TY - JOUR
T1 - Prehospital Indicators for Disaster Preparedness and Response
T2 - New York City Emergency Medical Services in Hurricane Sandy
AU - Smith, Silas W.
AU - Braun, James
AU - Portelli, Ian
AU - Malik, Sidrah
AU - Asaeda, Glenn
AU - Lancet, Elizabeth
AU - Wang, Binhuan
AU - Hu, Ming
AU - Lee, David C.
AU - Prezant, David J.
AU - Goldfrank, Lewis R.
N1 - Publisher Copyright:
© Copyright Society for Disaster Medicine and Public Health, Inc. 2016.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Objective We aimed to evaluate emergency medical services (EMS) data as disaster metrics and to assess stress in surrounding hospitals and a municipal network after the closure of Bellevue Hospital during Hurricane Sandy in 2012. Methods We retrospectively reviewed EMS activity and call types within New York City's 911 computer-assisted dispatch database from January 1, 2011, to December 31, 2013. We evaluated EMS ambulance transports to individual hospitals during Bellevue's closure and incremental recovery from urgent care capacity, to freestanding emergency department (ED) capability, freestanding ED with 911-receiving designation, and return of inpatient services. Results A total of 2,877,087 patient transports were available for analysis; a total of 707,593 involved Manhattan hospitals. The 911 ambulance transports disproportionately increased at the 3 closest hospitals by 63.6%, 60.7%, and 37.2%. When Bellevue closed, transports to specific hospitals increased by 45% or more for the following call types: blunt traumatic injury, drugs and alcohol, cardiac conditions, difficulty breathing, pedestrian struck, unconsciousness, altered mental status, and emotionally disturbed persons. Conclusions EMS data identified hospitals with disproportionately increased patient loads after Hurricane Sandy. Loss of Bellevue, a public, safety net medical center, produced statistically significant increases in specific types of medical and trauma transports at surrounding hospitals. Focused redeployment of human, economic, and social capital across hospital systems may be required to expedite regional health care systems recovery.
AB - Objective We aimed to evaluate emergency medical services (EMS) data as disaster metrics and to assess stress in surrounding hospitals and a municipal network after the closure of Bellevue Hospital during Hurricane Sandy in 2012. Methods We retrospectively reviewed EMS activity and call types within New York City's 911 computer-assisted dispatch database from January 1, 2011, to December 31, 2013. We evaluated EMS ambulance transports to individual hospitals during Bellevue's closure and incremental recovery from urgent care capacity, to freestanding emergency department (ED) capability, freestanding ED with 911-receiving designation, and return of inpatient services. Results A total of 2,877,087 patient transports were available for analysis; a total of 707,593 involved Manhattan hospitals. The 911 ambulance transports disproportionately increased at the 3 closest hospitals by 63.6%, 60.7%, and 37.2%. When Bellevue closed, transports to specific hospitals increased by 45% or more for the following call types: blunt traumatic injury, drugs and alcohol, cardiac conditions, difficulty breathing, pedestrian struck, unconsciousness, altered mental status, and emotionally disturbed persons. Conclusions EMS data identified hospitals with disproportionately increased patient loads after Hurricane Sandy. Loss of Bellevue, a public, safety net medical center, produced statistically significant increases in specific types of medical and trauma transports at surrounding hospitals. Focused redeployment of human, economic, and social capital across hospital systems may be required to expedite regional health care systems recovery.
KW - Hurricane Sandy
KW - disaster
KW - emergency departments
KW - emergency medical services
KW - prehospital
KW - warning
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U2 - 10.1017/dmp.2015.175
DO - 10.1017/dmp.2015.175
M3 - Article
C2 - 26740248
AN - SCOPUS:84953227176
SN - 1935-7893
VL - 10
SP - 333
EP - 343
JO - Disaster Medicine and Public Health Preparedness
JF - Disaster Medicine and Public Health Preparedness
IS - 3
ER -