Emergency Medical Services Responses at a Large Immigration Detention Facility in Rural Georgia: A Descriptive Analysis.

Objectives: As the number of individuals in Immigration and Customs Enforcement (ICE) detention facilities increases, there is concern for increased utilization of local Emergency Medical Services (EMS) that serve these facilities. With multiple ICE detention facilities located in rural areas of the United States, this can create operational challenges for EMS agencies. In this study, we explored EMS activations resulting in transport to acute care centers originating from Stewart Detention Center (SDC), one of the largest ICE detention facilities located in Stewart County, Georgia. Stewart County Fire and EMS is the primary EMS service in Stewart County and responds to the majority of EMS activations, including SDC.

Methods: We conducted a cross-sectional analysis of all EMS activations that led to transport from April 1, 2018 to August 31, 2021 at SDC using data obtained through state and county open-records requests. Demographics, dispatch complaints, vital signs, and disposition were analyzed descriptively.

Results: During the study period, there were 345 EMS-reported activations that required transport for offsite medical care. The most common symptoms were chest pain, abdominal pain, and shortness of breath. Approximately 38% of individuals had at least one abnormal vital sign during their encounter. Forty-three percent of individuals required transfer to a tertiary hospital located approximately 40 miles away. EMS activations at SDC comprised 13% (544 of 4148) of the local EMS agency's responses during the study period.

Conclusions: EMS activations from SDC represented a substantial share of the call volume often requiring long-distance transfer of high acuity presentations. As medical emergencies in ICE detention facilities are likely to increase with expanding detention, continued research is needed to better understand the operational and clinical implications for EMS systems and local public health infrastructure.