-
[show abstract]
[hide abstract]
ABSTRACT: Conducted electrical weapons (CEWs) such as the TASER are often used by law enforcement (LE) personnel during suspect apprehension. Previous studies have reported an excellent safety profile and few adverse outcomes with CEW use in adults. We analyzed the safety and injury profile of CEWs when used during LE apprehension of children and adolescents, a potentially vulnerable population.
Consecutive CEW uses by LE officers against criminal suspects were tracked at 10 LE agencies and entered into a database as part of an ongoing multicenter injury surveillance program. All CEW uses against minors younger than 18 years were retrieved for analysis. Primary outcomes included the incidence and type of mild, moderate, and severe CEW-related injury, as assessed by physician reviewers in each case. Ultimate outcomes, suspect demographics, and circumstances surrounding LE involvement are reported secondarily.
Of 2026 consecutive CEW uses, 100 (4.9%) were uses against minor suspects. Suspects ranged from 13 to 17 years, with a mean age of 16.1 (SD, 0.99) years (median, 16 years). There were no significant (moderate or severe) injuries reported (0%; 97.5% confidence interval, 0.0%-3.6%). Twenty suspects (20%; 95% confidence interval, 12.7%-29.1%) were noted to sustain 34 mild injuries. The majority of these injuries (67.6%) were expected superficial punctures from CEW probes. Other mild injuries included superficial abrasions and contusions in 7 cases (7%).
None of the minor suspects studied sustained significant injury, and only 20% reported minor injuries, mostly from the expected probe puncture sites. These data suggest that adolescents are not at a substantially higher risk than adults for serious injuries after CEW use.
Pediatric emergency care 08/2012; 28(9):873-7. · 0.92 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: TASER (TASER International, Scottsdale, AZ) conducted electrical weapons (CEWs) are commonly used by law enforcement officers. Although animal studies have suggested that transcardiac CEW discharges may produce direct cardiac effects, this has not been demonstrated in human studies. OBJECTIVES: This study sought to determine the incidence and outcomes of transcardiac CEW probe impact locations in a large series of actual CEW deployments. METHODS: A multi-center database of consecutive CEW uses by law enforcement officers was retrospectively reviewed. Case report forms were independently reviewed by three investigators to identify cases with paired probe configurations potentially producing a transcardiac discharge vector. Descriptive analysis was performed and inter-rater reliability was assessed. Results: Among 1201 total CEW uses, 813 included probe deployments and 178 cases had paired anterior probe impacts potentially capable of producing a transcardiac discharge vector. This represents 14.8% of all CEW uses (95% confidence interval [CI] 12.9-16.9%) and 21.9% of CEW uses in probe mode (95% CI 19.1-24.9%). Inter-rater agreement was very good, with kappa = 0.82. There were no immediate deaths in any cases (97.5% CI 0.0-0.3%) to suggest a cardiac dysrhythmia, including those with transcardiac discharge vector. CONCLUSION: CEW deployments with probe impact configurations capable of producing a transcardiac discharge occur in a minority of cases in field use conditions. None of these cases, transcardiac or otherwise, produced immediately fatal dysrhythmias. These data support the overall safety of CEWs and provide a benchmark estimate of the likelihood of transcardiac discharge vectors occurring in field use of CEWs.
Journal of Emergency Medicine 06/2012; · 1.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Excited delirium is increasingly recognized as a risk factor for sudden death, though the specific pathophysiology of these deaths is typically unclear. OBJECTIVES: We describe a survivor of excited delirium that displayed a transient severe prolongation of the QT interval, suggesting unmasking of long QT syndrome as a possible mechanism of sudden death. CASE REPORT: A 30-year-old man was arrested by police for violent assaultive behavior. Officers at the scene noted confusion, nonsensical speech, sweating, and bizarre agitated behavior; he was transported to the Emergency Department for medical evaluation of possible excited delirium. His initial electrocardiogram revealed a markedly prolonged corrected QT interval of over 600 ms. Intravenous hydration and sodium bicarbonate were administered, with normalization of the QT; he was admitted and recovered uneventfully. CONCLUSIONS: We discuss the possible association between long QT syndrome and unexplained sudden deaths seen with excited delirium. Sodium bicarbonate may be considered when long QT syndrome is identified during or after agitated delirium, though its routine use cannot be recommended based on a case report.
