Monthly Archives: April 2013

Amputee Marines Provide Comfort, Relief to Marathon Bombings Patients

Hope. Inspiration. Support. That’s what Marines who lost limbs in Iraq and Afghanistan provided to amputee victims of the Boston Marathon bombings when they visited BMC April 21. The Marines, members of Semper Fi Fund, a veteran non-profit organization that supports critically injured soldiers, met with five patients who lost limbs.

Semper Fi visits BMCSemper Fi Fund thanks ED staff for their heroic efforts caring for patients.

“As soon as we heard about the bombings, the Marines were texting me that we had to come to Boston and visit with the amputee victims,” says Karen Guenther, President and Founder, Semper Fi Fund. “They knew they could help.”

The five Marines flew in from around the country and visited with each patient for 30 minutes, answering questions and providing vital reassurance. Will I be able to drive? Can I wear heels with a prosthetic leg? Will I be able to go to the beach and swim in the ocean? Their response to each question: yes.

“I want to be independent,” said one patient who lost both legs through tears. “I don’t want to be in a wheelchair and need my family to take care of me.”

“You are going to go right back to your life,” said a Marine who lost both legs in Afghanistan in 2010. “You will be more independent than you were before.”

The Marines were quick to remove their prosthetic legs and hand them to patients to touch and examine. Smiles and laughter emerged from patients as they bonded with those who know best what they are going through.

“You’re part of a special group now,” one Marine told a patient. “You now have the same badge of honor that we do and celebrate another birthday, what we call our Alive day.”

The Marines also visited with BMC staff, thanking providers for the care they have given to the victims of the Marathon bombings.

“Thank you for everything you did and continue to do,” the Marines told Emergency Department, OR and SICU staff.

“Thank you for what you have done for us,” said one nurse who burst into tears while she hugged a veteran.

The Marines say they will continue to support the patients long after they leave BMC through the Semper Fi Fund.

“They are part of our family and we will support them in every way possible,” says Guenther.

Courtesy of BMC.org

Out of Darkness: BMC Shines in Light of Marathon Tragedy

On April 15, Marathon Monday, BMC hummed with its usual activity. Valet attendants parked cars, volunteers greeted and assisted visitors and clinicians treated patients and performed surgeries. In the Emergency Department (ED), staff geared up to receive marathon runners suffering from dehydration, muscle sprains and other common race ailments. No one was prepared for the horror that would come.

Flora Sam, MD
Flora Sam, MD, rushes to help in the ED. Photo courtesy of the Boston Herald

At 2:50 p.m., the first of two bombs exploded at the Marathon finish line. Hundreds were wounded and medical personnel rushed victims to hospitals around the city, including BMC. As ambulances arrived and patients poured into the ED, staff sprang into action. The ED quickly became a scene of organized chaos, with off-duty staff and employees from all areas of the hospital coming to assist in any way they could.

“Patients were bloody, missing limbs and in shock physiologically and psychologically,” says Joseph Bellabona, RN, a Nurse Manager in Renal Rheumatology Geriatrics who helped in the ED. “They had multiple shrapnel wounds and were being treated as though they had just been removed from the front lines of a war zone in Bosnia, Iraq or Afghanistan; instead, unbelievably, they were coming from only a few miles away in Boston’s Copley Square.”

“I saw so many doctors, nurses and other staff covered in blood, whose faces were filled with bewilderment and frustration,” he continued. “You could see them struggling, asking themselves, who and why, but they were professional and focused on the task at hand and did the extraordinary.”

With determination and resolve, BMC staff pitched in and did whatever was necessary. Surgeons pushed stretchers and fetched blood from the blood bank. Patient Transport staff staged themselves in the ED to make sure wheelchairs and stretchers were plentiful. Managers turned beds over between patients. Staff did everything they could to care for the 23 patients BMC received from the Marathon bombings.

“It did not matter what needed to be done, we just did it,” says Jaouad Boughadi, a Patient Transporter in the ED. “We did not wait to receive a page or a call to act. We all pitched in and just did whatever needed to be done.”

“I did not care about a break or eating lunch,” says Gregorio Amado, a fellow ED Patient Transporter. “All I wanted to do was play my role as a team member.”

