From reduced visibility to sharp objects on costumes, Halloween can provide a fair amount of circumstances that get healthcare providers like:
This year, Halloween falls on a weekend which can add to the perception that emergency departments need to hulk out.
However, EDs don’t typically see as much of an increase of patients as one may expect. “Like St. Patrick's Day, Halloween is associated with drinking and partying but we typically do not see any significant increases in related ED visits,” Dr. Ron Roth, professor of emergency medicine at University of Pittsburgh School of Medicine and medical director for the Department of Public Safety for the city of Pittsburgh, told Healthcare Dive.
Dalton Sawyer, director of emergency preparedness and business continuity at UNC Healthcare in Chapel Hill, NC, echoes this saying providers see the same type of patient in the ED on Halloween that they might see on Superbowl Sunday or New Years Eve. Except they could be wearing costumes.
While most experts agree Halloween doesn’t present a significant increase of patients to the emergency department, the holiday does present an excellent training opportunity for staff to smooth out potential kinks in emergency/public health preparedness plans. In addition, the holiday can serve as an opportunity for providers to increase their organization's community outreach/public education efforts.
For example, Sawyer sits down every year with representatives from partnering emergency medical services to city officials to make sure everyone is on the same page.
Such efforts include making sure that critical staff, if offsite, are able to physically get to a service area quickly and efficiently. For example, if certain roads are closed off during holidays, critical staff can receive an emergency placard that allow them through roadblocks or on routes generally off limits to the public. In addition, some emergency tents, like those at sporting events, could be set up to triage cases that don’t need severe emergency intervention.
At the VCU Medical Center in Richmond, VA, simulation training is done throughout the year. Dr. Stephen Miller, assistant professor at the VCU department of emergency medicine, said the UCI Road World Championships in 2015 gave the center an opportunity to prepare for “mass casualty” incidents, such as those that can occur on Halloween or other events throughout the holiday season and beyond. He told Healthcare Dive the UCI races were a good opportunity to get the department on the same page and prepare to work under stretched resources.
Preparing as far out as a year in advance of the cycling event, the department went through five training scenarios where, in large numbers, volunteer “mock” patients would present themselves to the facility. Working as a team, staff members from trauma surgeons to EMS and ED staff would triage and work together as if they were working on a real patient.
According to WTRV, 645,000 onsite spectators watched the event over the course of 10 days. "An onsite spectator is considered a fan over the entirety of the event," the report noted. "So a fan who watched the race for 10 days, counted 10 times toward the 645,000 figure." While the event didn’t increase emergency events dramatically, Miller says the simulation training acted as a springboard to carry on into events such as Halloween and other holidays.
As far as Halloween goes, Sawyer encourages departments to be flexible and stay in communication with with their local partners. In addition, know what events are going on in the local community ans be aware of the weather. If the weather is cold, some costumes might not be suitable for low temperatures. Conversely, dull coats can cover up bright costumes reducing a person’s visibility. “You never really know what you’re going to see until after it’s over,” he said.
Reaching out
While Roth notes the holiday is associated with drinking and partying, Dr. Rebecca Parker, chair of the board of directors for the American College of Emergency Physicians, reminds Healthcare Dive that the holiday is for the kids. She noted twice as many kids are hit and killed by cars between 4pm and 10pm on Halloween. In addition, she warns some costumes can contribute to injuries due to sharp objects on costumes and reduced visibility from wearing a mask.
From a healthcare executive standpoint, she said Halloween and such events are great opportunities to reach out to the community for public awareness efforts. Parker notes there are some PR and outreach work that hospitals can do to educate their community to help prevent accidents so individuals do not have to access their health system’s services. “It’s a tremendous public service,” Parker told Healthcare Dive.
Community involvement for a public health event is critical, notes Miller, adding it’s important to try to offer education and put those efforts out beforehand to create awareness. If something does happen, the hope is the public is prepared and ready to handle such an event.
Parker notes some free, evidence-based materials are available on ACEP’s EmergencyCareForYou website.
Stay spooky. Stay safe.