Journal of Emergency Medicine 05/2012; · 1.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Specially trained tactical emergency medical support (TEMS) personnel provide support to law enforcement special weapons and tactics (SWAT) teams. These programs benefit law enforcement agencies, officers, suspects, and citizens. TEMS programs are increasingly popular, but there are wide variations in their organization and operation and no recent data on their prevalence.
We sought to measure the current prevalence and specific characteristics of TEMS programs in a comprehensive fashion in a single southeastern state.
North Carolina emergency medical services (EMS) systems have county-based central EMS oversight; each system was surveyed by phone and e-mail. The presence and selected characteristics of TEMS programs were recorded. U.S. Census data were used to measure the population impact of the programs.
All of the 101 EMS systems statewide were successfully contacted. Thirty-three counties (33%) have TEMS programs providing medical support to 56 local law enforcement agencies as well as state and federal agencies. TEMS programs tend to be located in more populated urban and suburban areas, serving a population base of 5.9 million people, or 64% of the state's population. Tactical medics in the majority of these programs (29/33; 88%) are not sworn law enforcement officers.
Approximately one-third of county-based EMS systems in North Carolina have TEMS programs. These programs serve almost two-thirds of the state's population base, using primarily nonsworn tactical medics. Comparison with other regions of the country will be useful to demonstrate differences in prevalence and program characteristics. Serial surveillance will help track trends and measure the growth and impact of this growing subspecialty field.
Prehospital Emergency Care 04/2012; 16(3):361-5. · 1.78 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The term Excited Delirium Syndrome (ExDS) has traditionally been used in the forensic literature to describe findings in a subgroup of patients with delirium who suffered lethal consequences from their untreated severe agitation.(1-5) Excited delirium syndrome, also known as agitated delirium, is generally defined as altered mental status and combativeness or aggressiveness. Although the exact signs and symptoms are difficult to define precisely, clinical findings often include many of the following: tolerance to significant pain, rapid breathing, sweating, severe agitation, elevated temperature, delirium, non-compliance or poor awareness to direction from police or medical personnel, lack of fatiguing, unusual or superhuman strength, and inappropriate clothing for the current environment. It has become increasingly recognized that individuals displaying ExDS are at high risk for sudden death, and ExDS therefore represents a true medical emergency. Recently the American College of Emergency Physicians (ACEP) published the findings of a white paper on the topic of ExDS to better find consensus on the issues of definition, diagnosis, and treatment.(6) In so doing, ACEP joined the National Association of Medical Examiners (NAME) in recognizing ExDS as a medical condition. For both paramedics and physicians, the difficulty in diagnosing the underlying cause of ExDS in an individual patient is that the presenting clinical signs and symptoms of ExDS can be produced by a wide variety of clinical disease processes. For example, agitation, combativeness, and altered mental status can be produced by hypoglycemia, thyroid storm, certain kinds of seizures, and these conditions can be difficult to distinguish from those produced by cocaine or methamphetamine intoxication.(7) Prehospital personnel are generally not expected to differentiate between the multiple possible causes of the patient's presentation, but rather simply to recognize that the patient has a medical emergency and initiate appropriate stabilizing treatment. ExDS patients will generally require transfer to an emergency department (ED) for further management, evaluation, and definitive care. In this paper, we present a typical ExDS case and then review existing literature for current treatment options.
Journal of forensic and legal medicine 04/2012; 19(3):117-21.
-
Gary M Vilke,
Mark L Debard,
Theodore C Chan,
Jeffrey D Ho,
Donald M Dawes,
Christine Hall,
Michael D Curtis,
Melissa Wysong Costello,
Deborah C Mash,
Stewart R Coffman,
Mary Jo McMullen,
Jeffery C Metzger,
James R Roberts,
Matthew D Sztajnkrcer,
Sean O Henderson,
Jason Adler,
Fabrice Czarnecki,
Joseph Heck, William P Bozeman
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Patients present to police, Emergency Medical Services, and the emergency department with aggressive behavior, altered sensorium, and a host of other signs that may include hyperthermia, "superhuman" strength, diaphoresis, and lack of willingness to yield to overwhelming force. A certain percentage of these individuals will go on to expire from a sudden cardiac arrest and death, despite optimal therapy. Traditionally, the forensic community would often classify these as "Excited Delirium" deaths. OBJECTIVES: This article will review selected examples of the literature on this topic to determine if it is definable as a discrete medical entity, has a recognizable history, epidemiology, clinical presentation, pathophysiology, and treatment recommendations. DISCUSSION: Excited delirium syndrome is characterized by delirium, agitation, acidosis, and hyperadrenergic autonomic dysfunction, typically in the setting of acute-on-chronic drug abuse or serious mental illness or a combination of both. CONCLUSIONS: Based upon available evidence, it is the consensus of an American College of Emergency Physicians Task Force that Excited Delirium Syndrome is a real syndrome with uncertain, likely multiple, etiologies.
