How Boston’s Medical Professionals Were Able To Save So Many Lives This Week

At this point, it appears that all of the nearly 200 people who were treated for injuries in the aftermath of the Boston Marathon bombings will survive. As the New Yorker points out, this is no small accomplishment for the city’s medical professionals — particularly since explosions resulting from domestic terrorist attacks are typically about three times deadlier than explosions that occur in the midst of warfare, because civilians don’t have specialized equipment, training, or armor.

That wasn’t the case this week in Boston, even though over the explosions left about dozen people in critical condition and at least 10 people in need of amputations. That’s probably partly because the city has an especially large hospital system, which means that first responders and medical teams were well-equipped with the resources they needed to spring into action after this type of tragedy. It’s also, as Mother Jones details, a result of the lessons that doctors have learned from the past decade of modern warfare in Iraq and Afghanistan:

Those wars in effect served as field trials for doctors developing a new set of best practices for dealing with traumatic lower-body wounds, helping to dramatically lower mortality rates for injuries that were once virtual death sentences.

Military hospitals “can’t do prospective research, but they can record a tremendous amount of experience and give that back to civilian research,” said Dr. Carl Hauser, a trauma surgeon at Boston’s Beth Israel Deaconess Medical Center. “This particular incident here was very much one where they had helped us.” […]

“Learning how to care for these wounds, how much work has to be done, how much tissue you need to remove, how much to leave behind — that’s something that is almost impossible to recreate in a civilian training environment,” [Donald Jenkins, director of the trauma center at the Mayo Clinic in Rochester, Minn., and a 24-year Air Force veteran] says. “We all learned to do this when we went to the war. And those of us who learned early passed it on, literally, surgeon to surgeon, as they exchanged positions in the war…Now we have scores, hundreds of surgeons who have been through that and know how to do this.”

Perhaps most notably, military doctors have learned how to more effectively stem the flow of blood. They re-popularized the use of tourniquets — which were discouraged at the beginning of the Afghanistan War because too many people were misusing them — after finding that a correctly-applied tourniquet can reduce mortality rates by a staggering 80 percent. They also discovered a better way of doing blood transfusions that resulted in much less blood loss and therefore fewer deaths. Now, those tactics have become standard procedures for the United States’ trauma teams responding to crises here at home.

“As an orthopedic surgeon, we see patients like this, with mangled extremities, but we don’t see 16 of them at the same time, and we don’t see patients from blast injuries,” Dr. Peter Burke, the trauma surgery chief at Boston Medical Center, told the New York Times in reference to the bombing’s aftermath. Fortunately, that didn’t prevent Boston’s medical staff from ultimately saving each one of those lives.