Updated: Medical details emerging on Boston emergency


Relevant information will be added to the top of this blog post as it becomes available. Madelyn Kearns contributed to this post.

Here is a recap of information on medical emergencies related to the April 15 bombings at the Boston Marathon. Information posted comes from national news sources.

One suspect reportedly pronounced dead at Beth Israel Deaconess
Updated April 19, 7:15 a.m. EDT, reported by Bloomberg

After a chase and standoff between police and two suspects believed to be connected to the April 15 bombings at the Boston Marathon, one suspect is dead while the other is still on the loose, according to Bloomberg news service.

The Bloomberg report said police brought one of the suspects, an adult male with multiple gunshot wounds and an injury consistent with an explosion, to Beth Israel Deaconess Medical Center at 1:20 a.m. on April 19. Dr. Richard Wolfe, chief of emergency medicine, conveyed the information to reporters at a news conference held with the hospital’s chief executive officer, Dr. Kevin Tabb.

The patient, whose name Tabb wouldn’t release, was pronounced dead at 1:35 a.m. local time after efforts to resuscitate him failed, Bloomberg reported.

Beth Israel cared for 24 of the injured from the bombings. Twelve remain in the hospital, one of them in serious condition, Tabb said.

Further details from the Bloomberg report:

"Dr. David Schoenfeld, who worked on the injured male early this morning before he died, told reporters he was home in Watertown last night catching up on paperwork. When he heard the gunfire and explosions outside, he headed to the hospital to help with what he assumed were casualties headed to Beth Israel."

Inpatient count down to 58
Updated April 18, 4:00 p.m. EDT, reported by NBC News

Fifty-eight patients were still being treated in Boston area hospitals as of the morning of April 18, according to an NBC News report. That was down from 65 on April 17.

“In general, people are getting better, and we are happy with their progress,” Dr. Peter Burke, chief of trauma at Boston Medical Center, told reporters.

Doctor finishes one race to start another
Updated April 17, 3:23 p.m. EDT, reported by Reuters

A team of 20 Massachusetts General surgeons, who amputated four legs above the knee, included one MD who had completed the 26.2 mile marathon before the blast. 

According to Reuters: "At Boston Medical Center, surgeons performed five amputations and at Brigham & Women's there was one."

"If these victims had spent even a few more minutes at the scene they would not be alive today," Alasdair Conn, chief of emergency services at Massachusetts General Hospital, said on April 16.

Tourniquets may have saved lives
Updated April 17, 12:20 p.m. EDT, reported by the New York Times

Tourniquets, once discouraged because they were thought to cause damage to injuries, have returned to favor and have been used to treat wounds inflicted by explosive devices in the wars in Iraq and Afghanistan, said Dr. Allan Painter, a physician and spectator who helped treat serious leg injuries in the medical tent near the Boston Marathon finish line.

“With blast injuries to the lower extremities that we’re getting in the Middle East, you bleed out,” Painter explained in a report published by the New York Times. Tourniquets “can help save lives. I don’t know if they helped in this situation, but it sure couldn’t hurt.”

Panter, an emergency-room physician from Gainesville, Ga., was standing 10 yards from the blast near the finish line, waiting for his wife, Theresa, to complete her 16th Boston Marathon, the Times reported. Assisted by others, he said he used gauze wraps to apply tourniquets to several victims, including a man who appeared to be in his late 20s who lost both of his lower legs in the blast. He told the newspaper he saw another six or seven victims with belts tied around their wounded legs.

Patients released from Boston hospitals
Updated April 17, 7:25 a.m. EDT, reported by CNN

At least 100 patients have been released from Boston area hospitals, according to the latest CNN tally, the news source's What We Know webpage reported.

Physicians battle to save limbs
Updated April 17, 6:50 a.m. EDT, reported by the Washington Post

"We'll go to the mat to save a leg," said David Mooney, director of the trauma center at Boston Children’s Hospital, where three of the nine children brought in after the bombings remained hospitalized April 16, two in critical condition with severe leg injuries, reported the Washington Post. Surgeons were fighting to avoid amputation, Mooney told the Post, because of the impact it would have on a child’s life.

“We found BBs inside of kids,” said Mooney in the newspaper's account. “We found nails that looked almost like carpet tacks, maybe a centimeter long that were sticking out of a kid’s body.”

The Post article stated:

"The disproportionate number of leg injuries has convinced some medical experts that the bombs were on the ground or not high above it. The carnage from two- to three-millimeter diameter pellets and half-inch nails has convinced some that the main goal of the bombs was to injure as many people as possible."

At Brigham and Women’s Hospital, where another 31 victims were treated, almost all the injuries were in the lower extremities, according to Michael Zinner, chief of surgery. "Think of this like an IED,” said Zinner at a news conference on April 16.

The Post report noted that the quality of life for many survivors can depend on how much leg doctors can save. The article explained:

"Physicians will work fiercely to preserve a patient’s knee because prostheses work much better when that joint is intact, said Richard Neville, chief of the division of vascular surgery at George Washington University School of Medicine. And mobility means less stress on patients’ hearts and lungs, improving their chances at long-term survival."

Third fatality announced; injury count reaches 183
Updated April 16, 10:45 p.m. EDT, reported by CNN

CNN reported a Chinese national who was a graduate student at Boston University has died of injuries sustained in the bombings. The student's name was not made public at her family's request. When the explosions occurred, according to CNN's "What We Know" newsfeed, the victim was watching the race near the finish line with two other students -- one of whom is in stable condition at Boston Medical Center after two surgeries each of the past two days, while the other emerged unharmed.

The news source also reported that limbs were amputated in the treatment of 13 people, who were among the 183 injured treated at 11 Boston-area hospitals.

Trauma surgeon says fragments did not appear to be environmental
Updated April 16, 12:10 p.m. EDT, reported by CBS News

In contrast to a report from Brigham and Women's Hospital that bomb fragments appeared to be environmental, George Velhamos, MD, chief of trauma surgery at Massachusetts General Hospital, said the shrapnel removed from victims at his hospital looked like pellets, nails or sharp objects.

Velhamos gave the following report in a video posted online by CBS News:

"We are still getting details of all the events that have happened. Obviously it is very difficult to conclude, based on initial impressions. I wouldn't exclude completely the possibility that some of these fragments are environmental, but my opinion is that most of them were in the bomb. Because of the consistency of the fragments -- most of them are pellets, some of them are nail-like -- so I think it is unlikely they would be so consistent if they were pulled out from the environment...I can't say what they are with certainty, but that is what they look like."

Velhamos also described the types of injuries sustained by victims:

"After a bomb, there are a number of traumatic injuries…some of them are a direct effect of the bomb, when the extremities are severely damaged or there is internal bleeding, for example. But then there is secondary injury from the bomb blast, the wave of the bomb, that can push people away, that can throw them against walls. There is also another form of injury from the particles that are broken and embedded in people. We have seen all three of them after this event."

Eight Boston hospitals treating 140+ patients
April 15, reported by the Boston Globe

The Boston Globe reports eight city hospitals treated at least 144 patients, many in critical condition. The injured include at least 10 children.

Here are the patient counts available from the Globe report:

Brigham and Women's Hospital treated 31 patients ranging in age from 16 to 62.

Massachusetts General Hospital treated 29 patients, including at least four who lost limbs.

Boston Medical Center treated 23 patients.

Beth Israel Deaconess treated 21 patients.

Boston Children's Hospital treated eight patients (seven children ranging in age from 2 to 12 years old, and one child's parent).

Map image attributed to www.cityofboston.gov.

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