Journal of Emergency Medicine 03/2011; · 1.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Conductive energy weapons (CEWs) are used daily by law enforcement, and patients are often brought to an emergency department (ED) for medical clearance.
To review the medical literature on the topic of CEWs and to offer evidence-based recommendations to Emergency Physicians for evaluation and treatment of patients who have received a CEW exposure.
A MEDLINE literature search from 1988 to 2010 was performed and limited to human studies published from January 1988 to January 20, 2010 for English language articles with the following keywords: TASER, conductive energy device(s), electronic weapon(s), conductive energy weapon(s), non-lethal weapon(s), conducted energy device(s), conducted energy weapon(s), conductive electronic device(s), and electronic control device(s). Studies identified then underwent a structured review from which results could be evaluated.
There were 140 articles on CEWs screened, and 20 appropriate articles were rigorously reviewed and recommendations given. These studies did not report any evidence of dangerous laboratory abnormalities, physiologic changes, or immediate or delayed cardiac ischemia or dysrhythmias after exposure to CEW electrical discharges of up to 15 s.
The current medical literature does not support routine performance of laboratory studies, electrocardiograms, or prolonged ED observation or hospitalization for ongoing cardiac monitoring after CEW exposure in an otherwise asymptomatic awake and alert patient.
Journal of Emergency Medicine 01/2011; 40(5):598-604. · 1.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Introduction. In the summer of 1998, a series of wildfires swept across Florida. Firefighters and support personnel were imported and based in a central camp in Flagler County, Florida. Local residents were evacuated. Disaster medical assistance teams (DMATs) were deployed to provide medical support. Similar large-scale fire disasters occur frequently, but the illnesses and injuries seen have not been described. Objectives. To report the descriptive epidemiology of illnesses and injuries seen in firefighters and support personnel engaged in control and suppression of a series of wildfires. Methods. Review of DMAT treatment records to determine the nature of illnesses and injuries seen during a 19-day deployment. Results. Approximately 1,600 firefighters and support personnel were present in the camp. There were 3,404 patients seen with 3,841 complaints. An average of 179 patients was seen per day (range 47–414). A prominent bimodal pattern of presentations was noted during the course of each day. Reasons for seeking medical care included: preventive/hygiene and environmental, 33%; foot-related, 15%; rashes, 14%; ear, nose, and throat (ENT)/allergies, 9%; headache, 4%; eye irritation, 4%; gastrointestinal/abdominal complaints, 3%; cuts and penetrating injuries, 3%; strains/sprains, 2%; bites/stings, 2%; others, 1%. Eight patients (0.2%) were transferred to an emergency department for further care; 99.8% were treated on site. Conclusions. In this setting the majority of illnesses and injuries are minor. Visits related to preventive care and hygiene are common. This information can help in planning medical support operations in similar situations.
07/2009; 6(1):22-26.
-
[show abstract]
[hide abstract]
ABSTRACT: Objectives: Modification of traditional emergency medical services (EMS) principles and procedures for use in the tactical law enforcement setting is emerging as a subspecialty of emergency medicine. Few opportunities exist to train physicians in the principles of tactical medicine, and no studies demonstrate the effectiveness of physician-level training in tactical EMS. Methods: A standardized eight-hour CONTOMS (Counter Terrorism Operations Medical Support) Physician Awareness course was presented to a group of emergency physicians. The physicians completed an anonymous survey before and after the course, and again four months later. A five-point Likert scale (0-4) was utilized to measure knowledge and comfort levels among six areas specific to tactical EMS. Changes were measured from precourse scores. Results: Of 39 eligible physicans, 38 completed surveys before and 35 completed surveys after the course, while 16 returned four-month follow-up surveys. Mean scores rose in all areas specific to tactical EMS (p < 0.0005 compared with pretest scores). Mean scores for each topic were: Conclusions: The COMTOMS Physician Awareness course is effective in increasing physicians' knowledge and comfort levels in areas related to tactical EMS. Knowledge retention at four months is very good.
