Boston City Hospital merged with the Boston University Medical Center Hospital and unfortunately the majority of its records and archives have been lost. Fortunately, we know more about the practices and techniques used at Mass General as a result their excellent archives and due to the June, 1943 Annals of Surgery, which was dedicated to the Symposium on the Management of the Cocoanut Grove Burns at the Massachusetts General Hospital.
While innovations in burn treatment were a major focus, burns were not the only medical problem. Upon arrival at the hospitals, it was obvious that a large number of patients had severe respiratory distress. Some patients showed evidence of obstruction to the air passages. Non-burn specialists were quickly called to the scene to perform laryngoscopes, tracheal suction and tracheotomies. Such a large number of respiratory patients at one time enabled doctors and researchers to better understand the impact of various treatments, leading to many advances in the field.
Penicillin also played a role in the treatment. At the time of the fire, penicillin was a top secret drug being used by the military. Few civilians had been treated with it, but a quantity was rushed to MGH. Some reports say that the use of penicillin saved many Cocoanut Grove patients’ lives from death by staphylococcal infections. However, other reports indicate that as a new drug, there was not information about dosage amounts, and as a result, most patients were not given a high enough dosage to have made a difference.
Severe loss of fluids is also a major problem with burn victims. Fluid replacement is critical to replace the fluids that flow out of leaking capillaries. As a result, the normal exchange of blood plasma into the site of the injury results in rapid fluid loss, which could lead to declined cardiac output and renal and tissue perfusion. The Red Cross replenished plasma when stores were depleted.
One of major non-medical problems for medical personnel was recognized as the ambulances started arriving—identification of the dead and the unconscious. While in most cases, men carried their ID papers in their pockets, most women either had no ID with them or their IDs were in lost purses or in coat pockets left in the coat room. Women without IDs were often identified by their jewelry, or their clothing, when possible.