Skip to main content

Emergency Department (ED)

On 24 December 2009, a female New Hampshire resident was confirmed to have gastrointestinal anthrax on the basis of clinical findings and laboratory testing. Her source of anthrax was not immediately known, so the New Hampshire Department of Health and Human Services, in conjunction with several other state and federal agencies, conducted a comprehensive epidemiologic investigation, which included active surveillance to identify any additional anthrax cases from a similar exposure. It was determined that the index patient participated in a drumming event with animal-hide drums on 4 December, one day before the onset of symptoms. Two drums used at the event were later found to be contaminated with Bacillus anthracis.

 

Objective

This paper describes the use of customizable tools to query electronic emergency department data, as part of case finding, during the response to a community anthrax exposure in New Hampshire.

Referenced File
Submitted by hparton on

From January to March 2010, thirteen outbreaks of Norovirus infection were reported to the Epidemiology, Disease Control and Immunization Service (EDC-IS), up from four outbreaks in the entire 2008 and same number during 2009. Individual cases of Norovirus are not reportable in the State of Florida. That makes it difficult to track the onset, rise, peak, and fading of epidemics of this disease.

 

Objective

To demonstrate how the EDC-IS at the Miami-Dade County Health Department used ESSENCE to track gastrointestinal symptoms during a Norovirus epidemic.

Referenced File
Submitted by hparton on

Biosurveillance systems commonly use emergency department (ED) patient chief complaint data (CC) for surveillance of influenza-like illness (ILI). Daily volumes are tracked using a computerized patient CC classifier for fever (CC Fever) to identify febrile patients. Limitations in this method have led to efforts to identify other sources of ED data. At many EDs the triage nurse measures the patient’s temperature on arrival and records it in the electronic medical record. This makes it possible to directly identify patients who meet the CDC temperature criteria for ILI: temperature greater than 100 degrees F (T>100F).

Objective

To evaluate whether a classifier based on temperature >100F would perform similarly to CC Fever and might identify additional patients.

Referenced File
Submitted by hparton on

The Duval County Health Department (DCHD) serves a community of over one million people in Jacksonville, FL, USA. Each year, DCHD Epidemiology Program reports an average of 1133 (4-year average) notifiable diseases and conditions (NDC) with the exception of STD/HIV, TB, and viral hepatitis. Within Duval County, emergency medical care is provided by eight local hospitals, including one pediatric facility and a level-1 trauma center. These facilities contribute syndromic surveillance (SS) chief complaint (CC) data to the Electronic Surveillance System for Early Notification of Community-based Epidemics of Florida.

Historically, evaluations of SS systems have used ICD-9 diagnoses as the gold standard to determine predictive values. However, limited studies have surveyed reports of NDC to identify related emergency department (ED) visits and subsequent CC-based syndrome categorization. These data may provide public health investigators insight into health seeking behaviors, interpretation of SS signals, and prevalence of NDC within ED data.

 

Objective

This paper characterizes ED utilization among individuals diagnosed and reported with NDC. Furthermore, it evaluates the subsequent assignment of SS syndromes based on the patient’s CC during their ED visit.

Referenced File
Submitted by hparton on

West Virginia continues to lead the nation in drug overdose deaths per capita. In 2016, the age-adjusted rate of drug overdose deaths was 52 per 100,0001. In the same year, there were roughly 64,000 overdose deaths in the United States, a 21.5% rate increase from 20151. The drug overdose epidemic in West Virginia has taken a significant toll on individuals, families, communities, and resources. As part of a rapid response plan to help reduce the burden of overdose deaths, the West Virginia Department of Health and Human Resources conducted an investigative report to study 830 overdose related deaths that occurred in 2016 and identify opportunities for intervention in the 12 months prior to death. Utilization of EMS among decedents was analyzed to determine demographic differences between decedents at different time points of EMS contact: EMS contact at death only; EMS contact 12 months prior to death only; and both EMS contact at death and 12 months prior to death.

Objective: Opioid and illicit substance abuse continues to have major public health implications in the state of West Virginia. By analyzing the Emergency Medical Service (EMS) utilization history of drug overdose decedents, opportunities to improve surveillance of fatal and non-fatal drug overdoses can be identified which can help lead prevention efforts of fatal drug overdoses in the state.

Submitted by elamb on

In March 2018, the Illinois Department of Public Health (IDPH) was informed of a cluster of coagulopathy cases linked to SC use. By June 30, 2018, 172 cases were reported, including five deaths, where 74% were male and the mean age was 35.3 years (range: 18–65 years). All cases presented to an emergency department (ED) at least once for this illness. Ninety-four cases provided clinical specimens and all tested positive for brodifacoum, a long-acting anticoagulant used in rodenticide. Cases were reported to the health department by the Illinois Poison Control Center and direct reporting from hospitals. REDCap was the primary database for tracking cases and collecting demographic information, risk factor data and healthcare facility utilization, including number of ED visits. Syndromic surveillance was utilized to monitor ED visits related to the cluster, assist with case finding and provide situational awareness of the burden on the EDs and geographic spread. In this study, we retrospectively used syndromic surveillance along with the data in REDCap to quantify the number of ED visits per coagulopathy case, understand the reasons for repeat visits, and determine whether visits were captured in syndromic surveillance.

