Military Training Put in Practice to Save Boston Bombing Victims Published Jan. 8, 2014 By Karen Carstens Health.mil FALLS CHURCH, Va., -- Military doctors routinely treat wounded warriors flown in from dangerous deployments to far-flung facilities operated by the Defense Department, such as Landstuhl Regional Medical Center in Germany, the largest military hospital outside of the continental United States. In 2013, military personnel - many with medical training in life-saving skills - also proved how they can help the wounded in a crisis right here at home. On April 15, two bombs went off at the Boston Marathon. The big media story to initially come out of the attack was of course the massive manhunt for the culprits. Soldiers rushed to rescue victims of blasts Yet in the aftermath another story emerged about the heroism of Massachusetts National Guard soldiers who ran directly toward the scene of the crime, instead of away from it. After the second blast detonated near the finish line that day, 1st Lt. Steve Fiola, 1st Sgt. Bernard Madore and Staff Sgt. Mark Welch, all from the 1060th Transportation Company of Framingham, sprang into action to aid victims of the blasts. They had set off early that morning on the marathon course as part of a group of Massachusetts Army National Guard soldiers doing the "Tough Ruck," carrying some 35 pounds each in a 26.2-mile march to raise funds for families of fallen Massachusetts service members. Amid the chaos they rushed to remove scaffolding and fencing that separated first responders from the injured. Then they moved to the sidewalk to assist the wounded. "People keep asking, 'What were you guys thinking?' We weren't thinking about anything," Fiola later told Army.mil. "It's like the switch turns on, and you just go, and you just do what you're supposed to do to accomplish the mission." Among others with military training to respond that day was Roupen Bastajian, a Rhode Island state trooper and former Marine, who according to reports also rushed to aid the injured just after finishing the race himself. "I started running toward the blast. And there were people all over the floor," he told the Associated Press. "We started grabbing tourniquets and started tying legs. A lot of people [had limbs] amputated ... at least 25 to 30 people [had] at least one leg missing, or an ankle missing, or two legs missing." Military medical practices used to treat wounded Dr. Michael Yaffe, a trauma surgeon at Beth Israel Deaconess Medical Center in Boston and a lieutenant colonel in the Army Reserves, treated several people injured by the blasts that day. Some of the 25 critical care patients who arrived at Beth Israel had a "T" and a time marked on their foreheads indicating when a tourniquet was first administered, a clear signal that someone with military medical training had applied it, Yaffe told Health.mil recently. In terms of saving lives and limbs, this was critical. "If people hadn't used the tourniquets, it could have been worse," said Yaffe, adding that he was aware of at least one injured former service member who reportedly helped other victims apply tourniquets on themselves. In some instances, belts and shirts served as makeshift tourniquets. The coordinated triage efforts of service members and other individuals at the scene along with medical first responders resulted in most patients making it to the hospital within the "golden hour" from the time of injury. Some even made it within half an hour, Yaffe recalled. Marking the precise moment a tourniquet is applied to a patient allows doctors to better estimate the ideal time to later remove it prior to surgery. Similarly, as patients arrived at Beth Israel, the hospital's surgical team employed the battlefield lesson of writing in indelible marker on the chest of each patient their specific injuries and treatment needed. Yaffe said such military medical methods are also invaluable in treating civilian mass casualty victims. "A number of surgeons in our hospital have had military experience," he said, including a plastic surgeon who has deployed to Afghanistan, which Yaffe himself is also slated to do in 2014. Tactical Combat Casualty Care skills are designed for military medical personnel who are preparing to deploy in support of combat operations. Yaffe has taught these skills at the 399th Combat Hospital in Fort Devena, which is located near Boston and provides training support to all military services, active and reserve. Yaffe, who is also an MIT biology professor, volunteered for duty after ROTC students asked him about his experiences as a trauma surgeon, and he realized his specialty would be useful in the military. Prosthetics advancements give victims new lease on life He said that Defense Department funding for prosthetics advancements to help service members wounded in Afghanistan and Iraq has also had a significant impact on civilian trauma victims. These advances have both physically benefitted and emotionally reassured Boston bombing victims who lost limbs. "It helped psychologically because they were able to understand that this wasn't the end of the world," said Yaffe. "And I think that they will be much more equipped as a result to cope with life moving forward." Several victims of the Boston bombings now outfitted with prosthetics, mostly to their lower limbs, have moreover met with wounded warriors - including multiple amputees - to exchange experiences and seek moral support. At the same time, more surgeons have gained experience in this field over the past decade by treating wounded warriors. "Because of the wars in Iraq and Afghanistan, there are many people in the country that are skilled in treating traumatic injuries like amputations and traumatic brain injuries," Alex Horton, an Iraq-war veteran who now blogs for the Veterans Affairs Department, told Time magazine after the Boston Marathon bombing. "Physicians have a larger breadth of knowledge about these injuries than a dozen years ago, and lessons learned from the wars undoubtedly saved many lives in operating rooms in and around Boston."