The disaster drills that had been practiced many times before became a reality as armed guards lined the entrances of the hospital as it went into lockdown. Trauma surgeons worked on 16 patients in 10 operating rooms while activity outside the rooms shifted into high gear.

Beyond the ED, the Menino lobby was quickly turned into a receiving area for the wounded, with wheelchairs, stretchers, IV pumps and linen carts populating the space. Occupational and Environmental Medicine staff joined caregivers in setting up the make-shift clinic, providing supplies and screen barriers to ensure patient privacy. Facilities Management staff arrived on the scene to test electrical outlets and provide power strips, while law enforcement personnel patrolled the first floor to ensure the safety of patients and staff.

Meanwhile, across the street in the FGH building, staff led by Patient Advocacy was busy establishing a Family Resource Center for the victims’ loved ones. By 4:30 p.m., an hour and a half after the bombs went off, the Center was up and running, serving sandwiches, coffee and snacks provided by Food and Nutrition Services to 100 people. Information Technology Services set up computers, phones lines, including an international line, and had chargers on hand for people to power their cell phones. Social workers, chaplains, patient advocates and volunteers from other areas of the hospital worked with families to meet their every need, including serving as liaisons to the clinical teams caring for the victims.

By the time the Center closed at 11 p.m., all families had been reunited with their loved ones.

“The Center was an incredible team effort under the most challenging of circumstances,” says Sheryl Katzanek, Director, Patient Advocacy. “The families were an inspiration to all of us.”

Behind the scenes, Operator Services was hard at work, handling a large influx of calls from families inquiring about their loved ones and others just looking to help. Calls came from generous strangers inquiring how to financially support marathon patients and from nurses in other states hoping to come to Boston to lend a hand. That day, Operator Services answered 500 more calls than usual for a typical Patriots’ Day.

“The calls that came into Boston Medical Center for donations, volunteer services and blood donations made my heart flutter,” says Kristin Jeffes, Lead Telephone Operator. “It was at that point that I wished I could reach through the phone and express my thanks to them through a hug or a simple smile and say, ‘thank you.’”

“I may never speak to these callers again,” she continued,” but they left me with the impression that we are all united as one.”

Throughout the afternoon, evening and following days, BMC staff banded together to process the horror that had occurred. They spoke of the extraordinary strength displayed by physicians, nurses, first responders and one another despite the gravity of the situation.

“What helps me deal with this tragedy is knowing what BMC as a whole is capable of,” says Iman Bunton, Assistant Director, Transport. “Every employee gained a new-found appreciation for the duties of others. I am so proud of BMC staff.”

As patients emerged from surgery Monday, Operating Room and Post Anesthesia Care Unit (PACU) staff coordinated the transfer of patients directly to the Surgical Intensive Care Unit (SICU) and Intermediate Medical Care Unit (IMCU) to ensure the safe hand-off of the critically injured. Once there, SICU and IMCU staff sprang into action, with Materials Distribution staff providing dressing supplies, IV fluids and burn dressings to clinical staff. Environmental Services staff made sure rooms were cleaned, trash removed, and linens replaced quickly, while Anesthesia staff remained in the SICU and IMCU until each patient was settled in.

Those not directly involved in patient care soon discovered that they, too, would play an important role.

BMC Emergency Department
Staff wait for the influx of patients outside the ED. Photo courtesy of the Boston Globe

“As a pathologist, my role was not to comfort and stabilize the victims, but rather to take care of the parts that were taken from them,” said Cathryn Byrne-Dugan, a Pathology resident who documented the damage done by shrapnel and other objects to the patients’ amputated limbs. “We know what they lost. We may not have been able to be with them in the Emergency Department, but our thoughts and prayers will be with them forever.”

“It is often said that the best of people emerges in the worst of times, and this was never more evident than Monday inside the ER of Boston Medical Center,” wrote Roberta Gately, RN, in an open letter detailing her experience treating the Marathon patients in the ED. “As patients were saved and soothed and comforted, and tiny rays of hope and light broke through the darkness, I was reminded once again how great this city, this hospital, this country is, and how proud I am to be a small part of all of that.”

BMC’s phenomenal efforts in the face of tragedy have captured the hearts of people all over the country, with support pouring in commending staff on their heroic response.

