title: The blizzard of 1996: a pediatric emergency department.
abstract: OBJECTIVE
  To determine the effect of the blizzard of 1996 on the utilization of a pediatric emergency department (ED).
  
  
  METHODS
  The study consisted of a retrospective analysis of ED visits prior to, during, and after the storm using a computerized ED log, ED medical records, and Surface Weather observations. The setting was a suburban academic pediatric center in the mid-Atlantic region. Participants included all patients who visited the ED during the 36-hour storm period, the 72 hours before the storm, and the 72 hours after the storm. Number of visits, age, mode of arrival, triage acuity level, admission rate, and the ten most common discharge diagnoses for each time period were gleaned from medical records.
  
  
  RESULTS
  The ED census rose 35% above baseline during the 24 hours before the storm. During the 36-hour storm period, the census dropped to 15% of the census prior to the storm. Mode of arrival, age, triage acuity level, admission rate, and the ten most common discharge diagnoses for children seen in the ED during the storm period were not significantly different from those for children seen during the 36 hours before the storm. During the 72 hours after the storm (test period), the census was 40% less than that during the control period (72 hours before the storm). By the fourth day, the census had returned to normal. During the test period, there was a significant increase in the triage acuity level of patients. The percentage of children triaged as urgent, emergent, or critical was 29%, compared with 15% triaged in those categories during the control period (p < 0.05). Also, the overall admission rate increased from 8% during the control period to 22% during the test period (p < 0.01).
  
  
  CONCLUSIONS
  Among other effects, a significant increase in severity of presentations to a pediatric ED following a severe storm can be observed.
authors.affiliation: Department of Pediatrics, duPont Hospital for Children, Wilmington, Delaware, USA. mattia@aidi.nemours.org
authors.forename: M W
authors.initials: MW
authors.lastname: Attia
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D004190:Disasters; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006302:Health Services Research; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D008873:Mid-Atlantic Region; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012914:Snow; D018881:Suburban Health; D013997:Time Factors; D014218:Triage / Q000706:statistics & numerical data