Objectives: To explore the impact that a temporary influx of millions of people can make on the local pediatric emergent and urgent care systems. The spectrum of illness was also explored.
Design/methods: Prospective cohort of patients from outside the usual catchment area presenting at two children's emergency departments and their satellite urgent care centers during the 1996 Summer Olympics. A 13-point survey was completed on each which included general demographics, transportation, language, time in the area, chief complaint, past medical conditions, diagnosis, and medical complications or problems related to their visit.
Results: A total of 263 patients met criteria, mean age 6.7 years. Twenty-four percent were seen in the tertiary care centers and 76% in urgent care. Twenty-three countries with 15 primary languages were represented. Fifty-one percent were in Atlanta for less than seven days, and 44% were uninsured. Most presented with common concerns including; fevers, rashes, respiratory difficulty, and minor trauma. Children were sicker than our typical emergency department patients, with hospital admission rates two times the usual for the tertiary care children's hospital (27% vs 13%) and the county children's hospital (7% vs 3%). Nineteen (7.2%) had unusual presentations or difficulty with care. Notably, five had language barriers; three had serious chronic conditions of unknown detail to the temporary caregiver; two did not bring vital medical supplies (ie, spare tracheotomy tube); one mislabeled medications, causing an overdose; one had leukemia, needed transfusion, but did not know of the regional centers; and one required helicopter transport secondary to traffic.
Conclusion: A large influx of people resulted in a relatively minor impact on the emergent care system for children. Care could have been improved if those with chronic illnesses were better informed of regional health care centers, essential medical needs for travel, and if travel included a physician's medical summary. In addition, anticipation of the Olympic Games helped the pediatric emergency medicine community improve disaster preparedness, and enhance its working relationship with the adult emergency medicine community and the regional poison center. Ongoing efforts for disaster preparedness with periodic reevaluation have also been established.