“I can only imagine the complexities of treating the seriously injured, fielding inquiries from concerned family and friends, providing information to the media, and working to continue the vital services that BMC provides each day to your community,” read one letter.

“The thousands of individuals who are a part of your organization are heroes,” read another. “While I recognize your organization saves lives on a regular basis, on April 15 your preparation, responsiveness and diligence saved dozens of lives. As an American, I thank you.”

As Marathon patients leave BMC this week to continue their healing journeys, BMC staff also will move forward with a greater sense of unity.

“It was controlled chaos,” summed up Andrew Ulrich, MD, Executive Vice Chairman, Department of Emergency Medicine. “In my 20+ years, I’ve never been more proud to be a part of BMC than I was on Marathon Monday.”

BMC resources for staff wellness are available on the BMC intranet.

Boston Public Health Commission opens drop-in center for emotional support Read more: Boston Public Health Commission opens drop-in center for emotional support

Boston —

The Boston Public Health Commission (BPHC) has opened a new drop-in center to continue to provide emotional support to anyone affected by last week’s attack on the Boston Marathon.  People experience a range of emotions following traumatic events, and BPHC has trained clinicians on-site to speak with anyone that needs to talk. 

The drop-in center will provide free counseling at the Boston Area Health Education Center, located at 729 Massachusetts Ave. It will be open daily from 2 p.m. to 6 p.m. through Friday of this week.

While the physical injuries and destruction that resulted from the bombings might be the most visible signs of trauma, many people experience serious emotional distress based on what they saw, heard, and felt during and after the attack. Sometimes these symptoms do not surface immediately. For many people, a newly traumatic event can also trigger emotions and feelings associated with previous traumatic events, making recovery that much more challenging.

Understanding the deep impacts of this emotional distress, city officials opened the drop-in center as a safe place for people to come together and talk about their experiences over the past week. Anyone that needs to talk through their thoughts and feelings is encouraged to visit the center.

The drop-in center will offer one-on-one time with trained clinicians as well as facilitation of group conversations. Groups from a particular workplace or community affected by the attack are welcome and encouraged to visit the drop-in center together.

Free parking will be available at an adjacent garage, located at 35 Northampton Street.

The Mayor’s Health Line will continue to provide free trauma counseling and support over the phone throughout the week. Please call 617-534-5050, Monday through Friday from 9 a.m. to 5 p.m., to speak with a trained clinician. Groups that would like to visit the drop-in center are encouraged to call the Mayor’s Health Line ahead of their visit to make sure staff can properly accommodate them. Individual visitors do not need to call ahead.

The Federal Bureau of Investigation (FBI) also maintains a Victim Assistance Call Center, which operates 24-hours a day, at 1-800-331-0075. To learn more about other forms of assistance being offered by the FBI, please visit their website.

The Boston Public Health Commission (BPHC) has opened a new drop-in center to continue to provide emotional support to anyone affected by last week’s attack on the Boston Marathon.  People experience a range of emotions following traumatic events, and BPHC has trained clinicians on-site to speak with anyone that needs to talk. 

The drop-in center will provide free counseling at the Boston Area Health Education Center, located at 729 Massachusetts Ave. It will be open daily from 2 p.m. to 6 p.m. through Friday of this week.

While the physical injuries and destruction that resulted from the bombings might be the most visible signs of trauma, many people experience serious emotional distress based on what they saw, heard, and felt during and after the attack. Sometimes these symptoms do not surface immediately. For many people, a newly traumatic event can also trigger emotions and feelings associated with previous traumatic events, making recovery that much more challenging.

Understanding the deep impacts of this emotional distress, city officials opened the drop-in center as a safe place for people to come together and talk about their experiences over the past week. Anyone that needs to talk through their thoughts and feelings is encouraged to visit the center.

The drop-in center will offer one-on-one time with trained clinicians as well as facilitation of group conversations. Groups from a particular workplace or community affected by the attack are welcome and encouraged to visit the drop-in center together.

Free parking will be available at an adjacent garage, located at 35 Northampton Street.

The Mayor’s Health Line will continue to provide free trauma counseling and support over the phone throughout the week. Please call 617-534-5050, Monday through Friday from 9 a.m. to 5 p.m., to speak with a trained clinician. Groups that would like to visit the drop-in center are encouraged to call the Mayor’s Health Line ahead of their visit to make sure staff can properly accommodate them. Individual visitors do not need to call ahead.

