The 2017 Solar Eclipse: Implementing Enhanced Syndromic Surveillance on the Path of Totality in Kentucky

2020 ◽  
pp. 1-4
Author(s):  
Kristen Heitzinger ◽  
Douglas A. Thoroughman ◽  
Blake D. Johnson ◽  
Andrew Chandler ◽  
John W. Prather ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Solar Eclipse ◽  
Syndromic Surveillance ◽  
First Aid ◽  
Medical Services ◽  
Care Providers ◽  
Syndromic Surveillance System ◽  
Mass Gatherings ◽  
Emergency Medical

ABSTRACT Objective: The 2017 solar eclipse was associated with mass gatherings in many of the 14 states along the path of totality. The Kentucky Department for Public Health implemented an enhanced syndromic surveillance system to detect increases in emergency department (ED) visits and other health care needs near Hopkinsville, Kentucky, where the point of greatest eclipse occurred. Methods: EDs flagged visits of patients who participated in eclipse events from August 17–22. Data from 14 area emergency medical services and 26 first-aid stations were also monitored to detect health-related events occurring during the eclipse period. Results: Forty-four potential eclipse event-related visits were identified, primarily injuries, gastrointestinal illness, and heat-related illness. First-aid stations and emergency medical services commonly attended to patients with pain and heat-related illness. Conclusions: Kentucky’s experience during the eclipse demonstrated the value of patient visit flagging to describe the disease burden during a mass gathering and to investigate epidemiological links between cases. A close collaboration between public health authorities within and across jurisdictions, health information exchanges, hospitals, and other first-response care providers will optimize health surveillance activities before, during, and after mass gatherings.

Emergency Medical Services and Syndromic Surveillance: A Comparison With Traditional Surveillance and Effects on Timeliness

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 72S-79S
Author(s):  
Peter J. Rock ◽  
Dana Quesinberry ◽  
Michael D. Singleton ◽  
Svetla Slavova
Keyword(s):  
Public Health ◽  
Time Series ◽  
Emergency Medical Services ◽  
Syndromic Surveillance ◽  
Surveillance Data ◽  
Medical Services ◽  
Opioid Overdose ◽  
Billing Data ◽  
Public Health Response ◽  
Emergency Medical

Objective Traditional public health surveillance of nonfatal opioid overdose relies on emergency department (ED) billing data, which can be delayed substantially. We compared the timeliness of 2 new data sources for rapid drug overdose surveillance—emergency medical services (EMS) and syndromic surveillance—with ED billing data. Methods We used data on nonfatal opioid overdoses in Kentucky captured in EMS, syndromic surveillance, and ED billing systems during 2018-2019. We evaluated the time-series relationships between EMS and ED billing data and syndromic surveillance and ED billing data by calculating cross-correlation functions, controlling for influences of autocorrelations. A case example demonstrates the usefulness of EMS and syndromic surveillance data to monitor rapid changes in opioid overdose encounters in Kentucky during the COVID-19 epidemic. Results EMS and syndromic surveillance data showed moderate-to-strong correlation with ED billing data on a lag of 0 ( r = 0.694; 95% CI, 0.579-0.782; t = 9.73; df = 101; P < .001; and r = 0.656; 95% CI, 0.530-0.754; t = 8.73; df = 101; P < .001; respectively) at the week-aggregated level. After the COVID-19 emergency declaration, EMS and syndromic surveillance time series had steep increases in April and May 2020, followed by declines from June through September 2020. The ED billing data were available for analysis 3 months after the end of a calendar quarter but closely followed the trends identified by the EMS and syndromic surveillance data. Conclusion Data from EMS and syndromic surveillance systems can be reliably used to monitor nonfatal opioid overdose trends in Kentucky in near–real time to inform timely public health response.

