EMS Dispatches during Hurricanes Irene and Sandy in New Jersey

<b>Background</b>: Hurricanes Irene and Sandy heavily impacted New Jersey. Investigating EMS dispatch trends during these storms may allow us to prepare for future disasters. <b>Objectives</b>: Our objectives to characterize the types of EMS dispatches immediately before, during, and after landfall compared to a control period. <b>Methods</b>: This retrospective study was conducted at a large EMS dispatch center that provides first responders, Basic Life Support (BLS), Advanced Life Support (ALS), and critical care transport services to an area with approximately 20 receiving hospitals including a Level I Trauma Center. At peak staffing, there are 8–10 ALS vehicles, 25 BLS vehicles, and 3 critical care transport vehicles deployed. We included of the day of landfall and seven days before and after. We compared dispatch data to a control period in 2010 that mirrored Hurricane Sandy the dates of. Descriptive statistics and two way ANOVA were used to assess dispatch, gender and age differences. <b>Results</b>: We found Hurricane Sandy dispatches peaked 2 days after landfall. Both ALS and BLS had an increase in age in the post-Sandy period compared to the pre-Sandy (ALS 58.5 to 64.2, p = 0.005, ANOVA p = 0.078; BLS 47.4 to 56.3, p &lt; 0.001, ANOVA p = 0.001). There were 17 “hurricane related” (loss of power related issues, oxygen supply depleted, evacuation) and 15 carbon monoxide dispatches in the post-Sandy period and none in the others, including peri-Irene. The average age of cardiac arrest dispatches was lower in the post-Irene group compared to pre-Irene (74.3 to 47.8, p = 0.023). There were no critical care requests before or after Hurricane Sandy, but there were 14 around Hurricane Irene and 10 surrounding the control period. <b>Conclusions</b>: Dispatch data can inform natural disaster planning. Education efforts can focus on geriatric patients, as well as resource distribution planning for an increase in geriatric populations. However, pattern variability between storms shows further study is needed to clarify exactly which resources should be utilized in order to maintain an ideal response to a natural disaster.

**背景**：飓风艾琳（Hurricane Irene）与桑迪（Hurricane Sandy）对新泽西州造成了严重冲击。探究此类风暴期间的急诊医疗服务（Emergency Medical Services，EMS）调度趋势，可为未来灾害应对筹备工作提供参考。
**研究目标**：本研究旨在对比飓风登陆前、登陆期间及登陆后的EMS调度类型，并与对照周期的调度情况进行特征分析。
**研究方法**：本回顾性研究依托一家大型EMS调度中心开展，该中心可为覆盖区域提供院前急救、基础生命支持（Basic Life Support，BLS）、高级生命支持（Advanced Life Support，ALS）及重症转运服务，服务范围内共设有约20家接收医院，其中包括1所一级创伤中心。在人员配置峰值时段，该中心部署有8~10台ALS救护车、25台BLS救护车及3台重症转运救护车。本研究纳入了飓风登陆当日及其前后各7天的调度数据，并将上述时段的调度数据与2010年与桑迪飓风发生日期匹配的对照周期数据进行对比。研究采用描述性统计及双向方差分析（two-way ANOVA）对调度相关差异、性别及年龄差异进行评估。
**研究结果**：研究发现，桑迪飓风期间的EMS调度量在登陆后2日达到峰值。相较于桑迪飓风灾前阶段，灾后阶段的ALS及BLS服务对应的患者平均年龄均有所上升（ALS：58.5岁升至64.2岁，p=0.005，方差分析p=0.078；BLS：47.4岁升至56.3岁，p<0.001，方差分析p=0.001）。在桑迪飓风灾后阶段，共出现17例“飓风相关调度”（含电力中断相关问题、供氧耗尽、人员疏散等情况）及15例一氧化碳中毒相关调度，而其余时段（包括艾琳飓风前后）均未出现此类调度。艾琳飓风灾后阶段的心脏骤停调度病例平均年龄较灾前更低（74.3岁降至47.8岁，p=0.023）。桑迪飓风前后均未出现重症转运请求，但艾琳飓风期间共有14例重症转运请求，对照周期内则有10例。
**结论**：EMS调度数据可为自然灾害应对规划提供参考依据。相关宣教工作可针对老年人群开展，同时需针对老年患者占比上升的情况优化资源配置方案。但不同飓风的调度模式存在差异，因此仍需开展进一步研究，以明确应调配哪些资源以实现自然灾害应对的最优响应效果。