The Federal Bureau of Investigation (FBI) also maintains a Victim Assistance Call Center, which operates 24-hours a day, at 1-800-331-0075. To learn more about other forms of assistance being offered by the FBI, please visit their website.

Read more: Boston Public Health Commission opens drop-in center for emotional support – West Roxbury, MA – Wicked Local West Roxbury http://www.wickedlocal.com/roslindale/news/x935172141/Boston-Public-Health-Commission-opens-drop-in-center-for-emotional-support#ixzz2RJigfyhC

For Boston Medical Center pediatrician, trauma waited at the end of her race

http://www.latimes.com/news/nationworld/nation/la-na-0422pediatrician-trauma-video-20130421,0,3754822.premiumvideo

Click the above link to view her video.

The first victim the doctor approached was a slender young woman, her legs exposed and bloody where she fell after the explosions: at the edge of Boylston Street near a mangled stroller and toppled barricades.

Dr. Natalie Stavas performed CPR with the help of a stranger until paramedics arrived and loaded the woman, still unresponsive, onto a backboard and headed for the hospital.

Stavas, 32, had been near the finish of the Boston Marathon herself. She was covered in sweat and Gatorade, shivering, with numbness descending into her legs.

“I didn’t feel anything,” she later recalled.

She kept moving on to other victims. She plugged the gaping groin wound of a woman in her 30s with a borrowed T-shirt. She used other bits of clothing to stanch the bleeding from one man’s mangled foot, and another’s broken calf bone.

Then police, fearing another bomb, forced her to leave.

With no one to treat, Stavas was suddenly feeling things again: a rush of responsibility, guilt for not doing more.

“As a physician, I take an oath to do the best I can,” Stavas said at her apartment in Boston’s South End last week, stifling tears.

Before she left Boylston, Stavas snapped a photo with her cellphone of the spot where she treated the first woman.

A week later, more than 50 bombing victims were still recovering in Boston hospitals, and many more, like Stavas, are grappling with the emotional and psychological toll of the attack.

Stavas is not easily shaken. She is not normally a crier — she likes to tell people she didn’t cry in “Titanic” or “The Lion King.” The daughter of a doctor and nurse, the oldest of five raised in a Nebraska farm town, she knew what she was getting into when she embraced medicine. She was a trauma nurse in San Diego and Chapel Hill, N.C., and then became a pediatric resident treating some of Boston’s neediest children through the joint program at Boston Medical Center and Boston Children’s Hospital.

She is slender and petite, her hair a tumble of blond waves. She works 90-hour weeks. In her spare time this year she was teaching spin aerobics classes to fellow residents and training to run the Boston Marathon with her dad, her fourth time in the iconic race.

When she broke her left foot training weeks ago, she let her doctor know she still intended to complete the marathon. She was running for charity, and couldn’t let her father down.

Despite her injury, she was on pace to finish that day in 4:09 (45 minutes slower than her personal best) when she approached the corner of Boylston and heard the blasts.

Her father was with her at first as she sprinted toward the wounded. A police officer stopped her.

“I’m a pediatric physician — I have to get to the scene!” she shouted. The officer let her through. Stavas hopped a 4-foot barricade and went to work.

“She was like an Olympic runner — I couldn’t keep up with her,” recalled her father, Joe Stavas, 58, a radiologist, who also helped treat fellow runners.

After being ordered away, she walked to the nearby Colonnade Hotel, where she found her mother in the lobby, sobbing. Unable to reach her daughter or her husband, she had assumed the worst. Soon after, Stavas’ father arrived. Then the hotel was placed on lockdown as the area was searched for explosives. It was hours before Stavas finally returned home to her South End brownstone to rest.

Sleep brought nightmares. She relived her struggle to reach the wounded: An officer stopped her, she passed him but he trailed behind her, somehow slowing her down.

“It was just this recurring theme: that I had to get there,” Stavas said.

The pediatric resident returned to work Wednesday at Boston Medical Center, which treated a dozen of those wounded in the bombing. Although Stavas was not involved with their cases, she was reminded of them every time she entered the hospital and passed the slew of added police, huge men dressed all in black. She gave the hospital’s pediatric emergency department the money she raised running the marathon, $6,000.

