Smith Silas W, Braun James, Portelli Ian, Malik Sidrah, Asaeda Glenn, Lancet Elizabeth, Wang Binhuan, Hu Ming, Lee David C, Prezant David J, Goldfrank Lewis R
1Ronald O. Perelman Department of Emergency Medicine,NYU School of Medicine,New York,New York.
2Office of Medical Affairs,The Fire Department of the City of New York,New York,New York.
Disaster Med Public Health Prep. 2016 Jun;10(3):333-43. doi: 10.1017/dmp.2015.175. Epub 2016 Jan 7.
We aimed to evaluate emergency medical services (EMS) data as disaster metrics and to assess stress in surrounding hospitals and a municipal network after the closure of Bellevue Hospital during Hurricane Sandy in 2012.
We retrospectively reviewed EMS activity and call types within New York City's 911 computer-assisted dispatch database from January 1, 2011, to December 31, 2013. We evaluated EMS ambulance transports to individual hospitals during Bellevue's closure and incremental recovery from urgent care capacity, to freestanding emergency department (ED) capability, freestanding ED with 911-receiving designation, and return of inpatient services.
A total of 2,877,087 patient transports were available for analysis; a total of 707,593 involved Manhattan hospitals. The 911 ambulance transports disproportionately increased at the 3 closest hospitals by 63.6%, 60.7%, and 37.2%. When Bellevue closed, transports to specific hospitals increased by 45% or more for the following call types: blunt traumatic injury, drugs and alcohol, cardiac conditions, difficulty breathing, "pedestrian struck," unconsciousness, altered mental status, and emotionally disturbed persons.
EMS data identified hospitals with disproportionately increased patient loads after Hurricane Sandy. Loss of Bellevue, a public, safety net medical center, produced statistically significant increases in specific types of medical and trauma transports at surrounding hospitals. Focused redeployment of human, economic, and social capital across hospital systems may be required to expedite regional health care systems recovery. (Disaster Med Public Health Preparedness. 2016;10:333-343).
我们旨在评估紧急医疗服务（EMS）数据作为灾难指标的情况，并评估2012年桑迪飓风期间贝尔维尤医院关闭后周边医院和市政网络的压力。
我们回顾性分析了2011年1月1日至2013年12月31日纽约市911计算机辅助调度数据库中的EMS活动和呼叫类型。我们评估了贝尔维尤医院关闭期间以及从紧急护理能力逐步恢复到独立急诊科能力、具有911接收指定的独立急诊科以及住院服务恢复期间，EMS救护车将患者转运至各医院的情况。
共有2,877,087次患者转运可供分析；其中707,593次涉及曼哈顿的医院。距离最近的3家医院的911救护车转运量不成比例地增加了63.6%、60.7%和37.2%。当贝尔维尤医院关闭时，以下呼叫类型的特定医院转运量增加了45%或更多：钝器外伤、药物和酒精、心脏疾病、呼吸困难、“行人被撞”、昏迷、精神状态改变以及情绪困扰者。
EMS数据识别出了桑迪飓风后患者负荷增加不成比例的医院。作为公共安全网医疗中心的贝尔维尤医院的关闭，导致周边医院特定类型的医疗和创伤转运量出现了具有统计学意义的增加。可能需要在医院系统间有针对性地重新部署人力、经济和社会资本，以加快区域医疗保健系统的恢复。（《灾难医学与公共卫生防范》。2016年；10:333 - 343）
