A er Action Report for the Response to the 2013 Boston ...

1 After Action Report for the Response to the 2013 Boston marathon BombingsDecember 2014 After Action Report for the Response to the 2013 Boston marathon Bombings1TA B L E O F CO N T E N T SExecutive Summary ..3 Project Management Team ..12 Acknowledgements ..13 Introduction ..15 Section 1: Incident Timeline ..18 Section 2: Overview of Incidents ..34 marathon Monday 2013 ..35 Ongoing Activities ..47 Apprehension of Suspects ..53 Recovery ..66 Section 3: Analysis of Capabilities ..70 Focus Area 1: preparedness ..71 Best Practices ..71 Areas Needing Improvement ..77 Focus Area 2: Initial Response to Explosions.

2 79 Best Practices ..79 Areas Needing Improvement ..87 Focus Area 3: Ongoing Response to Explosions ..104 Best Practices ..104 Areas Needing Improvement ..106 Focus Area 4: Apprehension of Suspects ..108 Best Practices ..108 Areas Needing Improvement ..113 Focus Area 5: Recovery ..123 Best Practices ..123 Areas Needing Improvement ..126 After Action Report for the Response to the 2013 Boston marathon Bombings2 After Action Report for the Response to the 2013 Boston marathon Bombings3 EXECUTIVE SUMMARY The After Action Report for the Response to the 2013 Boston marathon bombings reflects the find-ings of an after Action review of Response and recovery activities of public safety, public health, and medical personnel related to the April 15 bombings , the care and support of those impacted by the events in the following days, and the search and apprehension of the bombing suspects.

3 The after Action review was coordinated by a multi-disciplinary, multi-jurisdictional project management team consisting of key organizations involved in Response activities, with the support of a private sector, third-party vendor. This Report details best practices, lessons learned and recommendations for the purpose of assisting public safety, public health, and medical personnel involved in the Response in further developing actions that went well, and taking corrective measures to address areas needing improvement. The majority of these agencies and organizations implemented a number of the recommendations identified in this Report prior to the 2014 Boston marathon .

4 In addition to providing assistance to Response agencies and organizations, the best practices and lessons learned identified through this after Action process can hopefully provide insight to other agencies, jurisdictions and organizations across the nation and assist them in better preparing for potential incidents in the EventsThe Boston marathon , unlike other large city marathon courses that run circuitously within a single jurisdiction, is a straight-line course that crosses eight cities and towns: Hopkinton, Ashland, Framingham, Natick, Wellesley, Newton, Brookline, and Boston .

5 To ensure streamlined coordina-tion among the many federal, state, and local public safety, public health and emergency medical services (EMS) personnel and the Boston Athletic Association (BAA), comprehensive, multi- jurisdictional, multi-disciplinary planning is conducted each year, beginning in January. This annual planning concludes with a tabletop exercise in which each of these partners participates to work through the coordination of Response activities to several marathon -specific public safety and medical scenarios. A significant byproduct of this planning process and exercise participation is the networking and relationship-building among public safety, public health and medical partners.

6 A significant planning component for the 2013 Boston marathon was the enhancement of the medical system supporting the race. Under the leadership of the BAA, the medical system consisted of 26 medical tents along the course (including eight enhanced medical tents) and two medical tents at the Finish Line (Alpha Medical Tent and Beta Medical Tent). Alpha Medical After Action Report for the Response to the 2013 Boston marathon Bombings4 Tent was the medical tent located closest to the This medical system was designed to have sufficient capabilities and capacity to handle an increased number of patients so as not to overburden area hospitals with non-critical patients.

7 On April 15, 2013 , 80 representatives from state and local law enforcement, fire services and EMS, the BAA, the Massachusetts Emergency Management Agency (MEMA), the Massachusetts De-partment of Public Health (MDPH), the Massachusetts National Guard (MANG), the American Red Cross (ARC), the Federal Bureau of Investigation (FBI), and the Department of Homeland Security (DHS) staffed the Multi-Agency Coordination Center (MACC) at MEMA Headquarters in Framingham. The purpose of the MACC was to coordinate public safety, public health and EMS activities across the jurisdictions, and provide situational awareness.

8 In addition to the MACC, various state and local coordination and operations centers were also activated, including: the Massachusetts Department of Public Health (MDPH) Department Operations Center (DOC), the Boston Police Department s (BPD) Law Enforcement Coordination Center (LECC), and the Boston Public Health Commission s (BPHC) Medical Intelligence Center (MIC).2At 2:49 the first of two bombs was detonated at 671 Boylston Street; the second bomb was detonated thirteen seconds later 180 yards up course at 755 Boylston Street. It was later deter-mined that explosions were caused by homemade improvised explosive devices (IEDs) hidden in backpacks and placed on the ground level in these viewing areas just seconds before they were detonated.

9 The explosions took the lives of three individuals and injured 264 spectators many critically, with 16 survivors suffering traumatic amputations. Following the explosions on Boylston Street, emergency responders (police, fire and EMS), BAA medical volunteers from Alpha Medical Tent, and numerous spectators and bystanders quickly responded to the critically injured, triaging their injuries and facilitating their transport to area hospitals. The hospitals that received patients rendered life-saving medical care; as a result, every patient that was transported to a hospital from the scene survived.

10 Unified Command began to form moments after the explosions when senior law enforcement and emergency management officials came together on Boylston Street and immediately began coordinating priorities. Less than 40 minutes following the explosions, UC shifted operations to a Unified Command Center (UCC) established at the nearby Westin Hotel. The UC would ultimately include the Governor, Mayor of Boston , Secretary of the Executive Office of Public 1 The 2012 Boston marathon took place on an unseasonably warm day with temperatures above 90 degrees, and resulted in a large surge of patients with heat-related injuries.