Explosions & Mass Gatherings

Boston Marathon

After the explosions in Boston, the National Center for Disaster Medicine and Public Health gathered resources for health professionals. Although these resources apply to the Boston bombing, they can be used more generally for explosions and mass gatherings.

Contribute to "a nation of resilient communities" by educating yourself and others on disaster health topics related to mass gatherings and explosions. NCDMPH has gathered resources to assist health professionals in preparing for these types of events.

By providing these resources, the National Center aims to foster resilience through learning. The organization of this content is intended to facilitate self-directed learning as well as provide materials for educators.

Additional ideas for educators who are teaching health professionals interested in learning content or activities related to explosions in mass gatherings may be found below.

Explosions & Mass Gathering Resources

Journal of the American Academy of Orthopaedic Surgeons- Trauma and Related Resources

Bombings and Blast Injuries: A Primer for Physicians.

Centers for Disease Control: Blast and Bomb Injuries

American College of Emergency Physicians "Bombings: Injury Patterns and Care" [interactive lesson, fact sheets, pocket card, materials for educators (slides, curricula)]

Borden Institute's Emergency War Surgery (2004) - Chapter 1

Borden Institute's Combat Casualty Care: Lessons Learned from OEF and OIF (2012)-Especially chapters 2, 3, 4, 5, 13

CDC Blast Injury Mobile Application. Centers for Disease Control and Prevention.

After Action Report for the 2013 Boston Marathon Massachusetts Emergency Management Agency.

The University of North Carolina. Gillings School of Global Public Health. Webinar: Mass Gatherings-Lessons Learned from the Boston Marathon

Biddinger P et al. Be Prepared - The Boston Marathon and Mass-Casualty Events. N Eng J Med. 2013.

Emergence of medicine for mass gatherings: Lessons from the Hajj (2012) The Lancet Infectious Diseases,12 (1), pp. 56-65.

Disaster Information Management Research Center: Mass Gatherings

CDC, NIOSH: Emergency Response Resources: Terrorism Response

Lund A, Turris S, Bowles R, et al. Mass-gathering Health Research Foundational Theory: Part 1 - Population Models for Mass Gatherings. Prehosp Disaster Med. 2014. 29(6): 648-654.

Turris S, Lund A, Hutton A, Mass-gathering Health Research Foundational Theory: Part 2 - Event Modeling for Mass Gatherings. Prehosp Disaster Med. 2014. 29(6): 655-663.

Children's Psychosocial Needs in Disasters. NCDMPH.

SAMHSA: Mass Casualty: Support and Response Webinar 

SAMHSA: Coping with Violence and Traumatic Events

Response Template Toolkit

Center for the Study of Traumatic Stress: Psychological First Aid 

Cook Children's course for physicians on traumatic stress (course length 1 hour)

Healthcare Toolbox: Health Care Providers'Response to Medical Traumatic Stress in Their Patients

Healthcare Toolbox Resource List: Provider Stress and Self-Care

DIMRC : Coping with Disasters, Violence and Traumatic Events

Talking to Children about Bombings

SAMHSA. Post-Disaster Retraumatization: Risk and Protective Factors

CDC: Interim planning guidance for preparedness and response to a mass casualty event resulting from terrorist use of explosives

DIMRC: Healthcare System Surge Capacity and Mass Gatherings

CDC's In a Moment's Notice : Surge Capacity for Terrorist Bombings Challenges and Proposed Solutions

CDC's Capability 10 : Medical Surge

Health care facility and community strategies for patient care surge capacity (2004) Annals of Emergency Medicine, 44 (3) , pp. 253-261. (Abstract)

Surge capacity for healthcare systems: A conceptual framework (2006) Academic Emergency Medicine. 13 (11), pp. 1157-1159. (Abstract)

Disaster metrics: Quantitative benchmarking of hospital surge capacity in trauma-related multiple casualty (2011) Disaster Medicine and Public Health Preparedness. 5: 117-124.

Explosions & Mass Gatherings

Ideas for Educators of Health Professionals 

Below are ideas for educators who are teaching health professionals and may wish to develop learning content or activities related to explosions in mass gatherings. These ideas should be customized based on the learners, their needs, scope of practice, and the educational context.

Options for Learning Objectives:

1. List sources of reliable information on blast injuries and mass gatherings, psychosocial issues associated with such events, and systems considerations.

2. Describe the clinical and public health implications of an explosion at a mass gathering event.

3. State ways in which you as a health professional can contribute to preparedness for, response to, and recovery from an explosion at a mass gathering event given your scope of practice.

4. Describe the expectations and responsibilities of your role(s) as a health professional regarding an explosion at a mass gathering event, from your:

  • individual perspective

  • team member perspective

  • organizational perspective

  • community perspective

Options for Learning Activities:

1. Assign specific resources to students and ask them to summarize key content for the class.

2. Walk through the cited resources online during class and discuss their reliability and how they may be pertinent for the learner.

3. Provide information and/or lead a discussion of:

  • the clinical implications of an explosion at a mass gathering event

  • the public health implications of an explosion at a mass gathering event

4. Invite learners to work in groups to consider and discuss how they as health professionals would contribute to preparedness for, response to, and recovery from an explosion at a mass gathering event, given their scope of practice.

5. Invite learners to work in groups to consider the expectations and responsibilities of their role(s) as a health professional regarding an explosion at a mass gathering event, from their:

  • individual perspective

  • team member perspective

  • organizational perspective

  • community perspective

6. Ask if any of the learners are involved in ESAR-VHP(link is external) or Medical Reserve Corps(link is external). If so, provide an opportunity for them to describe their involvement. Make links to these programs available to learners. Generate a discussion about the role of volunteers in responding to mass casualty events.

7. Invite a member of another health profession or the law enforcement community to discuss interprofessional coordination and collaboration necessary in response to an explosion at a mass gathering event. Discuss barriers to such interprofessional coordination and collaboration.

Resilience Through Learning Topics