It seems like Boston EMS, and a number of other agencies, did an excellent job anticipating, and preparing for a potential MCI. Brandon makes a great point, that it's too early to know a lot of information, especially the outcomes for critical patients. I understand this has garnered an enormous amount of media attention, that probably makes it much more stressful for anyone in the Boston area. I apologise if I add to this stress at all, but I think this is a relevant topic for conversation here.
I don't want to speak for JP, who's a very articulate individual, and capable of defending himself. The point I hear him making is that this situation worked well because there was an anticipated risk, extra units and resources were deployed, and an ICS system was in place prior to the event. He's asking, as I understand, how well would most EMS systems deal with a similar event if it didn't occur at a prestigious international sporting event, where preparations had already been made, but if it happened on any ordinary day?
I think this is also valid point, right? I know my system struggles to resource itself through its normal call volume. Some days we seem to be unable to drop a truck on a stabbing or a cardiac arrest in a timely manner. Add an MCI situation, and a system that's already in a state of near-collapse may fail spectacularly.
Anecdotally, my experience has been that when this does happen, it eventually gets taken care of. People are reluctant to criticise the response, and often make substantial allowances for delayed response times, out of recognition that this an extraordinary situation.
None of this should be taken as criticism of the excellent work done by our colleagues in Boston. All the best.