Half-a-Million Strong: The Emergency Medical Services Response to a Single-Day, Mass-Gathering Event

2004 ◽  
Vol 19 (04) ◽  
pp. 287-296 ◽  
Author(s):  
Michael J. Feldman ◽  
Jane L. Lukins ◽  
P. Richard Verbeek ◽  
Russell D. MacDonald ◽  
Robert J. Burgess ◽  
...  
Keyword(s):  
Medical Care ◽  
Emergency Medical Services ◽  
First Aid ◽  
Medical Services ◽  
Medical Attention ◽  
Mass Gathering ◽  
Field Hospital ◽  
Mass Gatherings ◽  
Emergency Medical ◽  
Included Patient

AbstractIntroduction:Emergency medical services (EMS) responses to mass gatherings have been described frequently, but there are few reports describing the response to a single-day gathering of large magnitude.Objective:This report describes the EMS response to the largest single-day, ticketed concert held in North America: the 2003 “Toronto Rocks!” Rolling Stones Concert.Methods:Medical care was provided by paramedics, physicians, and nurses. Care sites included ambulances, medically equipped, all-terrain vehicles, bicycle paramedic units, first-aid tents, and a 124-bed medical facility that included a field hospital and a rehydration unit. Records from the first-aid tents, ambulances, paramedic teams, and rehydration unit were obtained. Data abstracted included patient demographics, chief complaint, time of incident, treatment, and disposition.Results:More than 450,000 people attended the concert and 1,870 sought medical care (42/10,000 attendees). No record was kept for the 665 attendees simply requesting water, sunscreen, or bandages. Of the remaining 1,205 patients, the average of the ages was 28 ±11 years, and 61% were female. Seven-hundred, ninety-five patients (66%) were cared for at one of the first-aid tents. Physicians at the tents assisted in patient management and disposition when crowds restricted ambulance movement. Common complaints included headache (321 patients; 27%), heat-related complaints (148; 12%), nausea or vomiting (91; 7.6%), musculoskeletal complaints (83; 6.9%), and breathing problems (79; 6.6%). Peak activity occurred between 14:00 and 19:00 hours, when 102 patients per hour sought medical attention. Twenty-four patients (0.5/10,000) were transferred to off-site hospitals.Conclusions:This report on the EMS response, outcomes, and role of the physicians at a large single-day mass gathering may assist EMS planners at future events.

scholarly journals Approach to Onboarding Emergency Medical Services (EMS) Data Into a Syndromic Surveillance System

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Samurl P. Prahlow ◽  
David Atrubin ◽  
Allison Culpepper ◽  
Janet J. Hamilton ◽  
Joshua Sturms ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Health Surveillance ◽  
Use Cases ◽  
Data Sources ◽  
Medical Services ◽  
Emergency Medical ◽  
Data Elements

ObjectiveTo describe the strategy and process used by the Florida Department of Health (FDOH) Bureau of Epidemiology to onboard emergency medical services (EMS) data into FDOH’s syndromic surveillance system, the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL).IntroductionSyndromic surveillance has become an integral component of public health surveillance efforts within the state of Florida. The near real-time nature of these data are critical during events such as the Zika virus outbreak in Florida in 2016 and in the aftermath of Hurricane Irma in 2017. Additionally, syndromic surveillance data are utilized to support daily reportable disease detection and other surveillance efforts. Although syndromic systems typically utilize emergency department (ED) visit data, ESSENCE-FL also includes data from non-traditional sources: urgent care center visit data, mortality data, reportable disease data, and Florida Poison Information Center Network (FPICN) data. Inclusion of these data sources within the same system enables the broad accessibility of the data to more than 400 users statewide, and allows for rapid visualization of multiple data sources in order to address public health needs. Currently, the ESSENCE-FL team is actively working to incorporate EMS data into ESSENCE-FL to further increase public health surveillance capacity and data visualization.MethodsThe ESSENCE-FL team worked collaboratively with various public health program stakeholders to bring EMS data, aggregated by the FDOH Bureau of Emergency Medical Oversight Emergency Medical Services Tracking and Reporting System (EMSTARS) team, into ESSENCE-FL. The ESSENCE-FL team met with the EMSTARS team to discuss use cases, demonstrate both systems, and to obtain project buy-in and support. Initial project meetings included review of ESSENCE-FL system support, user types (roles and access), as well as data security and compliance. An overall project timeline was established, and deliverables were added into system support contracts. Multiple stakeholders, across disciplines representing each key use case, reviewed the Florida version of the National Emergency Medical Services Information System (NEMSIS) version 3.4 data dictionary to identify program-specific data element needs. An element scoring spreadsheet was returned to the ESSENCE-FL team. These scores were aggregated and discordant scores were reviewed by the ESSENCE-FL team. A one-month extract of EMS data was reviewed to assess variable completeness and relevance. Monthly team meetings facilitated the final decisions on the data elements by leveraging lessons learned through onboarding other data sources, findings from the analysis of the one-month extract, stakeholder comments, and advice from other states known to be leveraging EMS data for public health surveillance.ResultsThrough a collaborative and broad approach with partners, the ESSENCE-FL team attained stakeholder buy-in and identified 81 data elements to be included in the EMS feed to ESSENCE-FL. The final list of data elements was determined to best support health surveillance of this population prior to presenting to the ED. The inclusion of the EMS data in ESSENCE-FL will increase the epidemiologic characterization and analysis of the opioid epidemic in Florida. Additional key use cases identified during this project included enhanced injury surveillance, enhanced occupational health surveillance, and characterization of potential differences between EMS and ED visits.ConclusionsThis comprehensive approach can be used by other jurisdictions considering adding EMS data to their syndromic surveillance systems. When considering onboarding a new data source into a surveillance system, it is important to work closely with stakeholders from disciplines representing each of the key use cases to broaden buy-in and support for the project. Through employing this comprehensive approach, syndromic surveillance systems can be better developed to include data that are widely utilizable to many different stakeholders in the public health community.

