Factors Causing Emergency Medical Care Overload During Heatwaves: A Delphi Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Dec 20

PMID 38117826

Authors

Matteo Paganini

Hamdi Lamine

Francesco Della Corte

Ives Hubloue

Luca Ragazzoni

Francesco Barone-Adesi

Affiliations

Soon will be listed here.

Abstract

Heatwaves pose an important risk for population health and are associated with an increased demand for emergency care. To find factors causing such overload, an online Delphi study included 15 experts in emergency medicine, disaster medicine, or public health. One open-ended question was delivered in the first round. After content analysis, the obtained statements were sent to the experts in two rounds to be rated on a 7-point linear scale. Consensus was defined as a standard deviation ≤ 1.0. Thirty-one statements were obtained after content analysis. The experts agreed on 18 statements, mostly focusing on the input section of patient processing and identifying stakeholders, the population, and primary care as targets of potential interventions. Additional dedicated resources and bed capacity were deemed important as per throughput and output sections, respectively. These findings could be used in the future to implement and test solutions to increase emergency healthcare resilience during heatwaves and reduce disaster risk due to climatic change.

References

Madrigano J, Ito K, Johnson S, Kinney P, Matte T . A Case-Only Study of Vulnerability to Heat Wave-Related Mortality in New York City (2000-2011). Environ Health Perspect. 2015; 123(7):672-8. PMC: 4492264. DOI: 10.1289/ehp.1408178. View

Turner L, Connell D, Tong S . The effect of heat waves on ambulance attendances in Brisbane, Australia. Prehosp Disaster Med. 2013; 28(5):482-7. DOI: 10.1017/S1049023X13008789. View

Asplin B, Magid D, Rhodes K, Solberg L, Lurie N, Camargo Jr C . A conceptual model of emergency department crowding. Ann Emerg Med. 2003; 42(2):173-80. DOI: 10.1067/mem.2003.302. View

Conti A, Valente M, Paganini M, Farsoni M, Ragazzoni L, Barone-Adesi F . Knowledge Gaps and Research Priorities on the Health Effects of Heatwaves: A Systematic Review of Reviews. Int J Environ Res Public Health. 2022; 19(10). PMC: 9140727. DOI: 10.3390/ijerph19105887. View

Van Remoortel H, Scheers H, De Buck E, Haenen W, Vandekerckhove P . Prediction modelling studies for medical usage rates in mass gatherings: A systematic review. PLoS One. 2020; 15(6):e0234977. PMC: 7310685. DOI: 10.1371/journal.pone.0234977. View

Fullerton K, Crawford V . The winter bed crisis--quantifying seasonal effects on hospital bed usage. QJM. 1999; 92(4):199-206. DOI: 10.1093/qjmed/92.4.199. View

Turner 2nd B, Kasperson R, Matson P, McCarthy J, Corell R, Christensen L . A framework for vulnerability analysis in sustainability science. Proc Natl Acad Sci U S A. 2003; 100(14):8074-9. PMC: 166184. DOI: 10.1073/pnas.1231335100. View

Leppold C, Gibbs L, Block K, Reifels L, Quinn P . Public health implications of multiple disaster exposures. Lancet Public Health. 2022; 7(3):e274-e286. DOI: 10.1016/S2468-2667(21)00255-3. View

Tait P, Allan S, Katelaris A . Preventing heat-related disease in general practice. Aust J Gen Pract. 2019; 47(12):835-840. View

10.

Mayrhuber E, Duckers M, Wallner P, Arnberger A, Allex B, Wiesbock L . Vulnerability to heatwaves and implications for public health interventions - A scoping review. Environ Res. 2018; 166:42-54. DOI: 10.1016/j.envres.2018.05.021. View

11.

Cowling T, Cecil E, Soljak M, Lee J, Millett C, Majeed A . Access to primary care and visits to emergency departments in England: a cross-sectional, population-based study. PLoS One. 2013; 8(6):e66699. PMC: 3680424. DOI: 10.1371/journal.pone.0066699. View

12.

Mason H, King J, Peden A, Franklin R . Systematic review of the impact of heatwaves on health service demand in Australia. BMC Health Serv Res. 2022; 22(1):960. PMC: 9336006. DOI: 10.1186/s12913-022-08341-3. View

13.

Oliver D . David Oliver: Do public campaigns relieve pressure on emergency departments?. BMJ. 2019; 367:l6542. DOI: 10.1136/bmj.l6542. View

14.

Paganini M, Valente M, Conti A, Ragazzoni L, Barone-Adesi F . Emergency medical care overload during heatwaves: a neglected topic. Eur J Emerg Med. 2022; 30(1):5-6. DOI: 10.1097/MEJ.0000000000000975. View

15.

Kelen G, McCarthy M . The science of surge. Acad Emerg Med. 2006; 13(11):1089-94. DOI: 10.1197/j.aem.2006.07.016. View

16.

Campbell S, Remenyi T, White C, Johnston F . Heatwave and health impact research: A global review. Health Place. 2018; 53:210-218. DOI: 10.1016/j.healthplace.2018.08.017. View

17.

Gupta S, Carmichael C, Simpson C, Clarke M, Allen C, Gao Y . Electric fans for reducing adverse health impacts in heatwaves. Cochrane Database Syst Rev. 2012; (7):CD009888. PMC: 6457598. DOI: 10.1002/14651858.CD009888.pub2. View

18.

Epstein Y, Yanovich R . Heatstroke. N Engl J Med. 2019; 380(25):2449-2459. DOI: 10.1056/NEJMra1810762. View

19.

Bittner M, Matthies E, Dalbokova D, Menne B . Are European countries prepared for the next big heat-wave?. Eur J Public Health. 2013; 24(4):615-9. DOI: 10.1093/eurpub/ckt121. View

20.

Khan N, Khan U, Ahmed N, Ali A, Raheem A, Soomar S . Improvement in the diagnosis and practices of emergency healthcare providers for heat emergencies after HEAT (heat emergency awareness & treatment) an educational intervention: a multicenter quasi-experimental study. BMC Emerg Med. 2023; 23(1):12. PMC: 9890699. DOI: 10.1186/s12873-022-00768-5. View