Damage Control Surgery and the Boston Marathon Bombing
The practice of trauma surgery in the aftermath of the Boston Marathon bombing took place within the walls of the multiple Boston Level I trauma centers, as well as several adjacent community hospitals. The approach to these patients reflected the general philosophy of rapid damage control, abbreviated surgery, frequent returns to the operating room in a staged fashion, and high-ratio blood transfusions. The real lesson for surgeons, however, is learned from careful examination of the prehospital treatment of the injuries resulting from the two improvised explosive devices detonated on Boylston Street during the running of the 117th Boston Marathon at 14:49 on April 15, 2013: damage control starts at the point of wounding.
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