Læknablaðið : fylgirit - 15.06.2002, Qupperneq 18

POSTERS / ICELAND 2002: EMERGENCY MEDICINE BETWEEN CONTINENTS
than male patients to be “very satisfied” regarding specific aspects
of care.
P 04 - ED Systems: Efficlency, Productivity
Community planning for bioterrorism
Doyle CJ
St. Joseph Hospital / University of Michigan, United States
The Washtenaw County (Michigan) Bioterrorism Committee was
formed in April 2000 at the request of the Washtenaw County EMS
(Emergency Medical Services) Commission. Its charge was to
review information pertaining to acts of domestic and international
terrorism; review county vulnerabilities; review of the health and
safety impact on citizens; and to identify resources of response and
to develop local bioterrorism response procedures.
The committee is comprised of the Director of the county public
health department (chair), representatives of the local EMS com-
munity, hazardous materials responders (fire and EMS), infectious
disease representatives from the health department and local
hospitals, emergency medicine representatives, county commissio-
ner, county sheriff, local police, state police, FBI, county emergency
manager, EMS commission chair, environmental health, Red Cross,
and veterinary medicine.
Work groups were set up to accomplish specific goals and tasks.
The EMS, transportation and evacuation group looked at how the
EMS system might help with surveillance of unusual events, hazar-
dous materials including biologic response capability and response,
and hazardous materials drug box stocking and availability. A sur-
veillance group monitors food safety, environmental heath con-
cerns including vector control, water and solid waste, public health
reporting and detection of disease clusters and unusual diseases,
victim identification and mortuary services. A communications
group evaluated the county communications plan, including secure
communication, information and call out of responders and hospi-
tals, and information to the public and media during an incident. A
public heath information group was charged with dissemination of
public information, formation of a speaker’s bureau, interaction
and release of information to the media and establishing a website
with biologic and chemical information for personal and family
planning for the public. A training and exercise group was to
evaluate and coordinate training opportunities and exercises in the
county. A medical care group is working on hospital care, drug
availability, and development of alternative sites for surveillance,
triage, prophylaxis, and treatment if necessary. Consultant availa-
bility and resources for updated information are being reviewed.
Mental health care resources are to be surveyed. Smaller groups are
considering veterinary issues such as animal surveillance and care,
another group will review police and security issues including safe
methods of approach to a hazard.
The committee has met monthly since its inception and has
proved an invaluable network and working group that has assessed
the community’s vulnerability. It has completed a grant application
and since September 11,2001, has made concerted efforts to further
define and plan the community’s response to biologic and chemical
incidents.
P 05 - ED Systems: Efficiency, Productivity
Trends in pediatric EMS utilization in a rural state
Stone SM, Burton JH, Peredy TR
Departmcnt of Emergency Medicine, Maine Medical Center, United States
Introductiun: Little data exists in the literature on the characteri-
zation and trends of pediatric EMS utilization. Key to the under-
standing of the epidemiology of EMS activation, this information
would allow administrators to anticipate additional resource needs
in high growth areas and would impact EMS educator curricula
development. We hypothesized that patients in their late teens
would represent a group with high EMS utilization rates due to
increased risk taking behavior and interpersonal violence-related
emergencies.
Methods: Since 1992, the Maine EMS office has collected copies of
all state standardized run sheets. Data fields describing demo-
graphics, type of call, patient condition and EMS interventions are
transcribed into a central database. We reviewed the five most
recently completed years of data 1996-2000. Groups were divided
into pre-teen (ages 6-10), early teen (ages 11-15) and late teen (ages
16-20). Characteristics of scene calls for these groups were then
analyzed.
Results: From 1996-2000,907,150 total records were generated (see
table 1). Total EMS traffic increased by 4.9%, correlating with a 4%
annual population growth for the same period. 48,319 of the 78,904
EMS pediatric encounters were logged as primary scene calls
within the age groups described above. There was a slight female
predominance for both teen and late teen groups. Weekend calls
represented 33-45% of primary scene calls. EMS utilization in-
creased at a slightly faster rate in suburban areas (defined as
population 100-300/sq. mile). EMS utilization was higher in the
summer months (defined as mean daily temp. > 60 F). A majority
of scene calls were for injury or trauma encounters, especially in the
older group. While EMS encounters for the late teen group related
to high risk behavior (see Table 2) saw dramatic rises during the
study period in (alcohol-related 30%, drug overdoses 50%, behavi-
oral emergencies 60% and risk for suicide 200%) their respective
totals contributed little to the overall EMS call increases. The
greatest increase in EMS utilization related to high-risk behavior
was for non-vehicular trauma which rose >400 calls during the
study period.
Conclusions: Pediatric EMS encounters represent a small but
growing minority of the total EMS volume. Late teens saw the
highest utilization increases, largely due to non-vehicular trauma
(for example, interpersonal violence). A heightened awareness of
and preparation for Pediatric EMS encounters related to behavi-
oral, traumatic, or psychological emergencies will be important if
current trends continue.
Table 1. Database Totals.
1996 1997 1998 1999 2000 %change
EMScalls, total 158,638 173,871 187,354 189,401 197,886 4.9 (1.1-9.6)
EMS calls, ages 10-20 13,994 14,718 15,940 16,671 17,581 5.1 (•4.6-8.3)
EMS scene 8920 calls, ages 10-20 9105 9801 10,000 10,493 3.5 (2.0-7.6)
18 Læknablaðið/Fylgirit 45 2002/88