Changes in EMS utilization in the state of Maryland during the first 6 months of the COVID-19 pandemic

Authors

DOI:

https://doi.org/10.5055/ajdm.2022.0418

Keywords:

Emergency Medical Services, disaster planning, pandemics

Abstract

Introduction and objectives: Emergency medical services (EMS) is an invaluable healthcare resource, providing life-saving care in the prehospital setting. During the COVID-19 pandemic, there have been concerns that healthcare resources, including EMS, would be overwhelmed by the potential surge in critically ill patients. This study seeks to determine the impact of the COVID-19 pandemic on EMS utilization in the state of Maryland.

Methods: A retrospective review of data from the Maryland Emergency Medical Services Data System was performed. EMS call volumes were compared from March 1 to August 31 in the years 2018, 2019, and 2020. In addition, adult cases from the three time periods that contained an EMS impression of stroke, cardiac arrest, asthma, traumatic injury, ST elevation myocardial infarction (STEMI), sepsis, and overdose were also analyzed.

Results: There was a significant decrease in overall EMS call volumes in the state of Maryland in the first 6 months of 2020 compared to the prior 2 years. While the total number of calls decreased, a higher proportion of patients in 2020 had EMS impressions of cardiac arrest, STEMI, stroke, and traumatic injury compared to the previous 2 years. Additionally, there was an increase in termination of resuscitation for out of hospital cardiac arrest.

Conclusion: In the state of Maryland, overall call volumes decreased, but the proportion of EMS patients with time-sensitive illnesses increased during the COVID-19 pandemic.

Author Biographies

Gregory Jasani, MD

Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, Maryland

Teferra Alemayehu, MSc

Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland

Timothy Chizmar, MD

Maryland Institute for Emergency Medical Services Systems, Baltimore, Maryland

Lucy Wilson, MD, ScM

Department of Emergency Health Services, University of Maryland Baltimore County, Baltimore, Maryland

References

Stone W, Near Crisis MS: Some hospitals face tough decisions in caring for floods of patients. NPR. November 25, 2020. Available at https://www.npr.org/sections/health-shots/2020/11/25/939103515/near-crisis-some-hospitals-face-tough-decisions-in-caring-for-floodsof-patients. Accessed May 5, 2021.

Boserup B, McKenney M, Elkbuli A: The financial strain placed on America’s hospitals in the wake of the COVID-19 pandemic. Am J Emerg Med. 2020. DOI: 10.1016/j.ajem.2020.07.007.

Wu J, Smith S, Khurana M, et al.: Stay-at-home orders across the country. NBC News. April 29, 2020. Available at https://www.nbcnews.com/health/health-news/here-are-stay-home-orders-acrosscountry-n1168736. Accessed May 6, 2021.

Hogan L: Declaration of State of Emergency and Existence of Catastrophic Health Emergency-COVID-19. Annapolis, MD: State of Maryland, 2020.

R Core Team: R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing, 2020. Available at http://www.R-project.org/.

Maryland Department of Health: Maryland Medical Assistance Program Telehealth Updated Guidance Memorandum. Baltimore, MD: Maryland Department of Health, 2020.

Neall R: Directive and Order regarding Various Healthcare Matters. Baltimore, MD: Maryland Department of Health, 2020.

Foley S: State Superintendent Salmon Announces Temporary Closure of Maryland Public Schools. Baltimore, MD: Maryland Department of Education, 2020.

Hogan L: Prohibiting Large Gatherings and Events and Closing Senior Centers. Annapolis, MD: State of Maryland, 2020.

Ko PC, Chen WJ, Ma MH, et al.: Emergency medical services utilization during an outbreak of severe acute respiratory syndrome (SARS) and the incidence of SARS-associated coronavirus infection among emergency medical technicians. Acad Emerg Med. 2004; 11(9): 903-911.

Stella F, Alexopoulos C, Scquizzato, et al.: Impact of the COVID-19 outbreak on emergency medical system missions and emergency department visits in the Venice area. Eur J Emerg Med. 2020; 27(4): 298-300.

Lerner EB, Newgard CD, Mann NC: Effect of the coronavirus disease 2019 (COVID-19) pandemic on the US. Acad Emerg Med. 2020; 27(8): 693-699. DOI: 10.1111/acem.14051.

Venkatesh AK, Janke AT, Shu-Xia L, et al.: Emergency department utilization for emergency conditions during COVID-19. Ann Emerg Med. 2021; S0196-0644(21): 00046-00049. DOI: 10.1016/j.annemergmed.2021.01.011.

Sokoloff WC, Krief WI, Giusto KA, et al.: Pediatric emergency department utilization during the COVID-19 pandemic in New York city. Am J Emerg Med. 2021; 45(20): 100-104. DOI: 10.1016/j.ajem.2021.02.029.

Singhania N, Bansal S, Nimmatoori DP, et al.: Current overview on hypercoagulability in COVID-19. Am J Cardiovasc Drugs. 2020; 20: 393-403.

Helms J, Tacquard C, Severac F, et al.: High risk of thrombosis in patients with severe SARS-CoV-2 infection: A multicenter prospective cohort study. Intensive Care Med. 2020; 46(6): 1089-1098.

Elam S, Holcombe M: COVID-19 fears keep people from hospitals, but doctors say call 911 for heart attack and stroke. CNN. April 22, 2020. Available at https://www.cnn.com/2020/04/22/health/coronavirus-hospitals-heart-health-statement/index.html. Accessed May 5, 2021.

Lai PH, Lancet EA, Weiden MD, et al.: Characteristics associated with out-of-hospital cardiac arrests and resuscitations during the novel coronavirus disease 2019 pandemic in New York city. JAMA Cardiol. 2020; 5(10): 1154-1163.

Baldi E, Sechi GM, Mare C, et al.: Lombardia CARe researchers. Out-of-hospital cardiac arrest during the COVID-19 outbreak in Italy. N Engl J Med. 2020; 383(5): 496-498.

Hammad TA, Parikh M, Tashtish N, et al.: Impact of COVID-19 pandemic on ST-elevation myocardial infarction in a non-COVID-19 epicenter. Catheter Cardiovasc Interv. 2021; 97(2): 208-214.

Published

03/01/2022

How to Cite

Jasani, MD, G., T. Alemayehu, MSc, T. Chizmar, MD, and L. Wilson, MD, ScM. “Changes in EMS Utilization in the State of Maryland During the First 6 Months of the COVID-19 Pandemic”. American Journal of Disaster Medicine, vol. 17, no. 1, Mar. 2022, pp. 41-48, doi:10.5055/ajdm.2022.0418.

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