

Medical dispatches from the Boston #Marathon bombings

4/21 Check my Storify for updates on medical news.

Friday, Cambridge, Massachusetts, near Tsarnaev apartment.
Friday, Cambridge, Massachusetts, near Tsarnaev apartment.

4/21: More on the debate over whether docs might give pause when asked to treat bombing suspects. In this story. The doc in this  AP story addresses that: 

“Dr. David Schoenfeld said 26-year-old Tamerlan Tsarnaev was unconscious and had so many penetrating wounds when he arrived at Beth Israel Deaconess Medical Center early Friday that it isn’t clear which ones killed him, and a medical examiner will have to determine the cause of death… “How did the medical team react to treating the bombing suspect?
‘‘There was some discussion in the emergency room about who it was. That discussion ended pretty quickly,’’ Schoenfeld said. ‘‘It really doesn’t matter who the person is. We’re going to treat them as best we can.’’

 

 

4/19

Boston hospitals in lockdown as police seek surviving bombing suspect.

Suspect captured, Atul Gawande finds himself in a Twitter debate on the ethics of surgical care and suspected criminals.

BNB HMS
HMS flag at half mast

4/18

The Obama’s visited staff and patients at Boston hospitals after the morning prayer service. He to MGH, She to BWH.

Lots of reporting today on what the people who lost limbs can can except during recover.

From Commonhealth:

“I’ll make the following claim: If a person has lost a leg in this Boston attack — if they’re motivated and generally healthy and reasonably athletic — they could, given current technology, they could walk or run across the finish line at the Boston Marathon this time next year.”

Making that bold statement is Hugh Herr, the renowned prosthetics and assistive technology expert who heads the Biomechatronics research group at MIT’s Media Lab (and is himself a double amputee).

From the Globe

Three days after the bombings, people who lost limbs may differ in their emotional responses, but all are beginning a daunting journey that will force them to relearn many of the most basic activities of daily life. The challenges ahead range from brushing their teeth standing on one leg to pulling pants over their new prosthesis, specialists and amputees say.

Check the Globe’s live blog for the latest news. Also see WBUR, the BU News Service,  The Daily Free Press and NECN.

 

Check my Storify for updates on medical news.

storify

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4/17; The Globe staff members — including the health and science reporters — are doing an amazing job on this story. Today they offer a detailed graphic of how the medical tent became a trauma unit.

70 intense minutes: Around 3 p.m. medical staff in the 13,000-square-foot tent, already packed with runners suffering from dehydration and hypothermia, made a smooth transition to also treat bomb victims. A well-oiled machine from years of experience, the team worked tirelessly over the next critical 70 minutes.

April 16

Update from Boston Children’s Hospital

Update regarding explosion at the Boston Marathon
April 16, 2013

Boston Children’s Hospital received 10 patients injured in the explosion at the Boston Marathon on the afternoon of April 15, 2013. Our Trauma Activation Protocol was activated at 4 p.m. and deactivated at 9 p.m. All clinical and operational activities are occurring as scheduled today, Tuesday, April 16.

As of this morning at 9 a.m.,  seven patients have been discharged and three remain in the hospital.  Two are in critical condition in the Medical/Surgical ICU and one is on a surgical unit.

Details on the current patients:

  • 2-year-old boy with a head injury is in good condition
  • 10-year-old boy with multiple leg injuries is in critical condition.
  • 9-year-old girl with a leg injury is in critical condition.

The seven patients discharged were the following:

  • 14-year-old  boy with head injury
  • 42-year-old father of a patient
  • 7-year-old boy with a minor leg injury
  • 12-year old with a femur fracture
  • A child in good condition
  • A child in good condition
  • A pregnant woman who was transferred to BWH

4/15

This from the Globe:

Comm Ave.,  7 p.m.
Comm Ave,. 7 p.m.

Marathon medical tent ‘transformed into trauma unit’

My friend and colleague, Dr. Jennifer Rosenberg, a family physician in Coolidge Corner, was attending to her patient when we heard two explosions – the second a few moments after the first. The medical tent was already packed with runners lying on cots for dehydration or hypothermia. We heard a calm voice from the center of the tent, belonging to John Andersen, one of our medical coordinators. “Stay calm, and stay with your patients,” he said, “while we figure out what’s happening.”

A few minutes later, physicians, nurses, and coordinators were called to the site of the explosion; EMS ran to the scene and returned with stories about dismembered limbs and pools of blood. Immediately, the medical tent was transformed into a trauma unit.

The story gets very graphic after this excerpt.

Also from the Globe:

Physician leaders talk of day of trauma, shrapnel, and surgery

Brigham and Women’s treating victims, in lockdown

Mass General Hospital updates on care for bombing victims:

Monday 4/15, 8:20 p.m.
The MGH has seen 29 patients related to the Boston Marathon explosion today. Eight of the 29 are in critical condition.

Monday 4/15, 7:20 p.m.
At this time, the MGH can confirm we are treating 22 patients related to the Boston Marathon explosion. Eight of those patients are in critical condition. We can also confirm none of the 22 patients are pediatric (18 and younger). The injuries range from cuts and bruises to amputations. 

Please continue to monitor this page for additional updates.

Medical news from the Boston Marathon

Check out Boston.com’s live blog.

