A PROSPECTIVE EVALUATION OF PEDIATRIC EMERGENCY CARE DURING THE 1996 SUMMER OLYMPIC GAMES IN ATLANTA, GEORGIA

Objectives: To explore the impact that a temporary influx of millions of people can make on the local pediatric emergent and urgent care sys tems, The spectrum of illness was also explored, Design/Methods: Prosp ective cohort of patients from outside the usual catchment area presen ting at two children's emergency departments and their satellite urgen t 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 vis it, 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 re presented, 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 w ere sicker than our typical emergency department patients, with hospit al 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, No tably, five had language barriers; three had serious chronic condition s of unknown detail to the temporary caregiver; two did not bring vita l medical supplies (ie, spare tracheotomy tube); one mislabeled medica tions, causing an overdose; one had leukemia, needed transfusion, but did not know of the regional centers; and one required helicopter tran sport secondary to traffic, Conclusion: A large influx of people resul ted in a relatively minor impact on the emergent care system for child ren, Care could have been improved if those with chronic illnesses wer e better informed of regional health care centers, essential medical n eeds for travel, and if travel included a physician's medical summary, In addition, anticipation of the Olympic Games helped the pediatric e mergency 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 preparedn ess with periodic reevaluation have also been established.