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Managing the "Worried Well" during a large-scale incident
William Bullock1, E Reed Smith2, Craig Heligman3
1Director of Industrial Hygiene, CSX Transportation, Jacksonville, Florida.
Journal of Emergency Management (Weston, Mass.)
|March 16, 2018
Summary
Following chemical incidents, many "Worried Well" individuals seek ER care due to stress, not exposure. Improved communication between incident command and hospitals is crucial for managing these patients effectively.
Area of Science:
- Environmental Health
- Emergency Medicine
- Public Health
Background:
- Recent US incidents led to numerous Emergency Room (ER) visits from concerned citizens, termed "Worried Well."
- A transportation incident with chemical release and fire prompted over 100 evaluations in a local ER.
Purpose of the Study:
- To review patient presentations and outcomes following a chemical release incident.
- To assess the need for improved inter-agency communication during public health emergencies.
Main Methods:
- Retrospective review of patient data from a single transportation-related chemical release incident.
- Analysis of ER visit reasons and correlation with potential exposure levels.
Main Results:
- The majority of ER patients evaluated after the incident showed no evidence of chemical or combustion byproduct exposure.
- Symptoms experienced by most patients were likely psychosomatic, driven by stress hormone release.
Conclusions:
- Effective management of the "Worried Well" requires enhanced coordination between emergency incident command and healthcare facilities.
- Timely dissemination of critical information, such as wind direction and pollutant levels, is essential for appropriate medical response.