99 Empowering Emergency Responders to Treat on Scene Alleviates Hospital Strain During Disaster Events

TL;DR

Empowering emergency responders to treat minor burn injuries and CO exposures on-site during disasters reduces hospital strain.

Contribution

Demonstrates how on-scene EMS treatment of minor injuries during disasters can alleviate hospital burden.

Findings

EMS calls for CO and burn injuries increased during the disaster peak but stabilized afterward.

Empowering EMS to treat minor injuries on-site reduced hospital transports without compromising patient outcomes.

No fatalities occurred from CO poisoning among patients transported to the burn center.

Abstract

Disaster events can cause prolonged losses of electricity, leaving individuals to utilize alternative sources of energy such as fossil fuel generators, which in turn can lead to burn injuries and/or carbon monoxide (CO) exposure. The purpose of this study was to examine the impact of generator-related burn injury and CO poisoning (COP) following a region-wide disaster, and the effects of empowering EMS providers to treat many of these injuries on-scene.

Utilizing data gathered from Emergency Medical Services (EMS) provider agencies, we constructed three cohorts related to Hurricane Ida’s landfall: PRE-IDA (07/08/21 - 08/25/21), MID-IDA (08/26/21 – 09/08/21) and POST-IDA (09/09/21 – 10/31/21). We analyzed EMS calls, dispatches, and transports for primary complaints indicating COP or burn injury during these time periods. Statewide emergency response network representatives were contacted regarding and pre-hospital care and coordination during disaster responses.

PRE-IDA EMS averaged 15.4 calls per day indicating COP or burn injury. 1.4 (9%) of these calls were due to burn injury (61% of which were transported to nearest ED), while 13 (91%) were due to suspicion of COP (98% of which were transported to nearest ED). The mean turnaround time from dispatch to EMS being back in service was 63 (±36) minutes. MID-IDA EMS averaged 20.9 calls per day. 3.3 (16%) of these calls per day were due to burn injury, and 16.7 (84%) of these calls per day were due to COP. Of the MID-IDA calls, 73% of burn patients and 78% of COP patients were transported to the nearest ED. The mean turnaround time from dispatch to EMS being back in service was 64 (±31) minutes during MID-IDA. During POST-IDA, the mean calls per day to EMS decreased to 10.6 (16% of which were burn injury, 84% of which were suspected COP). Of the POST-IDA dispatches, 61% of burn patients and 97% of COP patients were transported to the nearest area hospital. The mean turnaround time from dispatch to EMS being back in service was 69 (± 49) minutes. Lastly, there were no fatalities from COP in patients transported to the burn center and only one patient required hyperbaric therapy for isolated COP.

At the peak, EMS had 90 calls each day per parish for COP requiring implementation of disaster plan. Our data shows an increase in CO related EMS dispatches during MID-IDA with fewer patients transported to regional area hospitals, but overall stable transport times from household to area hospitals amongst the three time periods. This study demonstrates the collaboration of a verified burn center and the EMS community when responding a to natural disaster.

This study demonstrates that empowering EMS to treat smaller burn injuries, and clinically mild CO exposures, on scene during a disaster event decreases strain on area hospitals’.