Botulism Outbreak in a Regional Community Hospital: Lessons Learned in Transfer and Transport Considerations.

Area of Science:

• Toxicology
• Emergency Medicine
• Public Health

Background:

• Botulism, a severe illness caused by Clostridium botulinum toxin, can lead to mass casualty incidents (MCIs) from foodborne sources.
• Effective emergency medical services (EMS) response and patient transport are crucial during large-scale botulism outbreaks.

Purpose of the Study:

• To analyze the EMS response and transport considerations during a recent regional botulism outbreak.
• To identify areas for improvement in managing mass casualty incidents related to botulism.

Main Methods:

• Retrospective review of 53 patients evaluated for botulism at a community hospital.
• Focus on patient disposition, intubation requirements, and interfacility transport by advanced life support (ALS) crews.
• Analysis of transport logistics and timing during the initial 24 hours of the outbreak.

Main Results:

• Eleven patients required intubation.
• Twenty-four patients were transported by critical care capable ALS crews, with 16 occurring within the first 24 hours.
• Two fatalities were recorded, one early in the outbreak and another after long-term acute care.

Conclusions:

• Local EMS and public safety personnel play a key role in identifying and managing botulism exposures.
• Opportunities for improvement exist in the organization and logistical coordination of transporting agencies during MCIs.
• Efficient patient transport and inter-agency communication are critical for mitigating the impact of botulism outbreaks.