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The Boston Marathon bombings: a post-event review of the robust emergency response.

With as many as five level I trauma centers, Boston is well-positioned to mount an emergency response, but the two terrorist bombs that went off near the finish line of the city's annual marathon on April 15 put high levels of stress and demand on emergency personnel. In post-crisis reviews, hospital administrators say that all the emergency planning and drilling that they carry out on a regular basis was instrumental in helping them quickly care for nearly 200 victims while also securing their facilities at a time when the threat to the city was not well understood. Medical personnel working in tents on site at the marathon were able to respond to the injured quickly, while also giving area EDs a heads-up on what to expect. ED leaders report that a robust effort from the upper floors of their hospitals was critical in: helping them clear their EDs for incoming patients; establishing a security perimeter around the facilities to thoroughly check any people entering or leaving to guard against potential external threats; and focusing on improving how many extra staff show up to help during the crisis because it actually requires extra resources to manage the personnel.