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Securing the Emergency Department During Terrorism Incidents: Lessons Learned From the Boston Marathon Bombings

Published online by Cambridge University Press:  12 March 2019

Horacio Hojman ,
Rishi Rattan ,
Rob Osgood ,
Mengdi Yao  and
Nikolay Bugaev
Horacio Hojman
Affiliation:
Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine. Boston, MA
Rishi Rattan
Affiliation:
Ryder Trauma Center, Department of Surgery, Miller School of Medicine, Universtiy of Miami, Miami, FL
Rob Osgood
Affiliation:
Tufts Medical Center, Boston, MA
Mengdi Yao
Affiliation:
Department of Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA
Nikolay Bugaev*
Affiliation:
Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine. Boston, MA
*
Correspondence and reprint requests to Dr Nikolay Bugaev, Division of Trauma & Acute Care Surgery, Tufts Medical Center, Tufts University School of Medicine, 800 Washington St., #4488, Boston, MA 02111 (e-mail: nbugaev@tuftsmedicalcenter.org).
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Abstract

Terrorist incidents that target hospitals magnify morbidity and mortality. Before a real or perceived terrorist mass casualty incident threatens a hospital and its providers, it is essential to have protocols in place to minimize damage to the infrastructure, morbidity, and mortality. In the years following the Boston Marathon bombings, much has been written about the heroic efforts of survivors and responders. Far less has been published about near misses due to lack of experience responding to a mass casualty incident resulting from terrorism. After an extensive review of the medical literature and published media in English, Spanish, and Hebrew, we were unable to identify a similar event. To the best of our knowledge, this is the first reported experience of a bomb threat caused evacuation of an emergency department in the United States while actively responding to multiple casualty terrorist incidents. We summarized the chronology of the events that led to a bomb threat being identified and the subsequent evacuation of the emergency department. We then reviewed the problematic nature of our response and described evidence-based policy changes based on data from health care, law enforcement, and counterterrorism. (Disaster Med Public Health Preparedness. 2019;13:791–798)

Keywords

evacuationmass casualtiesterrorist attack
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 4 , August 2019 , pp. 791 - 798
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

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Footnotes

A previous error in this article has since been corrected. Please see 10.1017/dmp.2019.51

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