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Impact of Citywide Blackout on an Urban Emergency Medical Services System

  • John Freese (a1), Neal J. Richmand (a2), Robert A. Silverman (a3), James Braun (a2), Bradley J. Kaufman (a2) and John Clair (a2)...



On 14 August 2003, New York City and a large portion of the northeastern United States experienced the largest blackout in the history of the country. An analysis of such a widespread disaster on emergency medical service (EMS) operations may assist in planning for and managing such disasters in the future.


A retrospective review of all EMS activity within New York City's 9-1-1 emergency telephone system during the 29 hours during which all or parts of the city were without power (16:11 hours (h) on 14 August 2003 until 21:03 h on 15 August 2003) was performed. Control periods were established utilizing identical time periods during the five weeks preceding the blackout.


Significant increases were identified in the overall EMS demand (7,844 incidents vs. 3,860 incidents; p<0.001) as well as in 20 of the 62 calltypes of the system, including ca rd i ac arrests (119 vs.76, p= 0.043).Significant decreases were found only among calls related to psychological emergencies (114 vs. 221; p= 0.006) and drugor alcohol-related emergencies (78 vs. 146; p = 0.009). Though median response times increased by only 60 seconds, median call-processing times within the 9-1-1 emergency telephone system EMS dispatch center of the city increased from 1.1 to 5.5 minutes.


The citywide blackout resulted in dramatic changes in the demands upon the EMS system of New York City, the types of patients for whom EMS providers were assigned to provide care, and the dispositions for those assignments. During this time of increased, system-wide demand, the use of cross-trained firefighter and first-responder engine companies resulted in improved response times to cardiac arrest patients. Finally, the ability of the EMS dispatch center to process the increased requests for EMS assistance proved to be the rate-limiting step in responding to these emergencies.These findings will prove useful in planning for future blackouts or any disaster that may broadly impact the infrastructure of a city.


Corresponding author

John Freese, MD Office of Medical Affairs, New York City Fire Department, 9 MetroTech Center, 4N–1 Brooklyn, NY 11201, USA E-mail:


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1. Fire Department, City of New York: City-wide performance indicators. Calendar year 2002. Available at: Accessed November 2003.
2.Spivak, M: Bay Area blackout. Emergency Medical Services response to city-wide power outage. Emerg Med Serv 1999;28(4):7273.
3. Anonymous: Report to Greater New York Hospital Association on the blackout of July 13–14, 1977. Hospital Eng 1979;33(5):2327.
4.Prezant, DJ, Clair, J, Belyaev, S et al: Effects of the August 2003 blackout on the New York City healthcare delivery system: A lesson for disaster preparedness. Crit Care Med 2005;33(1):S96–S101.
5.Hogan, DE, Burnstein, JL (eds): Disaster Medicine. New York: Lippincott, Williams & Wilkins. 2002.
6.Schneid, TD, Collins, L (eds): Disaster Management and Preparedness. New York: Lewis Publishers. 2001.
7.Emergency Response Task Force: Enhancing New York City's emergency preparedness: A report to Mayor Michael R. Bloomberg. New York, NY: Emergency Response Task Force, 2003. Available at: html/om/pdf/em_task_force _ final_10_28_03.pdf. Accessed November 2003.
8.Lombardi, G, Gallagher, J, Gennis, P: Outcome of out-of-hospital cardiac arrest in New York City: The pre-hospital arrest survival evaluation (PHASE) study. JAMA 1994;271((9):678683.


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Impact of Citywide Blackout on an Urban Emergency Medical Services System

  • John Freese (a1), Neal J. Richmand (a2), Robert A. Silverman (a3), James Braun (a2), Bradley J. Kaufman (a2) and John Clair (a2)...


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