Emergency Medical and Injury Surveillance during the 2007 San Diego County Wildfires

Background: In October 2007, several wildfires broke out in San Diego County, eventually consuming nearly 400,000 acres and 2,000 homes, and leading to the evacuation of more than 500,000 residents. The County Emergency Medical Services agency conducted continuous surveillance of ambulance responses during this time as well as hospital requests for emergency department diversion.

Methods: The number of ambulance responses and the chief complaints of their patients were monitored daily and compared with baseline averages for the year to date. Hospital diversions were tracked real-time. This information was communicated through the incident command structure and made available to the public through the public information officer.

Results: From October 21 – 28, 2007, paramedics responded to 3,606 patients. Several chief complaints were higher than the daily average for the year, including asthma (2.5 vs. 1.1 per day baseline), burns (3.4 vs. 1.0), COPD (0.9 vs. 0.3), and respiratory distress (50.5 vs. 35.6). Among these, asthma, burn, and respiratory distress had daily values that were the highest for the year to date.

The hospital diversion surveillance revealed that, not including two hospitals that were evacuated from the path of the fires, as many as eight hospitals were on bypass at the same time during the first week of the fires. During the second day, hospital bypass totaled 90 hours, which is double what would have been expected for an October day.

Conclusions: Emergency medical surveillance has proven to be an integral part of the immediate disaster response as well as the post-event review.