Emergency Department (ED)

Previous reports have demonstrated the media’s influence on ED visits in situations such as dramatized acetaminophen overdose, media report of celebrity suicides, television public announcements for early stroke care and cardiac visits following President Clinton’s heart surgery. No previous study has demonstrated the influence of media-publicized trauma on ED visits. On 16 March 2009, the actress Natasha Richardson suffered a traumatic brain injury leading to her death on 18 March; these events were widely publicized by national news sources. The health departments of New York City, Boston, Duval County and Seattle monitor ED visits daily, and capture 95, 100, 100 and 95% of all ED visits, respectively. The data collected include basic demographic information, chief complaint and in some cases ICD-9 diagnosis codes.

Objective

This study describes an increase in head trauma-related visits to emergency departments (ED) in New York City, New York; Boston, Massachusetts; Duval County, Florida; and Seattle, Washington following the widespread media coverage of actress Natasha Richardson’s head injury and subsequent fatal epidural hematoma.

Previous reports have demonstrated the media’s influence on emergency departments (ED) visits in situations such as dramatized acetaminophen overdose, media report of celebrity suicides, television public announcements for early stroke care and cardiac visits following President Clinton’s heart surgery. No previous study has demonstrated the influence of media-publicized trauma on ED visits. On 16 March 2009, the actress Natasha Richardson suffered a traumatic brain injury leading to her death on 18 March; these events were widely publicized by national news sources. The health departments of New York City, Boston, Duval County and Seattle monitor ED visits daily, and capture 95, 100, 100 and 95% of all ED visits, respectively. The data collected include basic demographic information, chief complaint and in some cases ICD-9 diagnosis codes.

Objective

This study describes an increase in head trauma-related visits to ED in New York City, New York; Boston, Massachusetts; Duval County, Florida; and Seattle, Washington following the widespread media coverage of actress Natasha Richardson’s head injury and subsequent fatal epidural hematoma.

The summer of 2010 in Maryland was characterized by unusually high temperatures. This type of increased and prolonged heat can potentially make residents sick, and extreme exposure can even kill people at highest risk. Numerous deaths throughout the state were attributed to this heat wave. The Maryland Department of Health and Mental Hygiene addressed this public health issue by using public messaging and maintaining constant situational awareness through the electronic syndromic surveillance. Thus, the electronic surveillance system for the early notification of community-based epidemics (ESSENCE) was used to monitor heat-related illnesses throughout the state.

Objective

This paper describes the use of ESSENCE, a syndromic surveillance system, to monitor heat-related illnesses throughout the state of Maryland during the summer of 2010.

Syndromic surveillance has been widely adopted as a real-time monitoring tool in early response to disease outbreaks. In order to provide real-time information on the impact of 2009 H1N1 during the Fall 2009 semester, Georgetown University (GU) and George Washington University (GWU) employed syndromic surveillance systems incorporating a variety of data sources. 

Objective

To describe the 2009 H1N1 outbreak at GU and GWU in Fall 2009. Identify the datasets that most accurately depict 2009 H1N1 disease in real time.

In November 2006, Ohioans supported a statute that set into law a requirement that all public places, and places of employment in Ohio prohibit smoking.1 The law took effect in December 2006; however, the rules for implementation were not finalized until June 2007. The primary purpose of the law was to protect employees in all workplaces from exposure to environmental tobacco smoke. When determining how best to evaluate the health impact of a smoke-free law as it relates to secondhand smoke exposure, most studies have reviewed the incidence of heart attacks or AMIs. In the 2006 Surgeon General’s Report, ‘The Health Consequences of Involuntary Exposure to Tobacco Smoke,’2 secondhand smoke exposure is causally associated with cardiovascular events, including AMI. The Institute of Medicine also released a report in 2009 from a meta-analysis, ‘Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence,’3 of 11 epidemiologic studies, reviewing the incidence of acute coronary events following the passing of a smoke-free law. Each of the 11 studies showed a decrease in heart attack rates after implementation of smoke-free laws. The purpose of this study was to evaluate this relationship in Ohio.

Objective

The objective of this study, after completion of the preliminary analysis, was to evaluate whether or not the smoke-free law in Ohio has made a positive change in reducing the effects of secondhand smoke exposure by comparing syndromic surveillance data (trends for emergency department, and urgent care chief complaint visits), related to heart attack and/or acute myocardial infarction (AMI) before and after the smoking ban.

National and state surveillance systems for oral health have relied on sample-based screenings and self-reported surveys.1 Recent publications suggest the need and potential for use of data from syndromic surveillance systems and insurers to monitor indicators of oral health status, utilization of care, and costs of treatment.2,3 Few consensus indicators for oral health derived from these data sources exist, with the exception of a set of five ICD-9 codes comprising ambulatory care sensitive dental problems (ACS-DP).4 This paper describes North Carolina’s Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) data analyzed within CDC’s BioSense System to report state and county population-based rates of hospital emergency department (ED) utilization for ACS dental conditions.

Objective

This paper describes use of national and state syndromic surveillance systems for monitoring and evaluating usage of hospital emergency departments for ambulatory care sensitive dental problems.

NC DETECT provides near-real-time statewide surveillance capacity to local, regional and state level users across NC with twice daily data feeds from 119 (99%) emergency departments (EDs), hourly updates from the statewide poison center, and daily feeds from statewide EMS runs, select urgent care centers and veterinary lab data. The NC DETECT Web Application provides access to aggregate and line listing analyses customized to users’ respective jurisdictions. Several reports are currently available to monitor the health effects of heat waves. Heat wave surveillance is essential as temperature extremes are expected to increase with climate change.

Objective

To examine the utilization of NC emergency departments for heat-related illness by age, disposition and cause based on chief complaint and triage note categorization.

A comprehensive electronic medical record (EMR) represents a rich source of information that can be harnessed for epidemic surveillance. At this time, however, we do not know how EMR-based data elements should be combined to improve the performance of surveillance systems. In a manual EMR review of over 15 000 outpatient encounters, we observed that two-thirds of the cases with an acute respiratory infection (ARI) were seen in the emergency room or other urgent care areas, but that these areas received only 15% of total outpatient visits.1 Because of this seemingly favorable signal-to-noise ratio, we hypothesized that an ARI surveillance system that focused on urgent visits would outperform one that monitored all outpatient visits.

Absenteeism is regarded as an expedient and responsive marker of illness activity. It has been used as a health outcome measure for a wide spectrum of exposures and as an early indicator of influenza outbreaks.1 A handful of studies have described its validity compared with traditional ‘goldstandards’ for influenza and ILI.2,3 We sought to further quantify the relationship between ED ILI and school absenteeism because absenteeism, as it relates to illness, and subsequent loss in productivity and wages for parents, school staff and children, is an important public health outcome.

Objective

To describe the relationship between emergency department (ED) visits for influenza-like-illness (ILI) and absenteeism among school-aged children.

The HEDSS system was implemented in 2004 to monitor disease activity.1 In all, 18 of 32 emergency departments (ED) and urgent care clinic provide data. Chief complaints are routinely categorized into eight syndromes. The fever/flu syndrome is used for early detection and monitoring of influenza in the community. Area-based measures, such as zip code, enable linkage to area-based socioeconomic census data. Neighborhood poverty, defined as the percentage of persons living below the federal poverty level in a geographic area, predicts a wide range of disease outcomes.

Objective

To describe the relationship between neighborhood poverty and emergency department visits for fever/flu syndrome illnesses reported through the Connecticut Hospital Emergency Department Syndromic Surveillance (HEDSS) system.