Boston Marathon Bombings: An Emergency Department Responds

Susan Yox, RN, EdD; Julia L. Compton, RN, BSN

Disclosures

April 24, 2013

In This Article

Another Unexpected Situation

Medscape: Once the patients had all arrived, did care progress fairly uneventfully?

Julia Compton: Unfortunately, no. We had to evacuate our department in the middle of this because there was a bomb scare.

Medscape: A bomb scare inside your hospital?

Julia Compton: Yes, in the main portion of the ED, and I was in the middle of it all. I was in the hallway, talking to a patient, and I felt a tap on my shoulder -- it was one of the police. He said, "Ma'am, you're going to have to move." I responded, "I'll be right with you; I'm in the middle of a triage." And then he said, "Ma'am, there's a bag in this room; we don't know where it came from and we're concerned about it because we think there might be something in it that could be explosive." I thought to myself, "Okay, normally this is my department and I tell people what to do, but I guess you win."

So, at that point, he told me that we needed to evacuate the department. My thought was, "You want me to do what? There's no way I can do that right now." But quickly I said, "Okay, everybody get a patient and move." I think we got everybody out of the department within 4 minutes -- patients, family members, and employees.

Medscape: Where did you go?

Julia Compton: We went to the atrium of the hospital, which is down the hall. The unfortunate thing about Tufts -- which is also a nice thing about Tufts -- is that it's just a very old hospital. There are multiple buildings. We're in what's called the North building, which obviously can accommodate all of our stretchers. We went to the atrium because our part of the North building was shut off. Once we got everybody out, we found that we couldn't get any farther because the elevators in the lobby of the atrium don't fit the stretchers. At that point, I'm standing on the steps, looking down. I'm looking down at my department, all at work, in the atrium. There's still patient care going on. One of the nurses is wheeling a patient over to the side to go on a bedpan-- in the middle of the entrance to the hospital, the main entrance. Everybody was just kind of like stunned.

Bomb-sniffing dogs came in. What was remarkable was the response of the emergency staff. I think that as long as everyone knew that I was calm and focused, then everyone was okay, right down to the patients. The patients knew that they were fine as long as they had their nurse and they saw that someone was directing traffic.

Medscape: You must have brought supplies out as well.

Julia Compton: We had some supplies, but then the nurses had to go upstairs to other floors, so the floor nurses just said, "What do you need? We'll bring it down." We had to get some vital-sign machines, little things like that. We even needed warm blankets because some of these patients were just runners who had finished the marathon and were cold. I look back on it now and think it was remarkable that it all worked.

We had plenty of equipment and all the treatments that we needed, because the really critically ill had gone up to the operating room very quickly. So, we knew we were okay. We had fluids that we were getting from other areas, and if we needed to get medications, we did that. We kept a close watch on everyone. As you know, we need to check marathon runners' sodium and other variables like that. We were able to do that in the atrium, using our cell phones to tap into the results. We also had a lab representative in the department who evacuated with us, so he was in constant contact with the lab, and he provided updated lab results.

Luckily, the situation lasted only about 45 minutes. We were almost getting ready to move people outside and down the street to go around to another entrance, but we were then cleared to go back to the ED.

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