title: Impact of Hurricane Sandy on the Staten Island University Hospital Emergency Department.
abstract: Introduction On October 29, 2012, Hurricane Sandy touched down in New York City (NYC; New York USA) causing massive destruction, paralyzing the city, and destroying lives. Research has shown that considerable damage and loss of life can be averted in at-risk areas from advanced preparation in communication procedures, evacuation planning, and resource allocation. However, research is limited in describing how natural disasters of this magnitude affect emergency departments (EDs). Hypothesis/Problem The aim of this study was to identify and describe trends in patient volume and demographics, and types of conditions treated, as a result of Hurricane Sandy at Staten Island University Hospital North (SIUH-N; Staten Island, New York USA) site ED.
  
  
  METHODS
  A retrospective chart review of patients presenting to SIUH-N in the days surrounding the storm, October 26, 2012 through November 2, 2012, was completed. Data were compared to the same week of the year prior, October 28, 2011 through November 4, 2011. Daily census, patient age, gender, admission rates, mode of arrival, and diagnoses in the days surrounding the storm were observed.
  
  
  RESULTS
  A significant decline in patient volume was found in all age ranges on the day of landfall (Day 0) with a census of 114; -55% compared to 2011. The daily volume exhibited a precipitous drop on the days preceding the storm followed by a return to usual volumes shortly after. A notably larger percentage of patients were seen for medication refills in 2012; 5.8% versus 0.4% (P<.05). Lacerations and cold exposure also were increased substantially in 2012 at 7.6% versus 2.8% (P<.05) and 3.8% versus 0.0% (P<.05) of patient visits, respectively. A large decline in admissions was observed in the days prior to the storm, with a nadir on Day +1 at five percent (-22%). Review of admitted patients revealed atypical admissions for home care service such as need for supplemental oxygen or ventilator. In addition, a drop in Emergency Medical Services (EMS) utilization was seen on Days 0 and +1. The SIUH-N typically sees 18% of patients arriving via EMS. On Day +1, only two percent of patients arrived by ambulance.
  
  
  CONCLUSIONS
  The daily ED census saw a significant decline in the days preceding the storm. In addition, the type of conditions treated varied from baseline, and a considerable drop in hospital admissions was seen. Data such as these presented here can help make predictions for future scenarios. Greenstein J , Chacko J , Ardolic B , Berwald N . Impact of Hurricane Sandy on the Staten Island University Hospital emergency department. Prehosp Disaster Med. 2016;31(3):335-339.
authors.affiliation: Emergency Department,Staten Island University Hospital,Staten Island,New YorkUSA.
authors.forename: Josh
authors.initials: J
authors.lastname: Greenstein
authors.affiliation: Emergency Department,Staten Island University Hospital,Staten Island,New YorkUSA.
authors.forename: Jerel
authors.initials: J
authors.lastname: Chacko
authors.affiliation: Emergency Department,Staten Island University Hospital,Staten Island,New YorkUSA.
authors.forename: Brahim
authors.initials: B
authors.lastname: Ardolic
authors.affiliation: Emergency Department,Staten Island University Hospital,Staten Island,New YorkUSA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Berwald
mesh_terms: D000328:Adult; D000368:Aged; D055867:Cyclonic Storms; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009519:New York City; D012189:Retrospective Studies; D055815:Young Adult
keywords: ED emergency department; EDIS Emergency Department Information Systems; EMS Emergency Medical Services; NYC New York City; RUMC Richmond University Medical Center; SIUH-N Staten Island University Hospital North; SIUH-S Staten Island University Hospital South; disaster medicine; emergency department; emergency preparedness; hurricane