Lessons From the Boston Marathon Bombing

Tobert, Daniel G.; Keudell, Arvind von; Rodriguez, Edward K.

doi:10.1097/bot.0000000000000413

Cited by 23 publications

(10 citation statements)

References 3 publications

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“…Appointing a senior liaison person to coordinate multiteam activities proved an effective solution, consistent with practices reported from Paris terrorist attack response. 9 The importance of emergency preparedness training within this COP was emphasised through participants' feedback. First, the knowledge of response roles was facilitated by departmental training opportunities and larger scale HEPEs.…”

Section: Lack Of Preparedness and Trainingmentioning

confidence: 99%

“…6 Scientific publications providing analysis of medical response to MCIs were acknowledged for having a significant effect on improving medical strategies. 7 By taking into account lessons identified from terrorist attacks in Paris, Boston and Brussels, [7][8][9] effective initiatives were introduced into the health emergency preparedness system and activities in the UK. 2 Sharing limitations and practices that did not work well stimulates further improvements to prevent duplicating mistakes.…”

Section: Introductionmentioning

confidence: 99%

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UK healthcare staff experiences and perceptions of a mass casualty terrorist incident response: a mixed-methods study

et al. 2020

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IntroductionSystem learning from major incidents is a crucial element of improving preparedness for response to any future incidents. Sharing good practice and limitations stimulates further actions to improve preparedness and prevents duplicating mistakes.MethodsThis convergent parallel mixed methods study comprises data from responses to an online survey and individual interviews with healthcare staff who took part in the responses to three terrorist incidents in the UK in 2017 (Westminster Bridge attack, Manchester Arena Bombing and London Bridge attack) to understand limitations in the response and share good practices.ResultsThe dedication of NHS staff, staff availability and effective team work were the most frequently mentioned enabling factors in the response. Effective coordination between teams and a functional major incident plan facilitated an effective response. Rapid access to blood products, by positioning the blood bank in the ED, treating children and parents together and sharing resources between trauma centres were recognised as very effective innovative practices. Recent health emergency preparedness exercises (HEPEs) were valued for preparing both Trusts and individual staff for the response. Challenges included communication between ambulance services and hospitals, difficulties with patient identification and tracking and managing the return to ‘normal’ work patterns post event. Lack of immediately available clinical protocols to deal with blast injuries was the most commonly mentioned clinical issue. The need for psychosocial support for responding and supporting staff was identified.DiscussionBetween-agencies communication and information sharing appear as the most common recurring problems in mass casualty incidents (MCIs). Recent HEPEs, which allowed teams, interdisciplinary groups, and different agencies to practice responding to similar simulated incidents, were important and informed actions during the real response. Immediate and delayed psychosocial support should be in place for healthcare staff responding to MCIs.

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Section: Lack Of Preparedness and Trainingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

UK healthcare staff experiences and perceptions of a mass casualty terrorist incident response: a mixed-methods study

et al. 2020

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“…Previous disasters such as the Boston Marathon bombing have led to shutdowns of cellular communication systems in affected areas. 2,12,13 As a result, a reliable and rapid means of communication is critical in disaster response. VUMC utilizes a mass notification platform (Everbridge Critical Event Management, Pasadena, CA) for time-sensitive situations such as mass casualty incidents and inclement weather.…”

Section: Rapid Communication System Implementationmentioning

confidence: 99%

“…Much of the planning for these disasters has centered around mass casualty incidents. [1][2][3][4] However, the 2015 Ebola virus outbreak reinforced the importance of incorporating pandemic events within health care disaster planning, [5][6][7] and the 2020 COVID-19 pandemic has again proven the need for effective systems-level preparations. Without established plans and logistical support, hospitals may struggle to identify personnel to fill vital roles in emergencies.…”

Section: Introductionmentioning

confidence: 99%

Knowing Your Team: Rapid Assessment of Residents and Fellows for Effective Horizontal Care Delivery in Emergency Events

