In the hours after the attack, Boston hospitals rallied to take care of the injured. Some of them were so badly injured a doctor says they came in as automatic amputees. FOX 5's Beth Galvin talked to a local surgeon about emergency situations.
The next few days will be critical for some of the most seriously injured in Monday's bombings.
Boston area hospitals found themselves dealing with not just major traumas like amputations and burns, but dozens of patients coming in at the same time.
The Boston bombing victims had nails and ball bearings embedded in their skin, which is a sign that the explosions were designed to do as much damage as possible. Grady Memorial Hospital trauma surgeon Dr. Ray Matthews, an assistant professor of surgery at the Morehouse School of Medicine, says blast injuries like these are the toughest to treat.
"Psychologically, you hate to see anybody lose limbs, you hate to see anybody lose their life," said Matthews.
Matthews works at the new Marcus Trauma Center at Grady Memorial Hospital -- one of the busiest in the country -- treating about 3,400 trauma victims a year. He says explosive injuries as so complicated, because they damage the body in so many ways.
"You're dealing with blast injuries, crush injuries, because with a bomb you get a blast effect. You cannot, sometimes not see things outside, you can get internal injuries, internal hemorrhage, you can get internal burns and things like that," said Matthews.
Matthews was in New York City during the September 11th attacks. He helped treat a few of the walking wounded on Ellis Island.
"It was a somber mood, sitting there, seeing the twin towers go down. It was kind of like surreal," said Matthews.
Matthews says the Boston EMS workers and runners saved lives by responding so quickly. In mass casualty disasters, he says that the best you can do is stay focused on helping one person at a time.
"You can't get too emotional, you can't get too excited, you just have to focus on doing your job," Matthews said. "I think you have to be born to do this. It's a calling, like any other job. It's tough."
Emergency teams in Boston have drilled for disasters, but they've never faced one with so many injuries.