"We basically just jumped in and did what we could do. There was no time to really even take vital signs, to really do anything," she said. "It was just place tourniquets, grab as much gauze as you can and get it to EMTs. Because that's what they were looking for -- people were taking their shirts off, people were taking their belts off, using anything as tourniquets. We didn't really have a large supply of tourniquets. We were basically ripping sheets apart, we weren't prepared for that kind of disaster."
JAMES HOOLEY WAS at the back of Medical Tent A in the EMS command center.
"When we heard the first blast, it kind of gave us all pause," the chief of Boston EMS said. "I kept thinking that it sounded like a detonation. And then I scrambled for a minute, probably like everybody, trying to come up with some other reasonable explanation for what I just heard. And six, whatever, so many seconds later you heard the second explosion and then the radios started going off, people reporting persons down and an explosion. So that quickly went from, 'Oh my God, could that have been ...?' to 'Yep, it was.' And then folks went to work."
For Hooley and EMS, that meant running toward the booms, the cries of fear and pain and the possibility of further danger.
"Because we had had two explosions, we knew there was a secondary device and there was really no reason not to expect that there weren't more," he said. "Law enforcement was certainly aware of that risk and they wanted to get us and the patients out of there as quickly as we could. And we wanted to get them out because of the seriousness of their injuries.
"I wound up going to the front of the tent, and then up to the first blast site and later down to the second one. From my focus as the EMS command, it was more to start getting out, making sure that notifications got out to hospitals in Boston that we had a mass casualty event, that there were multiple trauma victims and to also summon additional resources."
The Boston EMTs and paramedics sprinted to the bomb sites, surveyed the injured and sorted them by severity. They applied tourniquets, improvising where necessary, and directed bystanders and civilian first responders on how to do likewise.
The goals were simple: Stop the bleeding, then start the extraction.
"Because we do have a large transit system and an airport here, we do have to do annual disaster drills that could involve anything from crashes to explosions or whatever," Hooley said. "Because of that it was pretty well-rehearsed, so when all of a sudden you were presented with hundreds of people injured ... I'm not saying it was easy, but there wasn't a whole lot of people that had to be told what to do. It was like, 'Do the best you can for as many as you can. Sort them, get the sickest or the most grievously injured out first.' Those are a lot of the basic principles that people followed. People improvised when need be.
"Typically you may not send two critical patients in one ambulance, but when you're wheeling through that first wave of patients where we had 30 people basically labeled as red, or critical, yeah, you put two in a truck and send them off."
CARLOS ARREDONDO WAS in the grandstands in front of the Copley Library, holding an American flag in his right hand as he tried to take a photo with his left.
When the bombs went off, he didn't hesitate. He ran.