07/2009; 6(3):322-324.
-
[show abstract]
[hide abstract]
ABSTRACT: To compare laryngoscopy conditions produced by etomidate-only intubation (EOI) with those produced by rapid-sequence intubation (RSI) in the prehospital air medical setting.
A prospective crossover trial design used two helicopters staffed by the same flight paramedics and nurses. Each aircraft used an EOI protocol (0.3 mg/kg) for six months. An RSI protocol using the same dose of etomidate plus succinylcholine (1.5 mg/kg) was used for the alternate six months. Laryngoscopy conditions were graded by three scales: 1) a formal Laryngoscopy Grading Scale (LGS), 2) the Percentage of Glottic Opening (POGO) score, and 3) subjective overall intubation difficulty using a Likert scale of 1 (very easy) to 5 (very difficult). Orotracheal intubation success was also recorded.
Forty-nine patients were intubated using the EOI (n = 24) and RSI (n = 25) protocols. Mean age was 38 years, 76% were male, and 90% were intubated for trauma. Fifteen (63%) of the 24 EOI patients required additional etomidate (n = 3) or RSI (n = 12) to allow intubation, while one (4%) of the 25 RSI patients required additional medication dosing (p < 0.0001). Laryngoscopy conditions were assessed for all patients. Good or acceptable conditions as assessed by the LGS were seen in 79% of RSI patients and 13% of EOI patients (p < 0.0001). Mean rates of POGO visualization were 60% with RSI and 12% with EOI (p < 0.0001). Mean global intubation difficulty scores were 3.0 (moderate) with RSI and 4.7 (difficult to very difficult) with EOI (p < 0.0001). Ninety-two percent of the patients undergoing RSI and 25% of the EOI patients were successfully orotracheally intubated (p < 0.0001).
Patients receiving RSI had better laryngoscopy conditions and were easier to intubate than patients receiving EOI. Intubation success rate was higher with RSI.
Prehospital Emergency Care 07/2009; 10(1):8-13. · 1.78 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Conducted electrical weapons such as the Taser are commonly used by law enforcement agencies. The safety of these weapons has been the subject of scrutiny and controversy; previous controlled studies in animals and healthy humans may not accurately reflect the risks of conducted electrical weapons used in actual conditions. We seek to determine the safety and injury profile of conducted electrical weapons used against criminal suspects in a field setting.
This prospective, multicenter, observational trial tracked a consecutive case series of all conducted electrical weapon uses against criminal suspects at 6 US law enforcement agencies. Mandatory review of each conducted electrical weapon use incorporated physician review of police and medical records. Injuries were classified as mild, moderate, or severe according to a priori definitions. The primary outcome was a composite of moderate and severe injuries, termed significant injuries.
Conducted electrical weapons were used against 1,201 subjects during 36 months. One thousand one hundred twenty-five subjects (94%) were men; the median age was 30 years (range 13 to 80 years). Mild or no injuries were observed after conducted electrical weapon use in 1,198 subjects (99.75%; 95% confidence interval 99.3% to 99.9%). Of mild injuries, 83% were superficial puncture wounds from conducted electrical weapon probes. Significant injuries occurred in 3 subjects (0.25%; 95% confidence interval 0.07% to 0.7%), including 2 intracranial injuries from falls and 1 case of rhabdomyolysis. Two subjects died in police custody; medical examiners did not find conducted electrical weapon use to be causal or contributory in either case.
To our knowledge, these findings represent the first large, independent, multicenter study of conducted electrical weapon injury epidemiology and suggest that more than 99% of subjects do not experience significant injuries after conducted electrical weapon use.
Annals of emergency medicine 02/2009; 53(4):480-9. · 4.23 Impact Factor
-
Journal of Emergency Medicine 05/2008; 34(3):338-9. · 1.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Many emergency departments and trauma centers utilize extensive radiologic studies during the assessment of trauma patients. A point of concern arises about the possible biological effects of these cumulative radiation doses. The objective of this study is to determine the amount of ionizing radiation received by adult blunt trauma patients at a Level I trauma center during the first 24 hours of their care.
