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The blizzard of 1996: a pediatric emergency department
1Department of Pediatrics, duPont Hospital for Children, Wilmington, Delaware, USA. mattia@aidi.nemours.org
Insights
Severe storms significantly impact pediatric emergency department (ED) visits. Following a blizzard, ED visits decreased during the storm but increased in severity and admission rates afterward.
Area of Science:
- Pediatric Emergency Medicine
- Environmental Health Impacts
- Public Health Preparedness
Background:
- Severe weather events, such as blizzards, can disrupt healthcare access and patient flow.
- Understanding the impact of extreme weather on pediatric emergency department (ED) utilization is crucial for resource allocation and patient care.
Purpose of the Study:
- To analyze the effect of the 1996 blizzard on pediatric emergency department (ED) utilization patterns.
- To assess changes in patient volume, acuity, and admission rates during and after the severe weather event.
Main Methods:
- Retrospective analysis of ED visits over three periods: before, during, and after the 1996 blizzard.
- Data collected from a suburban academic pediatric center using ED logs, medical records, and weather observations.
- Key metrics included visit volume, patient demographics, mode of arrival, triage acuity, admission rates, and common diagnoses.
Main Results:
- ED visits decreased significantly during the 36-hour blizzard period.
- Post-storm, patient acuity increased, with a higher percentage triaged as urgent/emergent (29% vs. 15%).
- The overall admission rate rose from 8% pre-storm to 22% post-storm.
Conclusions:
- Severe storms can lead to a significant increase in the severity of pediatric presentations to EDs.
- Post-blizzard conditions necessitate preparedness for higher acuity patients and increased admission rates in pediatric EDs.
Objective:
To determine the effect of the blizzard of 1996 on the utilization of a pediatric emergency department (ED).
Methods:
The study consisted of a retrospective analysis of ED visits prior to, during, and after the storm using a computerized ED log, ED medical records, and Surface Weather observations. The setting was a suburban academic pediatric center in the mid-Atlantic region. Participants included all patients who visited the ED during the 36-hour storm period, the 72 hours before the storm, and the 72 hours after the storm. Number of visits, age, mode of arrival, triage acuity level, admission rate, and the ten most common discharge diagnoses for each time period were gleaned from medical records.
Results:
The ED census rose 35% above baseline during the 24 hours before the storm. During the 36-hour storm period, the census dropped to 15% of the census prior to the storm. Mode of arrival, age, triage acuity level, admission rate, and the ten most common discharge diagnoses for children seen in the ED during the storm period were not significantly different from those for children seen during the 36 hours before the storm. During the 72 hours after the storm (test period), the census was 40% less than that during the control period (72 hours before the storm). By the fourth day, the census had returned to normal. During the test period, there was a significant increase in the triage acuity level of patients. The percentage of children triaged as urgent, emergent, or critical was 29%, compared with 15% triaged in those categories during the control period (p < 0.05). Also, the overall admission rate increased from 8% during the control period to 22% during the test period (p < 0.01).
Conclusions:
Among other effects, a significant increase in severity of presentations to a pediatric ED following a severe storm can be observed.