Time-Critical Emergencies in Suburban Parks and Outdoor Recreation Spaces

Objective Prior studies have described the patterns of emergency medical service (EMS) activations in national parks in the United States. However, little data exists regarding EMS activations in local and regional outdoor recreational locations. We performed a retrospective analysis of EMS activations originating from parks and recreational areas in suburban Howard County, Maryland, to characterize those activations determined to be time-critical emergencies. Methods EMS activations originating from outdoor recreational areas and parks in Howard County, Maryland, between December 2018 and December 2022, were extracted from the Howard County Department of Fire and Rescue Services (HCDFRS) electronic medical records database. Patient complaints were categorized into medical or traumatic etiologies and then determined to be "time-critical" or "non-time-critical" by two emergency physician reviewers with a tie-breaker reviewer to resolve discrepancies. Results A total of 396 EMS activations in county parks and recreational areas were recorded during the study period, with 61 (15.40%) determined to be time-critical. The most commonly occurring time-critical calls were cardiac arrest (7; 11.48%), drug/alcohol-related complaints (5; 8.20%), and altered mental status (5; 4.92%). Most EMS activations were for male patients (273; 68.94%). Pediatric patients (<18 years old) constituted 161 (40.66%) time-critical traumatic injury activations, and these numbers decreased as patient age increased. The most commonly occurring time-critical medical activations (11; 2.78%), occurred in 40-64-year-olds. The highest number of total EMS activations occurred in October, with 57 calls (14.39%), and the greatest volume of time-critical activations occurred during June, with nine calls (14.75%). Conclusion Within a suburban county's EMS system, 15.4% of the total EMS activations to parks and outdoor recreational locations were found to be time-critical, significantly higher than in other places. Patients aged 0-18 experienced the highest number of time-critical trauma-related activations, whereas those aged 40-64 had the highest number of time-critical medical activations. EMS agencies should review their activation rates in these locations to determine the need to enhance education and operational readiness for response to time-critical activations for pediatric trauma and adult medical emergencies.