Broder Joshua, Mehrotra Abhishek, Tintinalli Judith
Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Neurosciences Hospital, Chapel Hill, NC 27599, USA.
Injury. 2005 Jan;36(1):21-6. doi: 10.1016/j.injury.2004.08.007.
In 2002, an ice storm interrupted power to 1.3 million households in North Carolina, USA. Previous reports described storm injuries in regions with frequent winter weather. [Blindauer KM, Rubin C, Morse DL, McGeehin M. The 1996 New York blizzard: impact on noninjury visits. Am J Emerg Med 1999;17(1):23-7; Centers for Disease Control and Prevention. Community needs assessment and morbidity surveillance following an ice storm--Maine, January 1998. MMRW 1998;47(17):351-5; Daley WR, Smith A, Paz-Argandona E, Malilay J, McGeehin M. An outbreak of carbon monoxide poisoning after a major ice storm in Maine. J Emerg Med 2000;18(1):87-93; Hamilton J. Quebec's ice storm'98: "all cards wild, all rules broken" in Quebec's shell-shocked hospitals. Can Med Assoc J 1998;158(4):520-4; Hartling L, Brison RJ, Pickett W. Cluster of unintentional carbon monoxide poisonings presenting to the emergency departments in Kingston, Ontario during 'Ice Storm 98'. Can J Public Health 1998;89(6):388-90; Hartling L, Pickett W, Brison RJ. The injury experience observed in two emergency departments in Kingston, Ontario during 'ice storm 98'. Can J Public Health 1999;90(2):95-8; Houck, PM, Hampson NB. Epidemic carbon monoxide poisoning following a winter storm. J Emerg Med 1997;15(4):469-73; Lewis LM, Lasater LC. Frequency, distribution, and management of injuries due to an ice storm in a large metropolitan area. South Med J 1994;87(2):174-8; Smith RW, Nelson DR. Fractures and other injuries from falls after an ice storm. Am J Emerg Med 1998;16(1):52-5]. We postulated that injuries might differ in a region where ice storms are less common.
Identify storm-related injuries.
Emergency department (ED) charts from the storm period (defined as onset of precipitation until 99% power restoration) were retrospectively reviewed. Included injuries were: falls on ice; injuries due to darkness; cold exposure; injuries from storm-related damage; burns; or carbon monoxide/smoke exposure.
Tertiary care ED, central North Carolina.
All ED patients.
None.
Mechanism of injury.
One hundred thirty incidents occurred, most resulting from storm damage and carbon monoxide. Seven were life threatening: four spinal fractures and two intracranial hemorrhages from falling tree limbs and one hypothermia. Carbon monoxide poisoning affected one pregnant woman and all children in our series. Twenty three percent of patients were Hispanic, although Hispanics comprise only 11% of the study ED population.
Injuries from storm-related damage and carbon monoxide exposure predominated. Available hyperbaric chambers were quickly filled to capacity. Hispanics experienced a disproportionate number of injuries.
2002年,一场冰暴导致美国北卡罗来纳州130万户家庭停电。此前的报告描述了冬季天气频繁地区的风暴伤害情况。[Blindauer KM, Rubin C, Morse DL, McGeehin M. 1996年纽约暴风雪:对非受伤就诊的影响。《美国急诊医学杂志》1999年;17(1):23 - 7;疾病控制与预防中心。1998年1月缅因州冰暴后的社区需求评估和发病率监测。《发病率与死亡率周报》1998年;47(17):351 - 5;Daley WR, Smith A, Paz - Argandona E, Malilay J, McGeehin M.缅因州一场重大冰暴后一氧化碳中毒的暴发。《急诊医学杂志》2000年;18(1):87 - 93;Hamilton J.魁北克1998年冰暴:魁北克受重创医院里“所有牌都乱了,所有规则都被打破”。《加拿大医学协会杂志》1998年;158(4):520 - 4;Hartling L, Brison RJ, Pickett W. 1998年“冰暴”期间安大略省金斯顿急诊科收治的意外一氧化碳中毒病例群。《加拿大公共卫生杂志》1998年;89(6):388 - 90;Hartling L, Pickett W, Brison RJ. 1998年“冰暴”期间安大略省金斯顿两个急诊科观察到的伤害情况。《加拿大公共卫生杂志》1999年;90(2):95 - 8;Houck, PM, Hampson NB.冬季风暴后的流行性一氧化碳中毒。《急诊医学杂志》1997年;15(4):469 - 73;Lewis LM, Lasater LC.大城市地区冰暴所致伤害的频率、分布及处理。《南方医学杂志》1994年;87(2):174 - 8;Smith RW, Nelson DR.冰暴后跌倒导致的骨折及其他伤害。《美国急诊医学杂志》1998年;16(1):52 - 5]。我们推测在冰暴不太常见的地区,伤害情况可能有所不同。
识别与风暴相关的伤害。
回顾性审查风暴期间(定义为降水开始至电力恢复99%)的急诊科(ED)病历。纳入的伤害包括:在冰上跌倒;因黑暗导致 的伤害;寒冷暴露;与风暴相关的损害导致的伤害;烧伤;或一氧化碳/烟雾暴露。
北卡罗来纳州中部的三级护理急诊科。
所有急诊科患者。
无。
伤害机制。
共发生130起事件,大多数由风暴损害和一氧化碳导致。7起危及生命:4起因树枝掉落导致的脊柱骨折和2起颅内出血,以及1起体温过低。一氧化碳中毒影响了我们研究系列中的1名孕妇和所有儿童。23%的患者为西班牙裔,尽管西班牙裔仅占研究急诊科人群的11%。
与风暴相关的损害和一氧化碳暴露导致的伤害占主导。可用的高压氧舱很快满负荷运转。西班牙裔遭受的伤害数量不成比例。