Impact of wildfires on emergency departments
Citation: Skinner R, Luther M, Hertelendy AJ, et al. A literature review on the impact of wildfires on emergency departments: enhancing disaster preparedness. Prehospital and Disaster Medicine. 2022;37(5):657–64.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: Nothing noted.
What is this? In this systematic review, the authors searched for articles about the impact of wildfires on emergency departments, specifically patient presentation characteristics, resource use and patient outcomes. They focused their searches on articles published in English, and do not report the date of their search. They included 21 articles, which were published between 1993 and 2020, from Australia (3 studies) and USA (18).
What was found: A significant positive relationship existed between exposure to wildfire smoke and presentation to an emergency department and subsequent hospital admission.
The primary presentation complaint in the included studies was respiratory (including asthma and bronchitis). Other common reasons for presentation were fractures and burns.
In some studies, there was a greater prevalence of hospital admissions in children and women.
In some studies, emergency department presentations were primarily from people with minor or no previous relevant medical history.
Nine included studies provided recommendations to enhance the preparedness of emergency departments for future wildfires. These covered three broad themes: communication (both within the emergency department and between the emergency department and hospital services), personnel (to ensure an adequate workforce was available) and the need to strengthen disaster, mass casualty and major incident plans relating to the management of the health impacts of wildfires.
Implications: The authors of the review concluded that effective and targeted community advisory programs and procedures should be put in place before and during wildfire events, and that there should be pre-event planning, development and robust resilience strategies for emergency departments; with this preparedness including adequate health care supplies (e.g. supplemental oxygen and respiratory-related medications) and surge capacity in in-patient and emergency department beds for respiratory-related presentations. They also recommended that the focus of future research should be on regions of the world outside of Australia and the USA, and on examining the preparedness of emergency departments for longer duration and more frequent wildfire events.
Other considerations: The authors of the review discussed their findings in the context of sex and age.
This summary was prepared and finalized by Mike Clarke.