title: The effect of an 18-hour electrical power outage on an urban emergency medical services system.
abstract: OBJECTIVE
  To describe the experience of an urban, commercial ambulance provider during the multistate August 2003 electrical power outage (EPO) and to identify how such an event can affect an emergency medical services (EMS) system.
  
  
  METHODS
  Data were abstracted from all dispatch and prehospital medical records generated during the 18-hour EPO. An hour-by-hour comparison was made between the median number of hourly EMS dispatches during the month of August 2003 and the total number of hourly EMS dispatches during the EPO. Presenting complaints were categorized, and all calls related to the EPO were identified.
  
  
  RESULTS
  During the first ten hours of the EPO, hourly call volume increased an average of 250% (range 50%-500%) as compared with all of August 2003. The greatest increase in call volume occurred during the first seven hours of the EPO. During the EPO, 16% (n = 13) of patients presented with a heat-related complaint precipitated by the failure of air conditioning. In the same period, 37% (n = 31) of patients presented with a respiratory-related complaint, 52% (n = 16) of which were precipitated by the failure of home respiratory equipment such as ventilators, nebulizers, and oxygen concentrators. During the EPO, the average time spent on scene with patients increased 63%, from 11 to 18 minutes, when compared with the time spent 16 hours immediately prior and 14 hours immediately after the EPO. Average response and transport times did not change.
  
  
  CONCLUSIONS
  Loss of power can cause a dramatic but short-term increase in call volume and lead to a disaster-like situation. EMS resources may be conserved by proactively assisting patients with home medical devices before they develop emergent conditions. Such a patient population might benefit, for example, from home deliveries of portable oxygen tanks or from the creation of temporary facilities that provide a climate-controlled environment and electrically powered medical devices.
authors.affiliation: Empress Emergency Medical Services, Yonkers, New York, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Rand
authors.forename: David J
authors.initials: DJ
authors.lastname: Mener
authors.forename: E Brooke
authors.initials: EB
authors.lastname: Lerner
authors.forename: Nicholas
authors.initials: N
authors.lastname: DeRobertis
mesh_terms: D000389:Air Conditioning; D000552:Ambulances; D004189:Disaster Planning; D004632:Emergency Medical Services; D005260:Female; D018882:Heat Stress Disorders / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D010102:Oxygen Inhalation Therapy; D011210:Power Plants; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D012138:Respiratory Therapy; D012189:Retrospective Studies; D014505:Urban Population