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| Boston doctors remove nails and pellets from blast survivors | Boston doctors remove nails and pellets from blast survivors |
| (4 months later) | |
| The Boston Marathon bombs had been packed with metal fragments and placed close to the ground, causing amputations and other severe lower body injuries, doctors treating survivors said on Tuesday. | The Boston Marathon bombs had been packed with metal fragments and placed close to the ground, causing amputations and other severe lower body injuries, doctors treating survivors said on Tuesday. |
| In a statement delivered outside Massachusetts General Hospital – where many of the injured had been taken in the aftermath of the double explosion – George Velmahos, the hospital's chief trauma surgeon, said nails and pellets had been removed from the bodies of the injured. | In a statement delivered outside Massachusetts General Hospital – where many of the injured had been taken in the aftermath of the double explosion – George Velmahos, the hospital's chief trauma surgeon, said nails and pellets had been removed from the bodies of the injured. |
| The make-up of the bombs, as well as their positioning in a crowded area and low to the floor, may account for the high number of patients suffering severe lower body injuries. Some of the injured victims were considered to be "automatic amputees," Velmahos said. "We just completed what the bomb had done." | The make-up of the bombs, as well as their positioning in a crowded area and low to the floor, may account for the high number of patients suffering severe lower body injuries. Some of the injured victims were considered to be "automatic amputees," Velmahos said. "We just completed what the bomb had done." |
| Velmahos said surgeons had performed four amputations, and said two more legs were "at risk", but that doctors hoped to be able to save them. | Velmahos said surgeons had performed four amputations, and said two more legs were "at risk", but that doctors hoped to be able to save them. |
| In all, 176 people were treated by emergency staff at the scene and in hospital. Injuries ranged from relatively minor wounds to severed limbs. An initial death count of two was later updated to three, an indication that at least one of the deaths may not have been recorded at the scene of the blast. A number of patients remained in a critical condition, various hospitals said on Tuesday. | In all, 176 people were treated by emergency staff at the scene and in hospital. Injuries ranged from relatively minor wounds to severed limbs. An initial death count of two was later updated to three, an indication that at least one of the deaths may not have been recorded at the scene of the blast. A number of patients remained in a critical condition, various hospitals said on Tuesday. |
| Velmahos gave further clues of the make-up of what appear to be home-made bombs. "Probably, this bomb had multiple metal fragments in it. We removed pellets and nails," he said. It was "not unusual" to see so many lower-body injuries given the nature of the device, he said. "This bomb was obviously placed low on the ground and therefore lower extremities are to be expected." | Velmahos gave further clues of the make-up of what appear to be home-made bombs. "Probably, this bomb had multiple metal fragments in it. We removed pellets and nails," he said. It was "not unusual" to see so many lower-body injuries given the nature of the device, he said. "This bomb was obviously placed low on the ground and therefore lower extremities are to be expected." |
| He confirmed that some of those treated at the hospital had suffered primary blast wounds. According to the American College of Emergency Physicians, such injuries are "often considered a marker for lethal injury". | He confirmed that some of those treated at the hospital had suffered primary blast wounds. According to the American College of Emergency Physicians, such injuries are "often considered a marker for lethal injury". |
| Velmahos said that secondary blast wounds, caused by bomb casing fragments and other projectiles, and tertiary blast wounds, the result of being thrown against nearby buildings, were also being treated at the hospital. Asked if the shrapnel injuries could have been caused by pieces of railings and barriers close to the bomb, Velhamos replied: "Some of the fragments are environmental, but most of them were in the bomb". | Velmahos said that secondary blast wounds, caused by bomb casing fragments and other projectiles, and tertiary blast wounds, the result of being thrown against nearby buildings, were also being treated at the hospital. Asked if the shrapnel injuries could have been caused by pieces of railings and barriers close to the bomb, Velhamos replied: "Some of the fragments are environmental, but most of them were in the bomb". |
| He continued: "Most of them were pellets, some of them were nail-like. I think it is unlikely that there would be so consistent if they had been pulled out of the environment." | He continued: "Most of them were pellets, some of them were nail-like. I think it is unlikely that there would be so consistent if they had been pulled out of the environment." |
| Hospital staff noted the resilience and stoicism of patients. But many of those who lost limbs will need counselling. "Peer support is critical to patients who undergo limb loss," said Kendra Calhoun, the president of the Amputee Coalition. | Hospital staff noted the resilience and stoicism of patients. But many of those who lost limbs will need counselling. "Peer support is critical to patients who undergo limb loss," said Kendra Calhoun, the president of the Amputee Coalition. |
| Dr Stephen Wegener, a psychologist and limb loss expert at Johns Hopkins school of medicine, said that the Boston victims may go through a lengthy process of physical, psychological and social rehabilitation. | Dr Stephen Wegener, a psychologist and limb loss expert at Johns Hopkins school of medicine, said that the Boston victims may go through a lengthy process of physical, psychological and social rehabilitation. |
| "People are very different in how they respond," he said. "We know that over the long term, about 30% of people who have an amputation will experience depression. If the amputation is associated with trauma – as in the case in Boston – those people have a risk of post-traumatic stress disorder (PTSD), around a third of people suffer PTSD. But the majority of amputees do not suffer PTSD. People are remarkably resilient." | "People are very different in how they respond," he said. "We know that over the long term, about 30% of people who have an amputation will experience depression. If the amputation is associated with trauma – as in the case in Boston – those people have a risk of post-traumatic stress disorder (PTSD), around a third of people suffer PTSD. But the majority of amputees do not suffer PTSD. People are remarkably resilient." |
| Wegener said amputees also face body-image challenges, as well as adapting to changes in personal relationships and working life. | Wegener said amputees also face body-image challenges, as well as adapting to changes in personal relationships and working life. |
| Among those reportedly suffering loss of limbs were two brothers who had gone to the finishing straight to cheer on the marathon runners. Their mother, Liz Norden, told the Boston Globe that her sons, aged 33 and 31, had both lost the lower half of one leg in the blast. | Among those reportedly suffering loss of limbs were two brothers who had gone to the finishing straight to cheer on the marathon runners. Their mother, Liz Norden, told the Boston Globe that her sons, aged 33 and 31, had both lost the lower half of one leg in the blast. |
| Others spoke Tuesday of a lucky escape. Nicholas Yanni, a patient at Tufts Medical Centre, said he and his wife were just 10 feet from one of the blasts. He suffered a perforated eardrum, while his wife had shrapnel piece her leg. They were taken to hospital together: "She was as cool as a cucumber," he said. "I'm freaking out." | Others spoke Tuesday of a lucky escape. Nicholas Yanni, a patient at Tufts Medical Centre, said he and his wife were just 10 feet from one of the blasts. He suffered a perforated eardrum, while his wife had shrapnel piece her leg. They were taken to hospital together: "She was as cool as a cucumber," he said. "I'm freaking out." |
| He added: "I was very fortunate. There are people who have lost their lives of lost their limbs – so I'm very fortunate." | He added: "I was very fortunate. There are people who have lost their lives of lost their limbs – so I'm very fortunate." |
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