10 am
Boston police just made sweep of grandstand with their dogs, spectators were carefully and tightly shuffled out of key areas and credentials were being checked at every stop along the finish line. Front of the medical tent is completely covered with just one opening in the tarp allowing a peek inside. Volunteers just wait now with most of the prep work done.

Watch the race live on WBZ

Check out our Storify

WBUR on one-legged runner:

BOSTON — When one-legged runner Chris Mehmel, of East Sandwich, Mass., was training for the 2012 Boston Marathon, an act of kindness occurred that had him overcome with gratitude.

Mehmel, who has a right leg below-knee prosthesis as a result of a birth defect, was out running up the notorious Heartbreak Hill — an uphill area between the 20- and 21-mile marks of the Boston Marathon route — when he was approached by a man who had caught sight of both his prosthetic leg and his Massachusetts Eye & Ear Infirmary training jersey

Metro West Daily on medical volunteers.

When runners cross the finish line at the 117th Boston Marathon on Monday, their work for the day will be done. But for the volunteers at the finish line medical tent, the work starts when the thousands of runners complete their 26.2-mile trek from Hopkinton to Boston.
 
According to the Boston Athletic Association, 1,300 medical personnel will provide care for runners this year. These include some local residents who will offer their medical expertise and make sure the runners get the help they may need.
 
“It is a lot of work, but it is a lot of fun,” said Jeanette Corsini, a Hopkinton resident and nurse at MetroWest Medical Center. “It is definitely rewarding. Certainly we get a lot of positive feedback from the runners. I don’t think any other marathon provides the care we do.”

Read more: http://www.metrowestdailynews.com/news/x935164262/Local-residents-provide-care-for-Boston-Marathon-runners#ixzz2QXnwmejr

Running teams

BMC 

BIDMC

UMass Med School

Newton Wellesley Hospital

More to come

Surviving the Boston Marathon

Some people would rather die that run a marathon. Others run the marathon and almost die.

 Here’s how Bostonians try to make sure runners avoid the big finish line in the sky.

 From the Boston Athletic Association, sponsor of the Boston Marathon

 The Athletes’ Village will have two medical tents that can offer assistance with most last-minute medical needs. Band-Aids, Vaseline, a pre-race stretch, or just a word of encouragement can be offered by our medical team….

 Write down your current or pre-event weight on the back of your bib. This figure may help us determine if you have been over-drinking during the event. Scales will be available at both medical tents…

The American Red Cross provides 26 medical aid stations strategically located along the course. Each tent is staffed with a variety of medical professionals, offering basic first aid to those in need. Course medical coverage is supported with ambulances and EMS bike teams provided by Fallon Ambulance, AMR and Cataldo Ambulance Company…

Medical sweep buses are positioned along the course aid stations. These buses are available to those runners that cannot finish the race and/or may have a minor medical problem. Each bus is staffed by medical volunteers who are available to provide first aid. A runner may choose to rest on the bus while it is parked at a first aid station. However, once the bus begins to move, the runner’s chip will be removed, once this occurs the runner may not re-enter the course to complete the marathon …

Medical teams are located at the finish line… Medical personnel can be identified by their red volunteer jackets: If you are injured or feeling ill, please seek out a member of the medical team for assistance…

Massage Therapy Services Massage therapy is offered to the athletes on a limited, first-come first-served basis. Treatments may last from five to 15 minutes…

After You Cross the Finish Line: During any prolonged physical activity, the body’s blood supply is usually redirected to the extremities and away from internal organs. Runners should continue to walk after finishing the race. Standing still or stopping can cause nausea, dizzy and weakness – normally resulting with a runner passing out. Walking will help redirect your blood to vital organs, so it is advisable to keep moving. In any event, if you think you need help, ask one of our medical personnel for assistance.

And, finally,

Any medical expenses incurred on race day are the sole responsibility of the runner.

 Also, Runner’s World rounds up a list of medical research on Boston Marathoners, including one out of McLean Hospital on “The Causes of Marathon Collapse.”

April 19 update: The Globe offers this on the physical impact of the race:

Cramps like Cruz’s are just one of the calamities small or large that can befall a marathon runner. Months of preparation can bring amateur and professional athletes alike to a peak of fitness, but training can also take a toll on muscles and minds — after several hundred miles of training, about 30 percent of runners already have weathered injuries, many from overuse. Cap that with 26.2 miles of leave-it-all-out-there exertion — or so runners hope — and the next job is recovery.

Boston Marathon medics and truckin’ down Comm Ave.

(Sorry, I went to a The Grateful Dead show this weekend. I will spare you any long, strange trip puns.)  

WBUR’s Martha Bebinger had a nice piece on Marathon medics yesterday:

BOSTON – For runners, the Boston Marathon – the oldest in the country, with Heartbreak Hill and storied champions – is legendary. In public health circles, it’s known as one of the largest planned mass casualties in the country.

Roughly 1,300 medical responders are mobilizing on the morning of the marathon, ready to treat an expected 8,900 runners whose bodies will crack in the strain of running 26.2 miles.

Also, check out the Globe’s great photos of the day. I took my tween and his pal down to the finish line. Copley Square was jammed but it was fun for us to walk the end of the course and cheer on the middle of the pack  as they came into Back Bay: You can do it!…You’re almost there.”