This nonconcurrent case series reviewed the first 100 consecutive adult blunt trauma patients who presented to a Level I trauma center in 2006. All patients met hospital standards for the less acute major triage criteria. Individual radiation dose reports calculated by the computed tomography (CT) scanner were used to determine the radiation doses from each CT procedure. Standardized tables were used to determine radiation dose for plain radiographs. The median effective dose of radiation (millisieverts) was calculated for the first 24 hours of hospitalization.
A total of 100 eligible patients presented between January 1, 2006, and March 20, 2006. Eighty-six patients had complete radiologic records available. The median age was 32 years, with an intraquartile range of 23 to 46 years; the median Injury Severity Score was 14, with an intraquartile range of 9 to 29; and the median number of CT scans was 3, with an intraquartile range of 3 to 4. The median effective total dose of ionized radiation was 40.2 mSv, with an intraquartile range of 30.5 to 47.2 mSv. A dose of 40.2 mSv is the equivalent of approximately 1,005 chest radiographs.
Trauma patients meeting the less acute major triage criteria are exposed to clinically important radiation doses from diagnostic radiographic imaging during the first 24 hours of their care.
Annals of emergency medicine 04/2008; 52(2):93-7. · 4.23 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The Taser is an electrical conducted energy weapon used by law enforcement officers throughout the United States and the world. Though generally regarded as safe, conducted energy weapons can produce injuries. In this case report we describe for the first time thoracic spine compression fractures resulting from a conducted energy weapon discharge. Physicians who may care for patients who have been exposed to a conducted energy weapon discharge should be aware of this as a possible complication.
Annals of emergency medicine 12/2007; 50(5):584-6. · 4.23 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: An association between cervical fractures and thoracolumbar fractures after blunt trauma has long been assumed, but not adequately demonstrated. We sought to determine the actual association between these injuries in a large nationwide data set.
The National Trauma Databank (NTDB) was queried for victims of blunt vehicular trauma with at least minimal injury. An odds ratio was calculated for the association between cervical spine fractures and thoracolumbar fractures.
Overall 190,183 NTDB patient records met the criteria of a motor vehicle crash with more than minimal injury. Of these 7.51% (14,292) had cervical spine fractures, 4.73% (8,996) had thoracic spine fractures, 5.93% (11,280) had lumbar spine fractures, and 9.79% (18,623) had either thoracic or lumbar fractures. Of patients with a cervical spine fracture, 13.06% (2,433) also had a thoracic or lumbar fracture, whereas among patients without cervical spine fracture only 6.91% (11,859) had a thoracolumbar fracture. The odds ratio (OR) for a thoracolumbar fracture in the presence of a cervical spine fracture was 2.02 (p < 0.0001) (95% confidence interval 1.9318-2.1201).
These data confirm a strong association between cervical spine fractures and thoracolumbar fractures after blunt vehicular trauma, and support the practice of imaging the complete spine when a cervical fracture is identified.
The Journal of trauma 09/2006; 61(3):686-7. · 2.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Prospective and retrospective studies have shown that empiric use of fibrinolytic agents in sudden cardiac arrest is safe and may improve outcomes in sudden cardiac arrest. Use of fibrinolytic agents for this indication is increasing in response to these data.
A prospective multicenter observational trial was performed in three emergency departments (EDs) to determine the proportion of patients that respond to empiric fibrinolysis with tenecteplase (TNK) after failing to respond to Advanced Cardiac Life Support (ACLS) measures. Cardiac arrest patients unresponsive to ACLS, who were given TNK by their treating physician, were enrolled in an outcome registry. Return of spontaneous circulation (ROSC), survival, complications, and neurological outcomes were recorded.
Fifty patients received TNK after a mean of 30min of cardiac arrest and eight doses of ACLS medications. One hundred and thirteen concurrent control patients received standard ACLS measures. ROSC occurred in 26% of TNK patients (95% confidence interval (CI) 16-40%) compared to 12.4% (95% CI 6.9-20%) among ACLS controls (p=.04); 12% (4.5-24%) of TNK patients survived to admission compared to none in the control group (p=.0007); 4% (0.5-14%) survived to 24h (p=NS); and 4% (0.5-14%) survived to hospital discharge (p=NS). All survivors had a good neurological outcome (Cerebral Performance Category (CPC) 1-2). One intracranial hemorrhage (ICH) occurred. No other significant bleeding complications were observed.
