5-year-old boy among Marathon bombing victims who are ‘getting better’ at Boston Medical Center

A 5-year-old boy grievously injured in Monday’s Marathon bombings is getting better, according to Boston Medical Center Chief of Trauma Services Peter Burke, and is no longer listed in critical condition.

“You always worry about the little ones more. But I think he’s gonna be OK, and that’s great,” said Burke at a press briefing this morning.

The boy suffered soft tissue injuries to his extremities and “significant pulmonary injuries,” Burke said. The pulmonary injuries, he said, were likely caused either by compression from the blast or from being thrown into something. His mother was injured and is at a different hospital.

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Burke said that overall, the victims of the blasts who remain hospitalized “are getting better, and we are happy with their progress.”

Doctors likened the injuries they were treating to those suffered by troops in combat in Iraq and Afghanistan.

Sixteen patients remain in the hospital, Burke said: one 60-year-old man is still in critical condition, 10 patients are in serious condition and five are in fair condition; doctors expect to reoperate on two patients today. In the past 48 hours, he said, three patients have been discharged.

Doctors at BMC have amputated seven limbs on five patients, he said.

“Over the last few days, there were a fair amount of questions and some interest in how this experience compared to a wartime expreience,” said Joseph Blansfield, BMC’s trauma program manager, who spent a year in Iraq several years ago as the chief nurse of a combat support hospital. “This was disturbingly similar to our experiences with improvised explosive devices and treating large numbers of traumatized individuals.”

The silver lining, Blansfield said, was that doctors were better able to treat marathon victims because of lessons learned on the battlefield. The use of tourniquets, in particular, he said, has become standard for emergency responders as a result of combat experience, and patients arrived at the hospital with far less blood loss than doctors would have otherwise expected.

Several patients still require more surgeries, Burke said.

“These injuries are massive and require multiple trips to the operating room sometimes,” said Burke.

If doctors close wounds in one single operation, he said, they risk infection. Instead, wounds must be cleaned several times. Doctors have removed metal and concrete from patients, he said, and infection is one of the biggest concerns.

“It’s very much a stepwise process, and you can’t do it all at the same time,” Burke said.

Doctors are also keeping a close eye on patients’ emotional well-being.

“Everybody copes different with grief and loss,” said Lisa Allee, BMC’s community violence response team director. “It’s the loss of their limb, and the loss of their life as they expected it to be, the loss of the world as a safe place. We try to take every individual where they are.”

Many patients, she said, are experiencing flashbacks of the bombing.

Burke said that the Chinese BU student who was injured in the blast is also doing better.

“She is not in a coma, she is making progress, like all of our patients, actually,” he said. “Everybody’s moving along in the trajectory they should be.”

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