Marathon bombing victims aided by rapid response, imaging of injuries

The Boston Marathon bombing brought international attention back to the devastating effects of terrorism.

There were numerous victims with severe injuries that needed immediate attention. A novel study in Arthritis Care & Research, a journal published by Wiley on behalf of the American College of Rheumatology (ACR), presents cases from Boston-area hospitals where victims were treated, examining the medical response and imaging technologies used to save lives and limbs.

On April 15, 2013, at approximately 2:49 p.m. two pressure-cooker bombs exploded one after the other at the Boston Marathon finish line. As a result of the bombings, there were three fatalities and 264 casualties, with the most severe injuries involving lower extremities of those located closest to the blasts. Shrapnel disbursed by the bombs included pieces of metal, nails and ball bearings. Injuries resulting from the Marathon bombing are relevant to the fields of rheumatology, rehabilitation, orthopedics and musculoskeletal imaging.

“In an era of terrorism, even clinicians serving non-military patients need to understand the spectrum of injuries caused by bomb explosions,” explains lead author Dr. Ali Guermazi, Professor of Radiology at Boston University School of Medicine and one of the many specialists treating bombing victims at Boston Medical Center. “Critically ill bomb-blast patients needed quick assessments of their injuries, which had the most devastating effects to the lower limbs.”

According to the Centers for Disease Control and Prevention (CDC), bombing survivors have the highest incidence of injury to soft tissue and musculoskeletal systems with the most extreme injury being traumatic amputation, which is reported in up to 3% of cases. The CDC defines primary blast injuries as those caused by the blast wave—extremely compressed air moving away from the explosion—that can damage the lungs, bowel and ears. As the wave moves from the site of the explosion it creates a vacuum, which pulls materials and debris back toward the source of the bomb blast—the refilling of this void is known as the blast wind.

Victims from the Boston Marathon bombing were subject to blast waves and blast wind resulting in soft tissue damage (1), limb fractures (1), and amputations. The study demonstrates the systematic need to exam each extremity for musculoskeletal, neurological and vascular damage. In accordance with previous evidence, radiography (X-ray) and computed tomography (CT-scan) should be used liberally to detect foreign objects, to define basic penetration patterns, and assess bony and soft tissue injuries.

Dr. Guermazi concludes, “While blast injuries within civilian populations are rare in the U.S., when they do occur it challenges the medical community to rapidly respond to concurrent evaluation and treatment of many victims. We suggest that in urgent situations, like the Boston Marathon bombing, radiology resources be used liberally to save the lives and limbs of patients.”

2 COMMENTS

  1. LOL. Got to keep reinforcing the lie of the Boston Marathon “bombings”…By the way, critical thinkers, do you really think the actor Jeff Bauman could have survived more than 7 minutes after having both femoral arteries severed before getting medical assistance? And no, Carlos Arredondo did not have that tourniquet pulled tight enough to be of any use if you look at the pictures.

    Any normal person would be either unconscious or dead at that point,,,google Alex Zanardi if you want to see a real life example of what happens when someone gets both legs severed, to quote his doctor “…we had three minutes and had already used 20 seconds getting to him”…

    Zanardi’s release from hospital after six weeks was called “miraculous”. Jeff Bauman? 19 days and he’s waving a flag at the Bruins game. And of course within hours after his alleged traumatic injury he’s giving evidence against the alleged bombers…what a handy fellow he is.

    What about the fact that his legs appear to have been amputated twice, the first time below the knee, then 19 days later we see his legs amputated above the knee…what a superman. The event was so traumatic it straightened his ‘fro. Wake up everyone! These were actors and this was threater. Too bad so many of these doctors were so easily compromised. Or was it their ideology that caused them to go to the dark side?

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