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Boston Marathon tragedy: Inside local ERs

As Monday’s events unfolded, many began to wonder how local hospitals would handle such a mass casualty/mass injury event. As it turns out, they seem to be handling it well thus far.

Massachusetts General Hospital

Eric Feins, a surgical resident at Massachusetts General Hospital, says that they began setting up a makeshift triage center in the lobby of the ER to treat the incoming victims; the more serious injuries were sent through to be admitted. “We were prepared for waves of victims,” Feins told TIME.1 “In the end, we worked on six people. Four had small lacerations, and we sewed them up.”

Peter Fagenholz, a trauma surgeon at Massachusetts General Hospital, told The Telegraph that the hospital was treating 29 patients, eight of whom are in critical condition.2 "It's just depressing that it's intentional," he said. "I can't say I've ever seen this volume of patients come this quickly with this type of injury."

Dr. Fagenholz, who has performed at least six operations on victims of the explosions, would not comment on the nature of the bombs, but said, “It’s a lot of small metal debris; we can’t say if they were placed there intentionally, or were just part of the blast.”

Since the last terrorist attack on U.S. soil in 2001, the United States has spent billions of dollars to train emergency responders to build and maintain an enormous apparatus designed to respond to events like Monday’s.1 At Mass General, Feins witnessed America’s first response protocols first-hand. He witnessed patients being tested for hazardous residue before being admitted to the hospital. “We have to make sure they don’t bring in to the hospital any materials that would injure us or other patients,” Feins explained. Beth Israel Deaconess Medical Center

On the other side of town, Dr. Richard Wolfe, chief of Emergency Medicine at Beth Israel Deaconess Medical Center, told CBS News that four people remain in critical condition, two very critical, at his hospital following the bomb blasts.3 The rest of the 17 people who remain at the hospital are in serious condition. "There are good hopes that everyone will pull through," he said.

Wolfe says the injuries seem to be primarily due to shrapnel injury in the lower extremities. "Some hand injuries, but mainly devastating injuries to limbs," he said. "We have at least two amputations and a number of very serious wounds that require fairly aggressive care.” Of the 24 patients admitted at Beth Israel, seven patients have been released.

When asked if this type of event was expected in Boston, Wolfe said, "I don't think we expected this in Boston, frankly. We have seen other disasters elsewhere, and I have to say the combination of the way people responded spontaneously and came within 15 minutes, we were able to multiply the size of our staff five-fold, and the way everyone interfaced and functioned as a team, and I think the training that's been ongoing since September 11th, really did pay off in a way that was remarkable. It's been the smoothest sort of handling of mass casualty that I've ever seen in my career."

"At this point, we've been able to integrate the patients quickly into the system. The health care system is functioning, and back at normal and things are working very, very well,” Wolfe says.