Dennis¹,

Highet²,

Kendrick³

et al. 2020

Journal of Graduate Medical Education

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Background Horizontal care, in which clinicians assume roles outside of their usual responsibilities, is an important health care systems response to emergency situations. Allocating residents and fellows into skill-concordant clinical roles, however, is challenging. The most efficient method to accomplish graduate medical education (GME) assessment and deployment for horizontal care is not known. Objective We designed a categorization schema that can efficiently facilitate clinical and educational horizontal care delivery for trainees within a given institution. Methods In September 2019, as part of a general emergency response preparation, a 4-tiered system of trainee categorization was developed at one academic medical center. All residents and fellows were mapped to this system. This single institution model was disseminated to other institutions in 2020 as the COVID-19 pandemic began to affect hospitals nationally. In March 2020, a multi-institution collaborative launched the Trainee Pandemic Role Allocation Tool (TPRAT), which allows institutions to map institutional programs to COVID-19 roles within minutes. This was disseminated to other GME programs for use and refinement. Results The emergency response preparation plan was disseminated and selectively implemented with a positive response from the emergency preparedness team, program directors, and trainees. The TPRAT website was visited more than 100 times in the 2 weeks after its launch. Institutions suggested rapid refinements via webinars and e-mails, and we developed an online user's manual. Conclusions This tool to assess and deploy trainees horizontally during emergency situations appears feasible and scalable to other GME institutions.

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“…Following the 2013 Boston Marathon bombings, scholars focused their research on hospital response and preparedness in the greater Boston area (Nadworny, Davis, Miers, Howrigan, Broderick, Boyd, & Dunster, 2014;Oser, Shah, & Gitlin, 2015;Tobert, von Keudell, & Rodriguez, 2015), the mental health needs of the bombings' first responders (Beinecke, 2014), how the media framed the marathon runners following the attack (Oliver, 2014), and runners' coping strategies and resilience in the wake of the bombings (Timm et al, 2017). There is limited scholarly research on Emotional Processing Theory as it relates to the experiences of individuals directly involved in a terror attack while attending or competing in an athletic event.…”

Section: Chapter 1: Introductionmentioning

confidence: 99%

An interpretative phenomenological analysis of 2013 Boston Marathoners’ experience of running a subsequent Boston Marathon

Grace

Butryn

2018

Qualitative Research in Sport, Exercise and Health

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AN INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS OF 2013 BOSTON MARATHONERS' EXPERIENCE OF RUNNING A SUBSEQUENT BOSTON MARATHON by Allison Grace While trauma experiences have been explored in several sport-related research studies, there is a lack of research on athletes' experiences of a terror attack in sport. The present study qualitatively explored the meanings that 2013 Boston Marathoners ascribed to their experience of returning to the Boston Marathon to compete. Eight participants took part in semi-structured interviews. Interviews were analyzed via interpretative phenomenological analysis. Eight themes emerged and were organized temporally around pre-2013 Boston Marathon experience, 2013 Boston Marathon experience, and post-2013 Boston Marathon experience. Results suggest participants initially had difficulty processing their 2013 experience, but ultimately, several participants had a changed perspective on the sport. Furthermore, results suggest that a return to the Boston Marathon provided an outlet for some participants to demonstrate their defiance to the attackers, display resilience, and achieve a goal that they could not in 2013. The results are discussed within the context of Emotional Processing Theory. v ACKNOWLEDGMENTS I would like to express my gratitude to the individuals who assisted me in making this thesis possible. First, I would like to acknowledge my thesis committee chair, and graduate advisor, Dr. Ted Butryn. Dr. Butryn, thank you for your guidance, patience, and confidence in me throughout this project and during my graduate education at San José State University. Thank you for always making yourself available to listen to my ideas, questions, anxieties, and challenging me to be a better student and researcher. Additionally, I would like to express my gratitude to you and to San José State University for seeing my potential and for your confidence in my ability to succeed in this program. I am grateful to have had the opportunity to pursue my graduate education at this institution. To Dr. Tamar Semerjian and Dr. Cole Armstrong, I would like to thank you both for being a part of my thesis committee. I am grateful for your expertise, guidance, feedback, and support throughout this process. I would also like to express my sincere gratitude to the runners who volunteered to participate in this study. Thank you not only for your courage, but for your willingness and openness in sharing your experiences with me. I am honored and grateful that you chose to share these experiences with me. Without you, this thesis truly would not have been possible. Mom and Dad, thank you not only for your confidence in my abilities to succeed in graduate school, but for your support and reassurance of my abilities to succeed at vi anything I have set out to accomplish. Thank you for all that you do. And lastly, to my neighbors in San José who have become like a second family to me during my time here. Thank you for making San Joséa place I moved to knowing no oneinto a place where I have made lifelong friendship...

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Lessons From the Boston Marathon Bombing

Cited by 23 publications

References 3 publications

UK healthcare staff experiences and perceptions of a mass casualty terrorist incident response: a mixed-methods study

UK healthcare staff experiences and perceptions of a mass casualty terrorist incident response: a mixed-methods study

Knowing Your Team: Rapid Assessment of Residents and Fellows for Effective Horizontal Care Delivery in Emergency Events

An interpretative phenomenological analysis of 2013 Boston Marathoners’ experience of running a subsequent Boston Marathon

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