Objective: To determine whether emergency department (ED) visits were captured in syndromic surveillance for coagulopathy cases associated with an outbreak linked to synthetic cannabinoid (SC) use and to quantify the number of ED visits and reasons for repeat visits.

Submitted by elamb on

LBP is one of the leading contributors to disease burden worldwide [1]. In France, LBP is a frequent reason of general practice consultations. According to a study published in 2017 and based on 2014 data issued of the National Health Insurance Cross-Schemes Information System (Sniiram) [2], this pathology stands for 30% of thickness leave and 4 of 5 people will suffer of low back pain during their own life. Most often, LBP is a chronic pathology with acute episodes which most often require emergency care. In order to prevent chronicity, French health care insurance launched into a mainstream national prevention campaign during spring 2018. This campaign was also targeted for health professional to inform them of the best recommendations to provide to their patients. Then the French society of emergency medicine (SFMU) has been asked to relay this campaign to emergency departments (ED) where LBP is a frequent reason of attendance. Since 2004, the French syndromic surveillance system SurSaUD® [3] coordinated by the French Public Health Agency (Santé publique France) daily collects morbidity data from the emergency departments (ED) network Oscour®. Almost 92% of the French ED attendances were recorded by the system in 2017. The availability of this large ED dataset on the whole territory since several years gives the opportunity to describe LBP attendances before the potential fallout of the national prevention campaign.

Objective: The study describes the characteristics of attendances for low back pain (LBP) in the French emergency departments (ED) network Oscour®, in order to give an overview of this disease before launching a prevention campaign.

Submitted by elamb on

Recent reporting using data from CDC's National Syndromic Surveillance Program indicates that rates of emergency department (ED) visits involving suspected opioid overdoses increased by 70% in the Midwest from the third quarter (Q3) 2016 (July-September) to the Q3 2017. Large increases in the use and distribution of illicitly-manufactured fentanyl (IMF) and fentanyl analogs, are a key factor driving increased opioid overdose rates in the Midwest and east of the Mississippi River. Fentanyl is a synthetic opioid 50-“100 times more potent than morphine. A better understanding of the distribution of changes in opioid overdose rate from Q3 2016 to Q3 2017 within states needed to inform response and prevention efforts.

Objective: This presentation will provide insight into how the extensive spread of illicitly-manufactured fentanyl impacted opioid overdose rates throughout the Midwest and neighboring states.

Submitted by elamb on

State and local jurisdictions have been exploring the use of SyS data to monitor suspected drug overdose outbreaks in their communities. With the increasing awareness and use of SyS systems, staff from the Centers for Disease Control and Prevention (CDC) worked to develop several queries that jurisdictions could use to better capture suspected drug overdose visits. In 2017, CDC released their first two queries on heroin overdose and opioid overdose, followed in 2018 by stimulant and all drug overdose queries. Over time, and with the assistance from the SyS community and the CDC-funded Enhanced State Opioid Overdose Surveillance (ESOOS) state health departments, CDC has revised the queries to address suggestions from jurisdictions. However, it'™s not clear how often and in what way the syndrome definitions are updated over time. This is particularly true as new drugs emerge and the names of those drugs are integrated into syndrome definitions (e.g., recent Spice and œK2 synthetic cannabinoid outbreaks).

Objective: To discuss the process for developing and revising suspected drug overdose queries in syndromic surveillance (SyS) systems.

Submitted by elamb on

Cocaine, methamphetamine, and spice are addictive, non-opioid substances that negatively impact a person's health through direct and indirect means. Direct health concerns of non-opioid substance use include anxiety, paranoia, seizure, heart attack, stroke, and potentially death while indirect health concerns include the acquisition of disease and infections, particularly sexually transmitted infections (STIs). Substance users experience an increased risk of acquiring STIs since they may exchange sex for substances, use substances within a social setting that may lead to sexual activity, or engage in risky sexual behavior as a result of impaired judgement associated with substance use. The current study evaluated the use of multiple data sources to monitor changes in the rate of cocaine, methamphetamine, and spice related emergency department visits as well as cocaine- and methamphetamine-related death rates, within Marion County, Indiana between 2013 and 2017.

Objective: To assess the prevalence of non-opioid substance use ”including cocaine, methamphetamine and spice within Marion County, Indiana and propose response recommendations utilizing a current opioid response plan.

Submitted by elamb on
Subscribe to Emergency Department (ED)