Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-27T03:36:59.441Z Has data issue: false hasContentIssue false
  • English
  • Français

A Descriptive Analysis of Prehospital Response to Hazardous Materials Events

Published online by Cambridge University Press:  01 September 2015

Ashley J. Martin ,
Christine M. Lohse  and
Matthew D. Sztajnkrycer
Ashley J. Martin
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
Christine M. Lohse
Affiliation:
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MinnesotaUSA
Matthew D. Sztajnkrycer*
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
*
Correspondence: Matthew D. Sztajnkrycer, MD, PhD Associate Professor of Emergency Medicine Mayo Clinic GE-GR-G410 200 1st Street SW Rochester, Minnesota 55905 USA E-mail: sztajnkrycer.matthew@mayo.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Little is known about the overall frequency of hazardous materials (HazMat) events in the United States and the nature of prehospital care for those exposed. The purpose of the current study was to perform a descriptive analysis of Emergency Medical Services (EMS) activations reported to a national EMS database.

Methods

Analysis of the 2012 National EMS Information System (NEMSIS) Public Release Research Data Set v.2.2.1, containing EMS emergency response data submitted by 41 states, was conducted. Mandatory data elements E0207 (Type of Response Delay), E0208 (Type of Scene Delay), and E0209 (Type of Transport Delay) contained specific codes for HazMat events and were used to identify specific EMS activation records for subsequent analysis. Overlapping data elements were identified and combined in order to prevent duplicate entries. Descriptive analyses were generated from the NEMSIS Research Data Set.

Results

A total of 17,479,328 EMS activations were reported, of which 2,527 unique activations involved HazMat response. Mass-casualty incident was coded for 5.6% of activations. The most common level of prehospital care present on scene was Basic Life Support (BLS; 51.1%); 2.1% required aggressive Advanced Life Support (ALS) response. The most common locations for HazMat activations were homes (36.2%), streets or highways (26.3%), and health care facilities (11.6%). The primary symptoms observed by EMS personnel were pain (29.6%), breathing problems (12.2%), and change in responsiveness (9.6%). Two percent of HazMat activations involved cardiac arrest, with 21.7% occurring after EMS arrival. Delays in patient care included response delay, scene delay, and transport delay.

Conclusion

Hazardous materials events are rare causes of EMS activation in the United States. The majority occur in non-industrial venues and involve two or fewer patients. Scene time frequently is delayed due to multiple barriers. Cardiac arrest is rare but occurred after EMS arrival in one-fifth of patients.

MartinAJ, LohseCM, SztajnkrycerMD. A Descriptive Analysis of Prehospital Response to Hazardous Materials Events. Prehosp Disaster Med. 2015;30(5):466–471.

Keywords

cardiac arrestEmergency Medical Serviceshazardous materialsmass-casualty incident
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 5 , October 2015 , pp. 466 - 471
Copyright
© World Association for Disaster and Emergency Medicine 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kirk, MA, Cisek, J, Rose, SR. Emergency department response to hazardous materials incidents. Emerg Med Clin North Am. 1994;12(2):461-481.Google Scholar
2. Kales, SN, Polyhronopoulos, GN, Castro, MJ, et al. Injuries caused by hazardous materials accidents. Ann Emerg Med. 1997;30(5):598-603.Google Scholar
3. Burgess, JL, Kovalchick, DF, Harter, L, et al. Hazardous materials events: evaluation of transport to health care facility and evacuation decisions. Am J Emerg Med. 2001;19(2):99-105.Google Scholar
4. Duncan, MA, Orr, MF. Evolving with the times, the new national toxic substance incidents program. J Med Toxicol. 2010;6(4):461-463.CrossRefGoogle ScholarPubMed
5. Federal Interagency Committee on Emergency Medical Services. 2011 National EMS Assessment. US Department of Transportation, National Highway Traffic Safety Administration Web site. www.ems.gov. Published 2012. Accessed November 12, 2014.Google Scholar
6. Bailey, B, Conn, AKT, Delbridge, DR, et al. Emergency Medical Services agenda for the future. National Highway Transport Safety Administration, Health Resources and Services Administration. DOT HS 808 441. August 1996.Google Scholar
7. Dawson, DE. National Emergency Medical Services Information System (NEMSIS). Prehosp Emerg Care. 2006;10(3):314-316.CrossRefGoogle ScholarPubMed
8. NEMSIS Technical Assistance Center, University of Utah School of Medicine. National EMS Database 2012 NEMSIS Research Data Set v.2.2.1. https://www.nemsis.org/reportingTools/documents/NEMSISRDS2212012UserManual.pdf. Published August 2013. Accessed November 12, 2014.Google Scholar
9. Moles, TM. Emergency Medical Services systems and HazMat major incidents. Resuscitation. 1999;42(2):103-116.Google Scholar
10. Kales, SN, Polyhronopoulos, GN, Castro, MJ, et al. Injuries caused by hazardous materials accidents. Ann Emerg Med. 1997;30(9):598-603.CrossRefGoogle ScholarPubMed
11. Schenk, E, Wijetunge, G, Mann, NC, et al. Epidemiology of mass-casualty incidents in the United States. Prehosp Emerg Care. 2014;18(3):408-416.Google Scholar
12. NEMSIS Technical Assistance Center. Patient Complaint Reported by Dispatch: A National EMS Database Report. Bottom 10 Complaint Categories, Q1-4, 2012. https://reports.nemsis.org/Reports/Pages/Report.aspx?ItemPath=%2fNEMSIS+Version+2%2fNational+Reports%2fEMS+Agency%2fPatient+Complaint+Reported+by+Dispatch. Accessed November 12, 2014.Google Scholar
13. US Department of Health and Human Services. Hazardous Substances Emergency Events Surveillance. Annual Report 2009. Agency for Toxic Substances and Disease Registry. http://www.atsdr.cdc.gov/HS/HSEES/annual2009.html. Accessed November 12, 2014.Google Scholar