In Boston, radiologists helped provide organization amid chaos

Last week the nation--and much of the world--was transfixed by the events that took place in the city of Boston, as well as several of its inner suburbs.

The bombings that took place during the running of the Boston Marathon caused mass injuries, including three deaths. If not for the brave and immediate reaction of ordinary citizens, first responders, and medical personnel the death toll could have been much worse.

At least 10 Boston area hospitals treated the more than 170 persons who were injured in the bombings, many of them critically wounded. Radiologists were part of the first line team of physicians responding to the emergency. While those who lost limbs were whisked straight to surgery, radiologists like Jerry Tkacz of Boston Medical Center were tasked with examining images of some horrific injuries.

"There was a lot of shrapnel, some BBs, some oval-shaped pieces, and what looked like little metal arrows, embedded throughout the soft tissue," Tkacz told Maclean's. "We get a lot of trauma here, a lot of gunshot wounds. But I've never seen so much metal in soft tissue in my whole career."

Radiologic examinations--such as radiography, CT and sonography--are crucial in assessing the site and extent of these kinds of wounds; to that end, fast and accurate imaging was necessary to determine those patients who needed to be triaged to immediate surgery. Throughout the event, CT was critical in detecting unsuspected shrapnel sites, as well as demonstrating the path the shrapnel would have traveled and the resulting injuries that could have been caused.

By the end of the week there were dozens of patients still hospitalized. Many remained in critical condition, but the death toll never increased. By all accounts the medical professionals from these Boston-area hospitals responded brilliantly.

On Thursday, as at a memorial service in Boston's Cathedral of the Holy Cross attended by President Obama, two X-ray techs wearing their blue hospital scrubs were seen sitting next to Cellist Yo-Yo Ma, who performed Bach's Cello Suite No. 5 in C Minor during the service. As reported by the Boston Globe, the two techs had been on duty when the bombs went off and the casualties poured in to their hospital.

"I wish I brought a suit," said one of the techs, Mervyn Williams, as he looked at his blue fleece jacket, embossed with "Boston Medical Center Department of Radiology."

"But," he added, "I'm so proud to wear this jacket."

We all can be proud of the job imaging professionals--and the rest of the medical community--did in Boston last week. - Mike  @FierceHealthIT

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