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Freestanding Emergency Critical Care During the Aftermath of Hurricane Sandy: Implications for Disaster Preparedness and Response

Published online by Cambridge University Press:  13 May 2016

Silas W. Smith ,
Catherine T. Jamin ,
Sidrah Malik ,
Liliya Abrukin ,
Keegan M. Tupchong ,
Ian Portelli ,
Glenn Asaeda ,
David J. Prezant ,
Binhuan Wang  and
Ming Hu
...Show all authors
Silas W. Smith*
Affiliation:
Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, New York NYU Langone Medical Center Institute for Innovations in Medical Education, New York, New York
Catherine T. Jamin
Affiliation:
Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, New York
Sidrah Malik
Affiliation:
Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, New York
Liliya Abrukin
Affiliation:
Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, New York
Keegan M. Tupchong
Affiliation:
Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, New York
Ian Portelli
Affiliation:
Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, New York
Glenn Asaeda
Affiliation:
Office of Medical Affairs, The Fire Department of the City of New York, New York
David J. Prezant
Affiliation:
Office of Medical Affairs, The Fire Department of the City of New York, New York
Binhuan Wang
Affiliation:
Department of Population Health, Division of Biostatistics, NYU School of Medicine, New York, New York
Ming Hu
Affiliation:
Department of Population Health, Division of Biostatistics, NYU School of Medicine, New York, New York
Lewis R. Goldfrank
Affiliation:
Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, New York
Chad M. Meyers
Affiliation:
Icahn School of Medicine at Mount Sinai, New York, New York
*
Correspondence and reprint requests to: Silas W. Smith, MD, Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, Bellevue Hospital Center, 462 First Avenue, Room A-345A, New York, New York 10016 (e-mail: Silas.Smith@nyumc.org).
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Abstract

Objective

To assess the impact of an emergency intensive care unit (EICU) established concomitantly with a freestanding emergency department (ED) during the aftermath of Hurricane Sandy.

Methods

We retrospectively reviewed records of all patients in Bellevue’s EICU from freestanding ED opening (December 10, 2012) until hospital inpatient reopening (February 7, 2013). Temporal and clinical data, and disposition upon EICU arrival, and ultimate disposition were evaluated.

Results

Two hundred twenty-seven patients utilized the EICU, representing approximately 1.8% of freestanding ED patients. Ambulance arrival occurred in 31.6% of all EICU patients. Median length of stay was 11.55 hours; this was significantly longer for patients requiring airborne isolation (25.60 versus 11.37 hours, P<0.0001 by Wilcoxon rank sum test). After stabilization and treatment, 39% of EICU patients had an improvement in their disposition status (P<0.0001 by Wilcoxon signed rank test); upon interhospital transfer, the absolute proportion of patients requiring ICU and SDU resources decreased from 37.8% to 27.1% and from 22.2% to 2.7%, respectively.

Conclusions

An EICU attached to a freestanding ED achieved significant reductions in resource-intensive medical care. Flexible, adaptable care systems should be explored for implementation in disaster response. (Disaster Med Public Health Preparedness. 2016;10:496–502)

Keywords

critical caredisasteremergency departmentfreestandingHurricane Sandy
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Special Issue 3: Superstorm Sandy , June 2016 , pp. 496 - 502
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

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