Impact on the regional ambulance services and emergency departments of the 2017 freezing rain in Milan

Background: Freezing rain, also known as gelicidium, glaze, or ice storm, is an unpredictable and rare meteorological event with an impact on millions of citizens and which can affect the healthcare system of large areas. It occurs if rain hits the ground when surface temperatures are below 0◦C. Objective: To report what occurred on January 13th 2017 in Lombardy, a northern Italy region with Milan as capital, when a freezing rain caused an overload of the emergency system. Methods: We obtained data on emergency vehicles calls and missions from the emergency reports (four Lombardy areas covered by Azienda Regionale Emergenza e Urgenza-AREU-and encompassing 117 emergency departments). Emergency examinations data included overall visits, diagnosis, severity degrees and workload of emergency departments. Results: The Milan area emergency calls had an increase unseen in the previous four years of service (from 1369 to 2700 p < 0.001). A total of 1913 trauma cases were managed versus a daily average of 484 during January 2017 (p < 0.001). Road accidents and injuries at work increased while non–traumatic causes did not. More than 70% of the 38 emergency departments in the Metropolitan Area around the city of Milan were overloaded. Conclusion: We presented the first European report on the impact of an ice storm on a healthcare system, suggesting that early recognition, communication between meteorologists and health authorities, and an alert of ambulance services and healthcare professionals (orthopaedics above all) is mandatory, jointly with warnings to the population by public authorities.