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Hinman Pulse

April 15, 2014

Hinman Remembers: The 2013 Boston Marathon

by Hinman Team

Most people in the US have never heard of Patriot’s Day; only three states, Massachusetts, Maine, and Wisconsin officially observe the holiday and Florida strongly encourages people to observe it.  The day is meant to commemorate the anniversary of the battle of Lexington and Concord, the first battles of the Revolutionary War.  In Massachusetts, it has become a day rich with traditions.  There are early morning re-enactments of the battles, the Boston Red Sox have played a home game at Fenway Park since 1959, and beginning in 1897, the Boston Marathon has been run on this day,    

Growing up seven miles from the starting line of the Boston Marathon, I spent many mornings of my childhood as one of 500,000 spectators lined up on the side of the road to cheer on the runners.  I have seen Dick Hoyt, who has run 31 marathons, pushing his son Rick, who suffers from cerebral palsy, and is in a wheel chair.  Last year was going to be their last run, but now the Hoyts have a new reason for running for the 32nd time.  They will run to honor the victims of the 2013 Boston Marathon bombings.  

Four hours, nine minutes, and 43 seconds after the start of the 2013 marathon, at approximately 2:50 p.m., an explosion occurred on the north side of Boylston Street, very near the finish line. A second explosion followed approximately 10 seconds later, further down Boylston Street.  The backpacks containing pressure cooker bombs killed three spectators and injured more than 260 people.  In addition to low grade explosives, the bombs were built from mostly commercially available materials, such as nails and BBs.  The electrical fusing system was constructed from a remote control car.  The use of the shrapnel material resulted in 14 people requiring amputations. 

The outcome could have been far worse had the emergency response not been so rapid.   A FEMA Lessons Learned Information Sharing report describes the steps that the Boston area and Massachusetts have taken to better respond to a mass casualty incident (MCI) since 9/11. These steps played a positive role that day.  An improvised explosive device (IED) annex was developed for the regional response plan in 2011.  The implemented plans include defined roles and responsibilities for state, local, and federal agency’s to conduct a coordinated response.  

Since the development of the annex, several exercises and workshops have been held to improve communication and coordination.  Regional hospitals have participated in response exercises to determine how well they were coordinated to provide care for an event resulting in a large number of victims.  A Joint Counterterrorism Awareness Workshop Series (JCAWS) was held, at which 200 local, state, and federal community members were trained on how to respond to a complex attack.  Annual Urban Shield Boston conducts 24 hour full scale exercises where emergency personnel respond to a variety of scenarios, testing the current protocols and procedures.  Finally, prior to the marathon, an annual Pre-Boston Marathon Tabletop Exercise was hosted by the Massachusetts State Emergency Operations Center.  This exercise allowed the event organizers and first responders to get to know each other and to define each party’s roles and responsibilities should an MCI occur during the event.  One of the exercises included responding to an IED event. 

Because of this pre-planning and coordination, EMS, police, fire fighters, and event organizers/volunteers, to name a few, were able to provide rapid response to the event.   Medical supplies were available at the medical tents set-up for the event enabling first responders to provide triage care on-site. Victims were stabilized and picked up by ambulances.  The ambulances transported victims to six major trauma centers in the Boston area.  Ninety-seven victims were transported to these centers within 22 minutes of the bombing event.  

The training of the major groups involved in providing for the protection and safety of the  Boston Marathon participants and spectators in communication and coordination in response to a major event was one of the key factors in reducing the number fatalities and injuries due to the bombing.  Other metropolitan areas holding major events such as the Boston Marathon can learn from these training techniques.  

This year, strategies will focus more on the prevention of such incidents by introducing some new restrictions for both spectators and race participants.  There will be no bags, no strollers, and no signs cheering on the runners at the marathon venues near the start and finish lines. Containers with more than 1 liter of liquid will not be allowed.  There will be no bulky clothing.  Runners will be allowed only a clear plastic bag provided to them.  They can run with a small fanny pack with medication, cell phones, and a fuel belt holding 1 liter or less only.  This year, no unregistered runners are allowed from the start line or at any point along the race to encourage their family member or friend.  There will be double the number of police officers along the route (more than 3,500) and more security cameras.  

The new restrictions in combination with tried and true response plans to emergency events should help to minimize the chance of another catastrophic event, even at such a public and well attended one.  

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