Effects of the August 2003 blackout on the New York City healthcare delivery system: A lesson for disaster preparedness

David J. Prezant, John Clair, Stanislav Belyaev, Dawn Alleyne, Gisela I. Banauch, Michelle M. Davitt, Kathy Vandervoorts, Kerry J. Kelly, Brian Currie, Gary Kalkut

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Background: On August 14, 2003, the United States and Canada suffered the largest power failure in history. We report the effects of this blackout on New York City's healthcare system by examining the following: 1) citywide 911 emergency medical service (EMS) calls and ambulance responses; and 2) emergency department (ED) visits and hospital admissions to one of New York City's largest hospitals. Methods: Citywide EMS calls and ambulance responses were categorized by 911 call type. Montefiore Medical Center (MMC) ED visits and hospital admissions were categorized by diagnosis and physician-reviewed for relationship to the blackout. Comparisons were made to the week pre- and postblackout. Results: Citywide EMS calls numbered 5,299 on August 14, 2003, and 5,021 on August 15, 2003, a 58% increase (p < .001). During the blackout, there were increases in "respiratory" (189%; p < .001), "cardiac" (68%; p = .016), and "other" (40%; p < .001) EMS call categories, but when expressed as a percent of daily totals, "cardiac" was no longer significant. The MMC-ED reflected this surge with only "respiratory" visits significantly increased (expressed as percent of daily total visits; p < .001). Respiratory device failure (mechanical ventilators, positive pressure breathing assist devices, nebulizers, and oxygen compressors) was responsible for the greatest burden (65 MMC-ED visits, with 37 admissions) as compared with 0 pre- and postblackout. Conclusions: The blackout dramatically increased EMS and hospital activity, with unexpected increases resulting from respiratory device failures in community-based patients. Our findings suggest that current capacity to respond to public health emergencies could be easily overwhelmed by widespread/prolonged power failure(s). Disaster preparedness planning would be greatly enhanced if fully operational, backup power systems were mandated, not only for acute care facilities, but also for community-based patients dependent on electrically powered lifesaving devices.

Original languageEnglish (US)
JournalCritical Care Medicine
Volume33
Issue number1 SUPPL.
DOIs
StatePublished - Jan 2005

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Emergency Medical Services
Disasters
Hospital Emergency Service
Delivery of Health Care
Equipment Failure
Ambulances
Respiratory Insufficiency
Disaster Planning
Equipment and Supplies
Nebulizers and Vaporizers
Urban Hospitals
Mechanical Ventilators
Canada
Respiration
Emergencies
Public Health
History
Oxygen
Physicians
Pressure

Keywords

  • Blackout
  • Healthcare utilization
  • Mechanical ventilators
  • Power failure
  • Respiratory failure

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Effects of the August 2003 blackout on the New York City healthcare delivery system : A lesson for disaster preparedness. / Prezant, David J.; Clair, John; Belyaev, Stanislav; Alleyne, Dawn; Banauch, Gisela I.; Davitt, Michelle M.; Vandervoorts, Kathy; Kelly, Kerry J.; Currie, Brian; Kalkut, Gary.

In: Critical Care Medicine, Vol. 33, No. 1 SUPPL., 01.2005.

Research output: Contribution to journalArticle

Prezant, David J. ; Clair, John ; Belyaev, Stanislav ; Alleyne, Dawn ; Banauch, Gisela I. ; Davitt, Michelle M. ; Vandervoorts, Kathy ; Kelly, Kerry J. ; Currie, Brian ; Kalkut, Gary. / Effects of the August 2003 blackout on the New York City healthcare delivery system : A lesson for disaster preparedness. In: Critical Care Medicine. 2005 ; Vol. 33, No. 1 SUPPL.
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AU - Prezant, David J.

AU - Clair, John

AU - Belyaev, Stanislav

AU - Alleyne, Dawn

AU - Banauch, Gisela I.

AU - Davitt, Michelle M.

AU - Vandervoorts, Kathy

AU - Kelly, Kerry J.

AU - Currie, Brian

AU - Kalkut, Gary

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N2 - Background: On August 14, 2003, the United States and Canada suffered the largest power failure in history. We report the effects of this blackout on New York City's healthcare system by examining the following: 1) citywide 911 emergency medical service (EMS) calls and ambulance responses; and 2) emergency department (ED) visits and hospital admissions to one of New York City's largest hospitals. Methods: Citywide EMS calls and ambulance responses were categorized by 911 call type. Montefiore Medical Center (MMC) ED visits and hospital admissions were categorized by diagnosis and physician-reviewed for relationship to the blackout. Comparisons were made to the week pre- and postblackout. Results: Citywide EMS calls numbered 5,299 on August 14, 2003, and 5,021 on August 15, 2003, a 58% increase (p < .001). During the blackout, there were increases in "respiratory" (189%; p < .001), "cardiac" (68%; p = .016), and "other" (40%; p < .001) EMS call categories, but when expressed as a percent of daily totals, "cardiac" was no longer significant. The MMC-ED reflected this surge with only "respiratory" visits significantly increased (expressed as percent of daily total visits; p < .001). Respiratory device failure (mechanical ventilators, positive pressure breathing assist devices, nebulizers, and oxygen compressors) was responsible for the greatest burden (65 MMC-ED visits, with 37 admissions) as compared with 0 pre- and postblackout. Conclusions: The blackout dramatically increased EMS and hospital activity, with unexpected increases resulting from respiratory device failures in community-based patients. Our findings suggest that current capacity to respond to public health emergencies could be easily overwhelmed by widespread/prolonged power failure(s). Disaster preparedness planning would be greatly enhanced if fully operational, backup power systems were mandated, not only for acute care facilities, but also for community-based patients dependent on electrically powered lifesaving devices.

AB - Background: On August 14, 2003, the United States and Canada suffered the largest power failure in history. We report the effects of this blackout on New York City's healthcare system by examining the following: 1) citywide 911 emergency medical service (EMS) calls and ambulance responses; and 2) emergency department (ED) visits and hospital admissions to one of New York City's largest hospitals. Methods: Citywide EMS calls and ambulance responses were categorized by 911 call type. Montefiore Medical Center (MMC) ED visits and hospital admissions were categorized by diagnosis and physician-reviewed for relationship to the blackout. Comparisons were made to the week pre- and postblackout. Results: Citywide EMS calls numbered 5,299 on August 14, 2003, and 5,021 on August 15, 2003, a 58% increase (p < .001). During the blackout, there were increases in "respiratory" (189%; p < .001), "cardiac" (68%; p = .016), and "other" (40%; p < .001) EMS call categories, but when expressed as a percent of daily totals, "cardiac" was no longer significant. The MMC-ED reflected this surge with only "respiratory" visits significantly increased (expressed as percent of daily total visits; p < .001). Respiratory device failure (mechanical ventilators, positive pressure breathing assist devices, nebulizers, and oxygen compressors) was responsible for the greatest burden (65 MMC-ED visits, with 37 admissions) as compared with 0 pre- and postblackout. Conclusions: The blackout dramatically increased EMS and hospital activity, with unexpected increases resulting from respiratory device failures in community-based patients. Our findings suggest that current capacity to respond to public health emergencies could be easily overwhelmed by widespread/prolonged power failure(s). Disaster preparedness planning would be greatly enhanced if fully operational, backup power systems were mandated, not only for acute care facilities, but also for community-based patients dependent on electrically powered lifesaving devices.

KW - Blackout

KW - Healthcare utilization

KW - Mechanical ventilators

KW - Power failure

KW - Respiratory failure

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