Summary: Much to my delight, the Baltimore Ravens won the 2013 Super Bowl. While I
am not a diehard fan, it’s great to see my hometown team win the big
Dr. Mirvis is the Editor-in-Chief of this journal and a
Professor of Radiology, Diagnostic Imaging Department, University of
Maryland School of Medicine, Baltimore, MD.
Much to my
delight, the Baltimore Ravens won the 2013 Super Bowl. While I am not a
diehard fan, it’s great to see my hometown team win the big one.
Naturally, a considerable number of the 108 million viewers of the big
game were from Maryland.1 Unfortunately, I was not one of
them. Instead, I was working for our affiliated emergency department
(ED) on Super Bowl Sunday and had to rely on online updates to know what
was going on. I was a bit disappointed to miss the event, but I know
that, since the Ravens always lose when I watch their games, it was much
better for them that I missed the game. Yes, it all depends on me.
I was amazed at how low the study volume was at all 3 hospitals I was
covering that Sunday evening. The mix of cases was about the same—a few
folks with significant pathology mixed in with others with minor
findings or none at all—but I estimate I read about one-third of the
typical number of imaging studies for my shift. I know Christmas Day has
historically been pretty quiet in the ED and so has Thanksgiving Day,
to a lesser degree, but I was very impressed with the power of the Super
Bowl to influence patient volume.2
I asked my wife,
the Reference Librarian, to find out what other events have been found
to clearly reduce average ED volumes. She found studies indicating that
for 782 sporting events, including professional baseball and football,
Division 1 college football and college basketball games, a mean of 18.2
patients presented to the ED during the 2 hours before, 3 hours during,
and 2 hours after the games, compared to 23.3 patients during non-game
times. This was significant at p < .000074.3 The rate and
characteristics of ED visits were also measured before, during, and
after the Olympic men’s gold medal ice hockey game. There was a 17%
decrease (136 fewer patients per hour of broadcast) with p < 0001.4 The
relative decrease was particularly large for adult men with low triage
severity, and the decrease was most significant for patients with
abdominal, musculoskeletal, and traumatic disorders.4 Pediatric
ED visits and emergency surgical admissions at a Northern Ireland
hospital during a televised pan-European soccer tournament showed no
difference from visits/admissions on nights without such a broadcast.5 Clearly, children who complain to caregivers about health matters go to the doctor no matter what’s on television.
what’s going on here? For one thing, people with chronic or minor
problems are not going to electively come to the ED and risk missing
major televised sporting events. Perhaps even some with potentially
major problems are also too enthralled by the drama to tear themselves
from the TV and the many amiable comrades they are bonding with to watch
the manly brawl, particularly when the home team is involved. Someone
suffering crushing chest pain going into the left arm can always tough
it out until half-time (although even this is hard to overlook) or
subjectively downplay or completely ignore the symptoms. Suppose someone
at the typical Super Bowl party faints, has a seizure or hematemesis. Someone at the party certainly will notice and get help (or maybe not, since you can’t miss anything. After all, it is
the Big Game). This year’s Super Bowl, with its long power outage,
probably allowed for at least a cursory check of the well-being of the
crowd. However, some amount of acute illness is probably just the
expected background noise at a Super Bowl party. Another factor that may
affect ED volume could be the potential for large amounts of alcohol to
Whatever the specific reason, it is clear that what a
person is doing at the moment has a tremendous influence on deciding
how he reacts to acute health disorders or elective health matters. Face
it, there are more interesting things to do than visit the emergency
room, especially if it means missing the Big Game.
So, don’t fret
if you’re covering emergency radiology on an important holiday or
during a major entertainment event. Yes, you’ll miss the fun, but think
about how quiet it will be; how it will give you a chance to bond with
your colleagues in your mutual suffering and to revel in your feelings
of noble self-sacrifice.
This year, I finished reading the ED
studies by midnight and, sure enough, things were just beginning to heat
back up. The parties were over, and the ED was now turning into a more
enticing option, particularly since the postgame commentary was on the
big screen in the waiting room.
I didn’t speak to the next
radiologist covering the graveyard shift, but I suspect she was amazed
at the unusually high volume of visitors now freed from the bondage of
the famous football game to tend to their health.
- Jannarone J. Super Bowl audience totaled 108.4 million. Wall Street Journal. http://online.wsj.com/article/SB10001424127887323807004578284304135290258.html. Feb. 4, 2013. Accessed May 1, 2013.
- Reich NT, Moscati R, Jehle D, Ciotoli M. The impact of a major televised sporting event on emergency department census. J Emerg Med. 1994;12:15-17.
- Jerrard DA. Male patient visits to the emergency department decline during major sporting events. West J Emerg Med. 2009 May;10:101-103.
- Redelmeier DA, Vermeulen MJ. Emergency department visits during an Olympic gold medal television broadcast. Open Med. 2011;5:E113.
- Farrell S, Doherty GM, McCallion WA, Shields MD. Do major televised
events affect pediatric emergency department attendances or delay
presentation or surgical procedures. Ped Emerg Care. 2005;21:306-308.