The 130th Annual Meeting of APHA

Abstract #48674

Barbara M Stepanski, MPH¹, Leslie Upledger Ray, MA, MPPA², Alan M Smith, MPH¹, Edward M. Castillo, MPH¹, Patricia M Murrin, RN, MPH¹, and Marcy Metz, RN². (1) Health and Human Services Agency, Division of Emergency Medical Services, County of San Diego, 6255 Mission Gorge Rd, San Diego, CA 92120, 619-285-6429, bstepahe@co.san-diego.ca.us, (2) County of San Diego, Health and Human Services Agency, Emergency Medical Serrvices, 6255 Mission Gorge Rd, San Diego, CA 92120

Background: Investigators developed a real-time surveillance system to monitor public health events in a metropolitan area with 2.8 million population and 15 million overnight tourists annually. Originally to monitor flu outbreaks, the system was used in 2001 to identify several multi-victim events including 2 school shootings and a tour bus crash. After 9/11/01, the focus shifted to potential bioterrorism events. Monitoring EMS activity enables timely and appropriate response to crises. Methods: Using a real-time electronic system, researchers monitor prehospital activity to identify events that may indicate bioterrorism, disease outbreaks, injury clusters, or other public health crises. Monitored data included 40 medical complaints, 30 causes of injury, run outcome, location, interventions, hospital(s), patient demographics, etc. Data were compared to previous weeks and years. Standard thresholds were established to trigger further investigation. All system participants were updated regularly. Results: One critical finding was a 24% increase in cardiac chest pain following community crises. This knowledge helped EMS establish baseline resource needs following traumatic events. Flu monitoring lead to early identification of outbreaks and system resource monitoring. A previously unidentified trend was high frequency and specific characteristics of unarmed assaults. Surveillance data showed that EMS system resources were influenced by many extraneous factors. Conclusions: Real-time surveillance meets a variety of public health needs. For the public health professional it identifies trends and emerging issues. For the emergency medical professional it assists in the early identification of problems/needs and resource allocation. For the community it provides enhanced public health and safety.

Learning Objectives:

At the conclusion of this session participants will be able to
• describe the role of a surveillance system within the prehospital setting, 2)identify 3 components of a EMS surveillance system, and
• describe how the findings of an EMS surveillance system can be used.

Keywords: Emergency, Surveillance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.