Empiric fibrinolysis with TNK in cardiac arrest is associated with increased ROSC and short term survival, and with survival to hospital discharge with good neurological function in patients who fail to respond to ACLS. Results may improve with earlier administration. Prospective controlled interventional trials are indicated to evaluate this promising new therapy.
Resuscitation 07/2006; 69(3):399-406. · 3.60 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Controversy and speculation exist regarding intracranial pressure (ICP) changes produced by various combinations of rapid sequence intubation (RSI) agents. In this pilot study, we sought to develop a swine model to investigate these changes in classic RSI.
Eight adult swine were instrumented with arterial and intracranial pressure monitors. Four different versions of rapid sequence intubation were then performed sequentially in each animal in a crossover trial design: regimen 1, thiopental; regimen 2, thiopental and succinylcholine; regimen 3, lidocaine, thiopental, and succinylcholine; and regimen 4, pancuronium, lidocaine, thiopental, and succinylcholine. ICP and hemodynamic parameters were recorded and compared. Trials were excluded from analysis if baseline ICP measurements were unstable or if intubation was difficult.
Peak changes in ICP were noted at 2 to 3 minutes after administration of induction agents. Mean values for peak changes in ICP were as follows: regimen 1 (n = 5), 3.6 mm Hg (95% confidence interval [CI], 1.0-6.2 mm Hg); regimen 2 (n = 9), 13.6 mm Hg (95% CI, 9.6-17.6 mm Hg); regimen 3 (n = 2), 16.0 mm Hg (95% CI, -34.8-66.8 mm Hg); and regimen 4 (n = 3), 12.0 mm Hg (95% CI, -8.3-32.3 mm Hg).
The model is effective. It enables investigators to examine the aggregate ICP effects of combinations of RSI medications. RSI regimens with paralysis produced threefold increases in peak ICP change compared with the sedation-only regimen. Pretreatment agents did not affect ICP changes. Future investigations can examine other agents and add experimental manipulation of ICP to simulate head injury physiology. Additional parameters including cerebral metabolism and/or oxygenation may also be explored.
The Journal of trauma 03/2005; 58(2):278-83. · 2.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Weapons of mass destruction (WMDs) are capable of producing massive casualties and are typically grouped into nuclear, biologic, and chemical weapons. In the wake of the September 11th disasters, attention to terrorist groups and the potential for use of WMDs has increased. Biologic and chemical weapons are relatively accessible and inexpensive to develop, and are thought to be the most available to foreign states and subnational terrorist groups. This article reviews various biologic and chemical weapons, including emergency diagnosis and management of selected agents.
Emergency Medicine Clinics of North America 12/2002; 20(4):975-93, xii. · 0.86 Impact Factor
-
The Journal of trauma 11/2002; 53(4):790-2. · 2.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We sought to explore the relationship between temperature and spectator illness at Division I college football games by deriving a formula to predict the number of patrons seeking medical care based on the ambient temperature and attendance of the game.
A retrospective review was conducted of medical records from 47 Division I college football games at two outdoor stadiums from 2001 through 2005. Any person presenting for medical care was counted as a patient seen. Weather data were collected from the National Weather Service. A binomial model was fit to the spectator illness records by using the patients seen per attendance as the outcome measure, with temperature as the predictor.
Using a binomial model, a formula was derived to estimate the number of patients needing medical attention based on the temperature and the number of spectators in attendance. Predicted # of Patients = exp (-7.4383 - 0.24439* Temperature C + 0.0156032 * Temperature C(2) - 0.000229196 * Temperature(3)) * number of spectators; all factors were highly significant (p < 0.0001). The model suggests that as the temperature rises, the number of patients seeking medical attention will also increase. The formula shows that an increase in temperature from 20 to 21 degrees C will show an increase in patient encounters from 3.64 to 4.05 visits per 10,000 in attendance (an 11% increase).
These results show that temperature is an important variable to consider when determining the medical resources needed in caring for spectators at outdoor football games. Our model may help providers predict the number of spectators presenting for medical care based on the forecasted temperature and predicted attendance.
Prehospital Emergency Care 11(4):453-7. · 1.78 Impact Factor
