Joshua Broder1, Abhishek Mehrotra, Judith Tintinalli. 1. Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Neurosciences Hospital, Chapel Hill, NC 27599, USA. jbroder@med.unc.edu
Abstract
CONTEXT: In 2002, an ice storm interrupted power to 1.3 million households in North Carolina, USA. Previous reports described storm injuries in regions with frequent winter weather. [Blindauer KM, Rubin C, Morse DL, McGeehin M. The 1996 New York blizzard: impact on noninjury visits. Am J Emerg Med 1999;17(1):23-7; Centers for Disease Control and Prevention. Community needs assessment and morbidity surveillance following an ice storm--Maine, January 1998. MMRW 1998;47(17):351-5; Daley WR, Smith A, Paz-Argandona E, Malilay J, McGeehin M. An outbreak of carbon monoxide poisoning after a major ice storm in Maine. J Emerg Med 2000;18(1):87-93; Hamilton J. Quebec's ice storm'98: "all cards wild, all rules broken" in Quebec's shell-shocked hospitals. Can Med Assoc J 1998;158(4):520-4; Hartling L, Brison RJ, Pickett W. Cluster of unintentional carbon monoxide poisonings presenting to the emergency departments in Kingston, Ontario during 'Ice Storm 98'. Can J Public Health 1998;89(6):388-90; Hartling L, Pickett W, Brison RJ. The injury experience observed in two emergency departments in Kingston, Ontario during 'ice storm 98'. Can J Public Health 1999;90(2):95-8; Houck, PM, Hampson NB. Epidemic carbon monoxide poisoning following a winter storm. J Emerg Med 1997;15(4):469-73; Lewis LM, Lasater LC. Frequency, distribution, and management of injuries due to an ice storm in a large metropolitan area. South Med J 1994;87(2):174-8; Smith RW, Nelson DR. Fractures and other injuries from falls after an ice storm. Am J Emerg Med 1998;16(1):52-5]. We postulated that injuries might differ in a region where ice storms are less common. OBJECTIVE: Identify storm-related injuries. DESIGN: Emergency department (ED) charts from the storm period (defined as onset of precipitation until 99% power restoration) were retrospectively reviewed. Included injuries were: falls on ice; injuries due to darkness; cold exposure; injuries from storm-related damage; burns; or carbon monoxide/smoke exposure. SETTING: Tertiary care ED, central North Carolina. PATIENTS: All ED patients. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Mechanism of injury. RESULTS: One hundred thirty incidents occurred, most resulting from storm damage and carbon monoxide. Seven were life threatening: four spinal fractures and two intracranial hemorrhages from falling tree limbs and one hypothermia. Carbon monoxide poisoning affected one pregnant woman and all children in our series. Twenty three percent of patients were Hispanic, although Hispanics comprise only 11% of the study ED population. CONCLUSIONS: Injuries from storm-related damage and carbon monoxide exposure predominated. Available hyperbaric chambers were quickly filled to capacity. Hispanics experienced a disproportionate number of injuries.
CONTEXT: In 2002, an ice storm interrupted power to 1.3 million households in North Carolina, USA. Previous reports described storm injuries in regions with frequent winter weather. [Blindauer KM, Rubin C, Morse DL, McGeehin M. The 1996 New York blizzard: impact on noninjury visits. Am J Emerg Med 1999;17(1):23-7; Centers for Disease Control and Prevention. Community needs assessment and morbidity surveillance following an ice storm--Maine, January 1998. MMRW 1998;47(17):351-5; Daley WR, Smith A, Paz-Argandona E, Malilay J, McGeehin M. An outbreak of carbon monoxidepoisoning after a major ice storm in Maine. J Emerg Med 2000;18(1):87-93; Hamilton J. Quebec's ice storm'98: "all cards wild, all rules broken" in Quebec's shell-shocked hospitals. Can Med Assoc J 1998;158(4):520-4; Hartling L, Brison RJ, Pickett W. Cluster of unintentional carbon monoxide poisonings presenting to the emergency departments in Kingston, Ontario during 'Ice Storm 98'. Can J Public Health 1998;89(6):388-90; Hartling L, Pickett W, Brison RJ. The injury experience observed in two emergency departments in Kingston, Ontario during 'ice storm 98'. Can J Public Health 1999;90(2):95-8; Houck, PM, Hampson NB. Epidemic carbon monoxidepoisoning following a winter storm. J Emerg Med 1997;15(4):469-73; Lewis LM, Lasater LC. Frequency, distribution, and management of injuries due to an ice storm in a large metropolitan area. South Med J 1994;87(2):174-8; Smith RW, Nelson DR. Fractures and other injuries from falls after an ice storm. Am J Emerg Med 1998;16(1):52-5]. We postulated that injuries might differ in a region where ice storms are less common. OBJECTIVE: Identify storm-related injuries. DESIGN: Emergency department (ED) charts from the storm period (defined as onset of precipitation until 99% power restoration) were retrospectively reviewed. Included injuries were: falls on ice; injuries due to darkness; cold exposure; injuries from storm-related damage; burns; or carbon monoxide/smoke exposure. SETTING: Tertiary care ED, central North Carolina. PATIENTS: All ED patients. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Mechanism of injury. RESULTS: One hundred thirty incidents occurred, most resulting from storm damage and carbon monoxide. Seven were life threatening: four spinal fractures and two intracranial hemorrhages from falling tree limbs and one hypothermia. Carbon monoxidepoisoning affected one pregnant woman and all children in our series. Twenty three percent of patients were Hispanic, although Hispanics comprise only 11% of the study ED population. CONCLUSIONS: Injuries from storm-related damage and carbon monoxide exposure predominated. Available hyperbaric chambers were quickly filled to capacity. Hispanics experienced a disproportionate number of injuries.
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