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New tool available – because providing the best care for pediatric patients during disasters takes informed, thoughtful, and realistic planning

Author: Cynthia K. Hansen, PhD, Senior Advisor, National Healthcare Preparedness Programs, ASPR Office of Emergency Management
Published Date: 1/23/2015 3:29:00 PM
Category: Hospital Preparedness; Public Health Preparedness;

Children comprise more than a quarter of the U.S. population and account for a fifth of all hospital emergency department visits. Yet in 2013 when the National Pediatric Readiness Project assessed approximately 5,000 U.S. emergency departments, less than half of the 82 percent of hospitals that responded reported having written disaster plans addressing the specific needs of children.

The physical and psychological needs of children in disasters aren’t the same as those of adults, and healthcare workers need specific training and equipment to provide this care on both a day-to-day basis as well as during a disaster. Now there’s a tool to help healthcare facilities plan for children’s unique health needs in disasters.

Treating children requires clinicians to have different sized equipment and training in order to perform the procedures needed in an emergency situation, for example, to start IV-lines or ventilators. Pediatric patients require different medication dosages, and they have different health needs based on age, height, weight and emotional development. Young children tend to be less verbal, yet children of all ages are often more fragile and more affected by the stress of disasters than adults and often display these effects in different ways than adults. Disasters can take a heavy toll on a child’s development if not handled with care.

There are legal implications, too, that need to be considered in disasters. Children can’t consent to their own care, so parents and children may need to be treated in the same hospital to avoid the legal and emotional issues that result from separation. Hospital planners also need to consider that parents may not be willing to be treated in a different hospital than their children. Communities face similar dilemmas in planning for evacuation since children’s needs in emergency shelters differ from adults’ and must be considered in advance.

Medical surge also presents very differently for children than for adults. Surge may require that providers who don’t usually treat children do so in disasters. This possibility is important to account for in all surge planning. In addressing surge capacity for children’s care, one approach communities could take is to identify tiers of hospitals that treat pediatric patients as well as adults. Working as part of healthcare coalitions, hospitals can distribute resources and patients to support the community effectively and cost-efficiently.

To help hospitals and communities plan for such differences, ASPR worked with the HHS Health Resources and Services Administration (HRSA) and the HRSA Emergency Medical Services for Children (EMSC) Program to create a unique checklist to address pediatric domains to support hospital administrators and leaders when trying to incorporate pediatrics into their existing disaster plans; it is available as an interactive or downloadable tool.

The team consulted with a wide range of subject matter experts (SME’s) to develop consensus on ten essential domains of pediatric planning that should be incorporated into disaster policies for all hospitals. Then they identified and built on existing resources to create a checklist to help administrators and clinical leaders incorporate pediatric elements into hospital disaster plans. The team even incorporated real-world experiences, like New York University Hospital’s experience evacuating neo-natal patients after Hurricane Sandy.

To help promote the needs of children in disasters, the team included an online compendium of resources related to medical and public health issues for children in disasters and emergencies. Then they pilot tested the new tool.

Let’s move the dial from less than 50 percent to 100 percent of hospitals and healthcare facilities planning for the needs of children in disasters. The next level, of course, is to exercise those plans.

Has your facility cared for children and families in disasters? If so, share your best practices and lessons learned by commenting on this blog. 


Such an important topic

Thank you for giving this topic the attention it deserves. If disaster strikes our area, I definitely want to know that responders have planned for my little one's needs.
1/27/2015 12:33:44 PM

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