Boston Bombings: Response to Disaster MAUREEN HEMINGWAY, MHA, RN, CNOR; JOANNE FERGUSON, MSN, RN

Boston Bombings: Response to Disaster MAUREEN HEMINGWAY, MHA, RN, CNOR; JOANNE FERGUSON, MSN, RN

ABSTRACT

Disasters disrupt everyone’s lives, and they can disrupt the flow and function of an OR as well as affect personnel on a professional and personal level even

though perioperative departments and their personnel are used to caring for

trauma patients and coping with surprises. The Boston Marathon bombing was a

new experience for personnel at Massachusetts General Hospital, Boston. This

article discusses the incidents surrounding the bombing and how personnel at

this hospital met the challenge of caring for patients and the changes we made

after the experience to be better prepared in the event a response to a similar

incident is needed. AORN J 99 (February 2014) 277-288. � AORN, Inc, 2014. http://dx.doi.org/10.1016/j.aorn.2013.07.019

Key words: perioperative disaster care, OR triage, terrorist bombings, Boston

Marathon, shelter in care, city lockdown.

M assachusetts General Hospital (MGH),

Boston, is a level I trauma teaching

hospital where patients receive care for

all surgical specialties. Personnel have the capacity

and ability to care for a large number of patients

with varying acuity levels. There are 907 beds and

61 functional ORs located on one campus. In 2005,

MGH received designation as a Magnet� hospital, and, in 2008 and 2012, the American Nurses Cre-

dentialing Center renewed this designation. The

hospital’s perioperative nursing team cares for

approximately 36,000 patients per year and pro-

vides perioperative care, on average, for 150 pa-

tients per day. The ORs are located on three levels

across five different buildings. The OR personnel

comprise 235 RNs, 92 surgical technologists, 27

equipment technicians, 115 OR assistants, and 17

operations assistants.

The environment in the OR can change very

quickly during the course of any day. Perioperative

nurses who work in the OR are aware that the daily

schedule may be disrupted by unscheduled events,

such as the arrival of trauma patients, transplan-

tation recipients or donors, patients who need to

return to surgery, or equipment or facility failures.

When terrorist bombs exploded at the annual

Boston Marathon, the resources and disaster plans

at MGH were put to the test. This article discusses

the response of personnel and the outcome and

changes made as a result of this experience.

APRIL 15, 2013

It had been a typical “marathon Monday,” with an

atmosphere of excitement in the city that was felt in

the hospital and OR environment. The Boston

Marathon is a long-standing tradition for many

people who participate either as runners, volun-

teers, or bystanders. 1 Notably, this third Monday in

April is Patriot’s Day, a state holiday for many,

which coincides with the public school system’s

http://dx.doi.org/10.1016/j.aorn.2013.07.019

� AORN, Inc, 2014 February 2014 Vol 99 No 2 � AORN Journal j 277http://dx.doi.org/10.1016/j.aorn.2013.07.019

vacation week. However, it is one of the few state

holidays not observed at MGH.

This marathon Monday began no differently

than many others already past. The OR had pro-

cedures scheduled in 51 rooms that morning,

compared with the usual 61 rooms, and periopera-

tive leaders were projecting that there would be

fewer than 40 rooms running by 3 PM. That

morning, 135 nursing team members arrived for

the 7 AM shift, with more personnel sched