title: Freestanding Emergency Critical Care During the Aftermath of Hurricane Sandy: Implications for Disaster Preparedness and Response.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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).
authors.affiliation: 1Ronald O. Perelman Department of Emergency Medicine,NYU School of Medicine,New York,New York.
authors.forename: Silas W
authors.initials: SW
authors.lastname: Smith
authors.affiliation: 1Ronald O. Perelman Department of Emergency Medicine,NYU School of Medicine,New York,New York.
authors.forename: Catherine T
authors.initials: CT
authors.lastname: Jamin
authors.affiliation: 1Ronald O. Perelman Department of Emergency Medicine,NYU School of Medicine,New York,New York.
authors.forename: Sidrah
authors.initials: S
authors.lastname: Malik
authors.affiliation: 1Ronald O. Perelman Department of Emergency Medicine,NYU School of Medicine,New York,New York.
authors.forename: Liliya
authors.initials: L
authors.lastname: Abrukin
authors.affiliation: 1Ronald O. Perelman Department of Emergency Medicine,NYU School of Medicine,New York,New York.
authors.forename: Keegan M
authors.initials: KM
authors.lastname: Tupchong
authors.affiliation: 1Ronald O. Perelman Department of Emergency Medicine,NYU School of Medicine,New York,New York.
authors.forename: Ian
authors.initials: I
authors.lastname: Portelli
authors.affiliation: 3Office of Medical Affairs,The Fire Department of the City of New York,New York.
authors.forename: Glenn
authors.initials: G
authors.lastname: Asaeda
authors.affiliation: 3Office of Medical Affairs,The Fire Department of the City of New York,New York.
authors.forename: David J
authors.initials: DJ
authors.lastname: Prezant
authors.affiliation: 4Department of Population Health,Division of Biostatistics,NYU School of Medicine,New York,New York.
authors.forename: Binhuan
authors.initials: B
authors.lastname: Wang
authors.affiliation: 4Department of Population Health,Division of Biostatistics,NYU School of Medicine,New York,New York.
authors.forename: Ming
authors.initials: M
authors.lastname: Hu
authors.affiliation: 1Ronald O. Perelman Department of Emergency Medicine,NYU School of Medicine,New York,New York.
authors.forename: Lewis R
authors.initials: LR
authors.lastname: Goldfrank
authors.affiliation: 5Icahn School of Medicine at Mount Sinai,New York,New York.
authors.forename: Chad M
authors.initials: CM
authors.lastname: Meyers
mesh_terms: D055867:Cyclonic Storms; D004638:Emergency Treatment / Q000379:methods* / Q000706:statistics & numerical data; D006271:Health Facility Closure / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000706:statistics & numerical data*; D009519:New York City; D012189:Retrospective Studies
keywords: Hurricane Sandy; critical care; disaster; emergency department; freestanding