Emergency department visits for home medical device failure during the 2003 North America blackout

Objectives: During a widespread North American blackout in August 2003, the authors identified a cluster of patients presenting to their northern Manhattan emergency department (ED) with complaints related to medical device failure. The characteristics of this group with respect to presenting complaint, type of device failure, time spent in the ED, and disposition are described in an effort to better understand the resource needs of this population. Methods: This was a retrospective chart review for all patients evaluated in an urban teaching ED during a 24-hour period spanning the duration of regional power failure. Charts for patients presenting with medical device failure as part of their triage complaint were abstracted. Results: Twenty-three of 255 patients coming to the ED during the 24-hour period presented with medical device failure. Nineteen of the device failures were due to nonfunctioning oxygen conservers, three to ventilator failure, and two to airway suction device failure (one patient had two devices fail). Thirteen of these patients were admitted to the hospital and accounted for 22% of all admissions during the study interval. Discharged patients spent a mean of 15.1 hours (range: 3.8-24.4 hours) in the ED. Conclusions: Patients using electrical medical devices seek care in the ED when power failure occurs, and they require significant ED and hospital resources. Effective disaster planning should anticipate the needs of this population.