The next day, she attended the marathon memorial service at the Cathedral of the Holy Cross. As a first responder, she was ushered up front and seated amid a sea of firefighters, which she found comforting. The service became like a funeral for her, a time to mourn the victims.

“It was very cathartic,” she said. “I’ve been living with this sort of pit of grief inside me.”

Stavas was moved by President Obama‘s speech about the spirit of Boston and its first responders, his insistence that Boston will run again. By the end of the memorial, she was among those on their feet applauding, “whooping and hollering and amen-ing.”

As the manhunt continued last week, Stavas noticed the implied hope that capturing the suspects would bring an end to the city’s suffering.

“I just don’t think it’s going to be that simple,” Stavas said.

She was supposed to work a 28-hour on-call shift Tuesday, but was allowed to postpone it. She called her parents at the gate at Logan International Airport and asked them to stay.

“She was shaken and kind of still in shock,” her father recalled.

Stavas was by now known as a symbol of Boston’s heroism and resilience. She spoke with reporters, some of whom tried to get her to describe the first woman she treated, believed to be one of the two women killed. She refused, for privacy reasons.

She was home when news broke Friday of the capture of Dzhokhar Tsarnaev, 19.

The abstract evil that haunted her dreams had a face. To Stavas, who treats patients up to age 20, Tsarnaev seemed like so many other youths she had helped at the hospital.

“Capturing him made me even more sad that it was such a young person that created this mess,” she said. “What has gone so wrong in our world that a 19-year-old doesn’t think twice about killing and maiming people at a peaceful event?”

Stavas plans to participate in a debriefing for hospital staff on the bombings, which she thinks will help her process what she saw that day. She also plans to run the Boston Marathon again next year. If some of the victims she treated contact her, she said, maybe she could run with them.

Stavas never learned the identity of that first woman she treated, but she has let go of the need to know her fate.

“It’s time to move forward, without forgetting them, and tell myself I did the best I could do and I don’t have to feel guilty, or feel their injuries or their deaths were my responsibility,” she said Sunday as she returned home after a 30-hour shift at the hospital. “I know they survived, and I can kind of find some peace with that.”

*Courtesy of Los Angeles Times

Over the course of Boston’s most challenging week, hospital workers have been a shining light

If this had been an ordinary week in Boston, the workers who hustle down the hallways of our city’s hospitals would’ve been doing all the things they ordinarily do: drawing blood, tending to patients, performing heart bypasses, delivering babies, running MRIs.

This was nothing like an ordinary week.

On Monday, our city’s medical professionals tried to save as many victims of the Marathon blasts as they could. A resident at Boston Medical Center who had been running the race, Natalie Stavas, offered aid to victims on the scene. One trauma surgeon, Dr. David King,reported to work at Mass General not long after he himself crossed the finish line. Employees of Boston Children’s Hospital who had been manning a medical tent on the marathon route in Wellesley hurried to the hospital to see how they could help. Hundreds of others whose names we don’t know took care of the wounded as they were transported to the city’s hospitals, and once they arrived. 

By Thursday night, after some patients had been released, and others were on the road to recovery, there were new victims on their way to the hospitals: an MIT campus police officer, Sean Collier, who died, and an MBTA transit police officer, who was wounded in a firefight and brought to Mount Auburn Hospital. Then, Beth Israel staffers tried to revive one of the bombing suspects, who showed up in their emergency room at 1:10 a.m. this morning with gunshot and blast injuries. One Beth Israel doctor, David Schoenfeld, happens to live in Watertown. When he started hearing gunshots and sirens in his neighborhood last night, he did the obvious thing: he drove to work.

“You give the best care you can to every patient that comes to you, regardless of what may or may not be,” he said at a press conference earlier this morning. “Whether it was a suspect, an innocent, a police officer, you have no idea who it is when they arrive. You give them the best care you can.”

If this had been an ordinary week, doctors, nurses, technicians, and admin staffers would have simply been delivering their best care all around town, without getting much appreciation from those not wearing one of those plastic hospital bracelets. A few of them would have run the marathon on Monday to raise a few million for research initiatives and patient care, gone home, and maybe recuperated a bit.

