Prehospital Indicators for Disaster Preparedness and Response: New York City Emergency Medical Services in Hurricane Sandy

Abstract

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).

Vulnerability of Older Adults in Disasters: Emergency Department Utilization by Geriatric Patients After Hurricane Sandy

“…Closure of hospitals and outpatient clinics increased the burden on surrounding hospitals, EDs, and clinics to provide the needed medical care. 45,46 On the other hand, ensuring access to primary care health providers serving vulnerable subgroups can represent resiliency and display adaptive capacity under adverse circumstances from natural disasters. [45][46][47] Given the influx of older adult visits to EDs after the storm, local hospitals should anticipate a range of needs typically provided by community-based services.…”

“…45,46 On the other hand, ensuring access to primary care health providers serving vulnerable subgroups can represent resiliency and display adaptive capacity under adverse circumstances from natural disasters. [45][46][47] Given the influx of older adult visits to EDs after the storm, local hospitals should anticipate a range of needs typically provided by community-based services. These findings would be magnified by closure of local hospitals or outpatient clinics due to a storm, increasing the burden on emergency medical services workers, physicians, nurses, social workers, hospital administrators, disaster planners, and other medical professionals to meet older adults' disaster care needs.…”

System impacts of the COVID‐19 pandemic on New York City's emergency medical services

“…During the COVID-19 pandemic, the NYC 9-1-1 EMS system experienced the largest surge it ever recorded-a surge that was more sustained and involved more critically ill patients than past catastrophic events such as the World Trade Center attacks, the 2003 blackout, and Hurricane Sandy. [6][7][8][9] A series of pre-planned strategies were implemented to maintain the system's ability to function during a pandemic. These included: (1) a computer-assisted triage system to classify calls on the basis of their acuity, to dispatch response assets accordingly and to identify potential infectious disease calls so that responders could don appropriate personal protective equipment (PPE) that had been stockpiled to minimize infectious exposures and maintain workforce integrity; (2) using additional local and out-of-state ambulances to increase system capacity; and (3) addressing low-acuity call-types by telemedicine referrals that would not necessarily require an ambulance response or by a treat/release/no-transport option after ambulance response.…”

Access to Care for VA Dialysis Patients During Superstorm Sandy

“…8-11 During Superstorm Sandy, 6300 patients at 37 health care facilities in New York City were evacuated because of extensive flood damage, creating a surge of new patients to already overcrowded EDs at nearby facilities. 7,12-18 Additionally, many health care facilities, including dialysis clinics, in the affected areas closed, interrupting services for ESRD patients. The majority of ESRD patients missed at least one dialysis session following Sandy, and some received emergency dialysis.…”