scholarly journals (A231) Deficiencies in the Preparedness of Emergency Medical Services Providers for Terrorist Incidents Involving Children

2011 ◽  
Vol 26 (S1) ◽  
pp. s63-s63
Author(s):  
M. Reilly
Keyword(s):  
Public Health ◽  
United States ◽  
Emergency Medical Services ◽  
A Priori ◽  
The United States ◽  
Medical Services ◽  
Special Populations ◽  
Provider Education ◽  
Emergency Medical ◽  
Nationally Representative

IntroductionRecent studies have discussed major deficiencies in the preparedness of emergency medical services (EMS) providers to effectively respond to disasters, terrorism and other public health emergencies. Lack of funding, lack of national uniformity of systems and oversight, and lack of necessary education and training have all been cited as reasons for the inadequate emergency medical preparedness in the United States.MethodsA nationally representative sample of over 285,000 emergency medical technicians (EMTs) and Paramedics in the United States was surveyed to assess whether they had received training in pediatric considerations for blast and radiological incidents, as part of their initial provider education or in continuing medical education (CME) within the previous 24 months. Providers were also surveyed on their level of comfort in responding to and potentially treating pediatric victims of these events. Independent variables were entered into a multivariate model and those identified as statistically significant predictors of comfort were further analyzed.ResultsVery few variables in our model caused a statistically significant increase in comfort with events involving children in this sample. Pediatric considerations for blast or radiological events represented the lowest levels of comfort in all respondents. Greater than 70% of respondents reported no training as part of their initial provider education in considerations for pediatrics following blast events. Over 80% of respondents reported no training in considerations for pediatrics following events associated with radiation or radioactivity. 88% of respondents stated they were not comfortable with responding to or treating pediatric victims of a radiological incident.ConclusionsOut study validates our a priori hypothesis and several previous studies that suggest deficiencies in preparedness as they relate to special populations - specifically pediatrics. Increased education for EMS providers on the considerations of special populations during disasters and acts of terrorism, especially pediatrics, is essential in order to reduce pediatric-related morbidity and mortality following a disaster, act of terrorism or public health emergency.

The 1994 Northridge Earthquake Disaster Response: The Local Emergency Medical Services Agency Experience

1996 ◽  
Vol 11 (3) ◽  
pp. 172-179 ◽  
Author(s):  
Samuel J. Stratton ◽  
Virginia Price Hastings ◽  
Darlene Isbell ◽  
John Celentano ◽  
Miguel Ascarrunz ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Disaster Response ◽  
Communication Systems ◽  
Medical Services ◽  
Northridge Earthquake ◽  
Power Sources ◽  
Incident Command ◽  
Emergency Medical ◽  
1994 Northridge Earthquake

AbstractIntroduction:This paper describes the 1994 Northridge earthquake experience of the local emergency medical services (EMS) agency. Discussed are means that should improve future local agency disaster responses.Methods:Data reported are descriptive and were collected from multiple independent sources, and can be reviewed publicly and confirmed. Validated data collected during the disaster by the Local EMS Agency also are reported.Results:The experience of the Los Angeles County EMS Agency was similar to that of earthquake disasters previously reported. Communication systems, water, food, shelter, sanitation means, power sources, and medical supplies were resources needed early in the disaster. Urban Search and Rescue Teams and Disaster Medical Assistance Teams were important elements in the response to the Northridge earthquake. The acute phase of the disaster ended within 48 to 72 hours and public health then became the predominant health-care issue. Locating community food and water supplies near shelters, providing transportation to medical care, and public-health visits to shelter locations helped prevent the development of long-term park encampments. An incident command system for the field, hospitals, and government responders was necessary for an organized response to the disaster.Conclusion:Disaster preparedness, multiple forms of reliable communication, rapid mobilization of resources, and knowledge of available state and federal resources are necessary for a disaster response by a local EMS agency.

