One of the reasons that only 3 people have died in Boston is that there are 3 Level 1 Trauma Centers

[cali]

very close to the blast site, Beth Israel Deaconess, Brigham and Women's and Mass General which also has a pediatric trauma center

A Level I Trauma Center provides the highest level of surgical care to trauma patients. Being treated at a Level I Trauma Center increases a seriously injured patient’s chances of survival by an estimated 20 to 25 percent.[11] It has a full range of specialists and equipment available 24 hours a day[12] and admits a minimum required annual volume of severely injured patients. A Level I trauma center is required to have a certain number of surgeons, emergency physicians and anesthesiologists on duty 24 hours a day at the hospital, an education program, and preventive and outreach programs. Key elements include 24-hour in-house coverage by general surgeons and prompt availability of care in varying specialties—such as orthopedic surgery, neurosurgery, plastic surgery (plastic surgeons often take calls for hand injuries), anesthesiology, emergency medicine, radiology, internal medicine, oral and maxillofacial surgery and otolaryngology (trained to treat injuries of the facial skin, muscles, bones), and critical care—which are needed to adequately respond and care for various forms of trauma that a patient may suffer and rehabilitation services. Additionally, a Level I center has a program of research, is a leader in trauma education and injury prevention, and is a referral resource for communities in nearby regions.[13]

http://en.wikipedia.org/wiki/Trauma_center

[mnhtnbb]

1. Not to be discounted is the fact there was a medical tent close to the first blast.

Medical personnel were on the scene pronto--tourniquets were applied--and
immediate triage care available. Doesn't make much difference how many
Level I centers are available if you bleed out before reaching one.

http://www.boston.com/lifestyle/health/blogs/white-coat-notes/2013/04/15/marathon-medical-tent-transformed-into-trauma-unit/gUAgQIMwTYqwzRkcIDs5PJ/blog.html

[cali]

2. Many of those badly hurt were

were taken directly to the hospital. Like the man in the wheel chair with his legs blown off. Not that the work done and the Medical Tent wasn't heroic. There were ambulances on site.

[Victor_c3]

3. I hate to relate everything to my experiences with war

but I actually penned a paper about survival rates based on how soon injured receive medical evacuation when I was in the Army.

In Vietnam, if you survived an injury long enough to make it to a helicopter arrived you had a 90% chance of surviving. In Iraq, in 2004, if you survived long enough for a helicopter to get you, you had a 98% chance of survival. Relating this to yesterday's tragedy, I believe that a major reason that more people didn't die was because of the pre-positioned medical evacuation units hand and the quick evacuation of the wounded.

Getting seriously injured people stabilized and getting an IV started ASAP is a major help. Often I saw people go into shock and, as a result, the blood vessels constrict and it become extremely hard to start IVs. There are things that you need to do quickly before shock sets in that'll greatly improve your chance of survival.

In short, I think you are absolutely right.

[smirkymonkey]

4. We are so fortunate to have such excellent medical care here in Boston.

Thank god for all the excellent first responders and the dedicated medical staff that helped to save these lives!