This has been a far from ordinary week, and we owe tremendous gratitude to all those green-gowned workers who show up for work at our city’s hospitals on normal days and the rest, ready to help all of us.

*Courtesy of Boston.com

Boston Medical Center: Helping Patients and Staff Cope with the Aftermath of Marathon Bombing

Physicians at Boston Medical Center said their experiences overseas helped prepare them for Monday’s bombing at the Boston Marathon, according to a news conference Thursday morning.

Joe Blansfield, a nurse practitioner and trauma program manager, said he was in Iraq for 12 months, and Monday’s eventswere “disturbingly similar,” when it came to treating the large number of trauma patients.

“The lessons learned in Iraq definitely paid dividends on Monday,” said Blansfield, who was a colonel in the Army Nurse Corps, U.S. Army Reserve.

One of the biggest lessons? Tourniquets can be a useful way to treat injuries, if used properly, Blansfield said.

“Tourniquets applied in the field or en route saves lives,” he said. “That was a direct benefit from Iraq and Afghanistan.”

Boston emergency medical services have been carrying tourniquets in their trucks for a few years now, because of lessons learned overseas – and Blansfield encourages other cities to stock up as well.

However, Blansfield and Dr. Joseph Burke, BMC’s chief trauma surgeon, reiterated that if not applied properly, a tourniquet can cause more harm than good, and you should not apply one unless you have been properly trained.

Blansfield said they also learned to refrain from giving trauma patients “oceans of IVs,” because that interferes with the coagulation process. So, if the patient is losing blood, it’s better to give them red frozen blood cells and plasma, which they need more.

Lisa Allee, a licensed social worker and BMC’s injury prevention coordinator, said she and her staff have been debriefing physicians and emergency medical technicians on how to deal with such a traumatic event because it’s not just the patients who feel the emotional impact, but the ones treating the patients as well.

“They are already feeling the impact,” Allee said of the EMTs who initially responded to Monday’s scene. “ It’s similar to those of the families (of victims). They have the same feelings: shock, anger, grief.”

Burke noted if the treating physicians, nurses and EMTs aren’t talking about and dealing with their emotions, it will make it difficult to get up each morning and do their jobs – which is why it’s crucial to deal with stress in a timely manner.

“In order to take care of patients, we need to take care of ourselves,” Burke said.

Allee said she encourages these people to deal with stress by attending the debriefing sessions, using holistic methods, sharing their feelings and exercising.

Helping patients cope 

Allee added that hospital social workers are crisis-oriented right now, focusing on helping patients deal with their injuries.   
“As they (the patients) wake up, they are feeling anger, sadness; some are doing extraordinarily well,” Allee said. “And some are having flashbacks or intrusive thoughts – even during sleep. That’s normal.”

Burke said it’s important to realize the recovery process happens over a period of time, and people can go on to have a normal life.

“The cup should be half-full, not half-empty,” he said.

At least 16 patients remain at BMC, and only one is considered in critical condition at this point. Two patients will be operated on today.

Burke said many of these patients will require multiple surgeries, as there is due to massive tissue damage. – and this cannot be done all at once.

“You can’t just close a wound like that at first or else there would be an infection,” he said. “First, you go in and look at the wound (and treat it); the second time you make sure there’s no more debris and the third time you can close the wound.”

Then, he added, patients will require rehabilitation.

For amputees, it will be a while before they are ready for prosthetics.

Burke said seven amputations have been performed on five patients since Monday.

“One of the big fears is infection – not only in wounds, but in the lungs,” Burke said. “And clots in the veins, which can lead to pulmonary embolisms. And, of course, we worry a lot about mental health.”

On Wednesday, officials said an eight-year-old patient was in critical condition. That patient is no longer critical, Burke noted, and although he “always worries about the little ones,” the boy is making good progress.

“He’s strong,” Burke said, adding that he suffered from soft tissue and pulmonary injuries.

Allee said the boy was awake even when intubated, and he’s had family at his bedside the whole time. The boy’s mother was injured Monday, too, and is being treated at another health care facility, so Allee said technology like FaceTime and Skype is vital at a time like this.

Read more: http://www.foxnews.com/health/2013/04/18/boston-medical-center-copes-with-aftermath-marathon-bombing/#ixzz2QqNAvk3d