Pediatric Prehospital Care in Urban and Rural Areas

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 681-690 ◽  
Author(s):  
James S. Seidel ◽  
Deborah Parkman Henderson ◽  
Patrick Ward ◽  
Barbara Wray Wayland ◽  
Beverly Ness
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Pediatric Patients ◽  
Life Support ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10 493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P &lt; .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

Emergency Medical Services Liability Litigation in the United States: 1987 to 1992

1994 ◽  
Vol 9 (4) ◽  
pp. 214-220 ◽  
Author(s):  
David L. Morgan ◽  
Michael P. Wainscott ◽  
Heidi C. Knowles
Keyword(s):  
Emergency Medical Services ◽  
The United States ◽  
Medical Services ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Trial Court ◽  
Legal Cases ◽  
Patient Transport ◽  
Emergency Medical ◽  
The Common

AbstractIntroduction:Although emergency medical services (EMS) liability litigation is a concern of many prehospital health care providers, there have been no studies of these legal cases nationwide and no local case studies since 1987.Methods:A retrospective case series was obtained from a computerized database of trial court cases filed against EMS agencies nation-wide. All legal cases that met the inclusion criteria were included in the study sample. These cases must have involved either ambulance collisions (AC) or patient care (PC) incidents, and they must have been closed between 1987 and 1992.Results:There were 76 cases that met the inclusion criteria. Half of these cases involved an AC, and the other cases alleged negligence of a PC encounter. Thirty (78.9%) of the plaintiffs in the AC cases were other motorists, and 35 (92.1%) of the plaintiffs in the PC cases were EMS patients. Almost half of the cases named an individual (usually an emergency medical technician or paramedic) as a codefendant. Thirty-one (40.8%) of the cases were closed without any payment to the plaintiff. There were five cases with plaintiffs' awards or settlements greater than [US] $1 million. Most (71.0%) ofthe ACs occurred in an intersection or when one vehicle rear-ended another vehicle. The most common negligence allegations in the PC cases were arrival delay, inadequate assessment, inadequate treatment, patient transport delay, and no patient transport.Conclusion:Risk management for EMS requires specific knowledge of the common sources of EMS liability litigation. This sample of recent legal cases provides the common allegations of negligence. Recommendations to decrease the legal risk of EMS agencies and prehospital providers are suggested.

Trauma System Development and Future Directions

1993 ◽  
Vol 8 (2) ◽  
pp. 111-114 ◽  
Author(s):  
Judith B. Braslow ◽  
Joan A. Snyder
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Trauma Care ◽  
System Development ◽  
Trauma System ◽  
The United States ◽  
Advisory Council ◽  
Medical Services ◽  
Emergency Medical ◽  
Care Systems

AbstractTraumatic injury, both unintentional and intentional, is a serious public health problem. Trauma care systems play a significant role in reducing mortality, morbidity, and disability due to injuries. However, barriers to the provision of prompt and appropriate emergency medical services still exist in many areas of the United States. Title XII of the Public Health Service Act provides for programs in support of trauma care planning and system development by states and localities. This legislation includes provisions for: 1) grants to state agencies to modify the trauma care component of the state Emergency Medical Services (EMS) plan; 2) grants to improve the quality and availability of trauma care in rural areas; 3) development of a Model Trauma Care System Plan for states to use as a guide in trauma system development; and 4) the establishment of a National Advisory Council on Trauma Care Systems.

scholarly journals Harmonization of three public health insurance schemes on emergency medical services

2014 ◽  
Vol 14 (S1) ◽  
Author(s):  
Wannapha Bamrungkhet ◽  
Sutherada Chimnoi ◽  
Samrit Srithamrongsawat ◽  
Supasit Pannarunothai
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Emergency Medical Services ◽  
Public Health Insurance ◽  
Medical Services ◽  
Emergency Medical
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