CITIES Research Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
Emergency Department, Calvary Public Hospital Bruce, Canberra, Australian Capital Territory, Australia.
Prehosp Disaster Med. 2022 Oct;37(5):657-664. doi: 10.1017/S1049023X22001054. Epub 2022 Jul 25.
Global climate change (global warming) has been identified as the primary factor responsible for the observed increase in frequency and severity of wildfires (also known as bushfires in some countries) throughout the majority of the world's vegetated environments. This trend is predicted to continue, causing significant adverse health effects to nearby residential populations and placing a potential strain on local emergency departments (EDs).
The aim of this literature review was to identify papers relating to wildfires and their impact on EDs, specifically patient presentation characteristics, resource utilization, and patient outcomes.
This integrative literature review was guided by the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines for data collection, and Whittemore and Knafl's framework for data analysis. Data were collected from OvidSP, MEDLINE, DARE, CINAHL, PubMed, and Scopus databases. Various Medical Subject Headings (MeSH) and keywords identified papers relevant to wildfires/bushfires and EDs.
Literature regarding the relationship between ED presentations and wildfire events, however, is primarily limited to studies from the United States and Australia and indicates particulate matter (PM) is principally linked to adverse respiratory and cardiovascular outcomes. Observable trends in the literature principally included a significant increase in respiratory presentations, primarily with a lag of one to two days from the initial event. Respiratory and cardiovascular studies that stratified results by age indicated individuals under five, over 65, or those with pre-existing conditions formed the majority of ED presentations.
Key learnings from this review included the need for effective and targeted community advisory programs/procedures, prior to and during wildfire events, as well as pre-event planning, development, and robust resilience strategies for EDs.
全球气候变化(全球变暖)已被确定为导致世界上大多数植被环境中野火(在一些国家也称为丛林火灾)发生频率和严重程度增加的主要因素。预计这种趋势将持续下去,对附近居住人口造成重大不利健康影响,并对当地急诊部门(ED)造成潜在压力。
本文献综述旨在确定与野火及其对 ED 的影响相关的论文,特别是患者就诊特征、资源利用和患者结局。
本综合文献综述以系统评价和荟萃分析(PRISMA)的首选报告项目(PRISMA)指南为数据收集指导,以 Whittemore 和 Knafl 的数据分析框架为指导。数据来自 OvidSP、MEDLINE、DARE、CINAHL、PubMed 和 Scopus 数据库。各种医学主题词(MeSH)和关键词确定了与野火/丛林火灾和 ED 相关的论文。
然而,关于 ED 表现与野火事件之间关系的文献主要限于来自美国和澳大利亚的研究,表明颗粒物(PM)主要与不良呼吸和心血管结局有关。文献中观察到的主要趋势包括呼吸道表现显著增加,主要与初始事件后一到两天的滞后有关。对按年龄分层结果的呼吸和心血管研究表明,五岁以下、六十五岁以上或有既往疾病的人构成了 ED 就诊的大多数。
从本次综述中得出的主要结论包括在野火事件之前和期间需要制定有效的、有针对性的社区咨询方案/程序,以及 ED 的事前规划、发展和强大的弹性策略。