Attia M W
Department of Pediatrics, duPont Hospital for Children, Wilmington, Delaware, USA.
Prehosp Emerg Care. 1998 Oct-Dec;2(4):285-8. doi: 10.1080/10903129808958881.
To determine the effect of the blizzard of 1996 on the utilization of a pediatric emergency department (ED).
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.
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).
Among other effects, a significant increase in severity of presentations to a pediatric ED following a severe storm can be observed.
确定1996年暴风雪对儿科急诊科（ED）利用率的影响。
该研究包括使用计算机化的急诊日志、急诊病历和地面气象观测数据，对暴风雪来临前、期间和之后的急诊就诊情况进行回顾性分析。研究地点为大西洋中部地区的一家郊区学术性儿科中心。参与者包括在36小时暴风雪期间、暴风雪前72小时以及暴风雪后72小时内前往急诊室就诊的所有患者。从病历中收集每个时间段的就诊次数、年龄、就诊方式、分诊 acuity 水平、住院率以及十大最常见出院诊断。
在暴风雪来临前的24小时内，急诊室就诊人数比基线水平上升了35%。在36小时的暴风雪期间，就诊人数降至暴风雪前的15%。暴风雪期间在急诊室就诊的儿童的就诊方式、年龄、分诊 acuity 水平、住院率以及十大最常见出院诊断与暴风雪前36小时内就诊的儿童相比，没有显著差异。在暴风雪后的72小时（测试期）内，就诊人数比对照期（暴风雪前72小时）减少了40%。到第四天，就诊人数恢复正常。在测试期内，患者的分诊 acuity 水平显著提高。分诊为紧急、急症或危重症的儿童比例为29%，而对照期内此类分诊的比例为15%（p < 0.05）。此外，总体住院率从对照期的8%上升至测试期的22%（p < 0.01）。
除其他影响外，可观察到严重暴风雪后儿科急诊就诊患者的病情严重程度显著增加。
