ROSEVILLE (CBS13) – After two bombs exploded during the Boston Marathon on Monday, hospitals were flooded with the more than 140 injured runners and spectators.

Emergency room doctors train for similar situations and a Sutter Roseville Medical Center trauma surgeon shared his experience in dealing with the same kinds of injuries Boston physicians currently face.

“It can be a very bloody scene, especially in this type of environment,” said Dr. John Perlstein.

Perlstein has gone from treating bombing victims on the battlefield of Iraq to Sutter Roseville’s trauma center, and still vividly remembers the difficulty treating bomb wounds.

“The explosive devices have a lot of metal fragments that are placed inside. So people come in with holes anywhere from their head to their feet,” said Perlstein.

The bombs in Boston, according to doctors, contained shrapnel metal ball bearings, designed to make wounds even worse — leading to amputations in some cases.

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“The patients that are coming in are many times screaming and in pain,” said Perlstein.

Before patients even reach the hospital, they need to be assessed by paramedics on the scene.

“We constantly drill for situations like this. It’s a mass causality incident for multiple patients,” said John Widdifield, American Medical Response.

Widdifield helps coordinate the California International Marathon and says Boston’s bombing will now lead to a review of their plan.

“There are going to be challenges of that whole 26 miles of the whole race,” he said.

Those are challenges planners will try to overcome by learning lessons from Monday’s tragedy.

“We’re all glad they don’t happen that often,” said Widdifield.

Perlstein adds that triaging patients is very important. He says it comes down to having a good team of workers and making sure everyone knows their role in this type of a situation.