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6 Improving Emergency Preparedness and Response for Children Involved in Disasters
Pages 221-244

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From page 221...
... Understaffed and overcrowded emergency departments (EDs)
From page 222...
... . Emergency medical services (EMS)
From page 223...
... . EMS systems, for example, have received only 4 to 6 percent of federal disaster preparedness funds from the Department of Homeland Security (DHS)
From page 224...
... Younger patients require specialized equipment and different approaches to treatment in the event of a disaster. Children cannot be properly decontaminated in adult decontamination units (National Center for Disaster Preparedness, 2003)
From page 225...
... Open-wound management is a time-consuming task, particularly for uncooperative and frightened pediatric patients; thus although patient volume had returned to normal levels by the second week after the hurricane (Quinn et al., 1994) , additional physician staffing was necessary.
From page 226...
... Historically, the military was considered the only target of potential biological, chemical, and radiological attacks, so the focus for training, equipment, and facilities was on the care of healthy young adults (National Center for Disaster Preparedness, 2003)
From page 227...
... This represented one of the first efforts to define issues in pediatric disaster preparedness. The conference was sponsored by the Agency for Healthcare Research and Quality (AHRQ)
From page 228...
... Additionally, guidance for the bioterrorism grants offered by HRSA, AHRQ, and the Office of Domestic Preparedness indicates that all projects should consider the needs of children. Disaster preparedness has also been a key area of focus for the Emergency Medical Services for Children (EMS-C)
From page 229...
... The committee believes pediatric concerns should be in the forefront of disaster planning and recommends that federal agencies (the Department of Health and Human Services, the National Highway Traffic Safety Administration, and the Department of Homeland Security) , in partnership with states and regional
From page 230...
... 0 EMERGENCY CARE FOR CHILDREN planning bodies and emergency care providers, convene a panel with multidisciplinary expertise to develop strategies for addressing pediatric needs in the event of a disaster. This effort should encompass the following: • Development of strategies to minimize parent–child separation and improved methods for reuniting separated children with their families.
From page 231...
...  IMPROVING PREPAREDNESS AND RESPONSE FOR DISASTERS since many of the recovered bodies were not identified for a prolonged period of time. Another challenge was reuniting young, preverbal children with their parents, since these children were too young to give rescuers and social workers their name or identify family members in photographs.
From page 232...
... . Enhancing Pediatric Disaster Expertise One of the major challenges of disaster planning and response for children is that the number of emergency providers specifically trained and equipped to handle children is limited (see Chapter 4)
From page 233...
... An analysis of patients treated in New Mexico's DMAT field clinics during four recent natural disasters found that pediatric patients represented a third of all patients treated by the team (Nufer and Gnauck, 2004)
From page 234...
... To address these shortcomings, strategies to improve the level of pediatric expertise on DMATs and other organized disaster response teams need to be developed. This can be accomplished by improving the pediatric training required of teams, equipping them with appropriate pediatric resources, and taking active steps to recruit pediatricians and pediatric emergency medicine physicians to serve on the teams.
From page 235...
... It received 82 patients, 25 percent of whom were admitted, while 25 percent were transferred to other hospitals. A level I trauma center located 12 miles away from the nightclub received 68 patients, approximately 63 percent of whom were admitted (Gutman et al., 2003)
From page 236...
... Involvement of pediatric experts in disaster planning is critical to ensure that evacuation and sheltering plans can meet the needs of children, particularly those with special needs, as the plans are operationalized. Disaster plans should include protocols for schools and day care centers and other places where children congregate.
From page 237...
... The consensus in the medical community is that this treatment is appropriate for infants and children with severe, life-threatening nerve agent toxicity (National Center for Disaster Preparedness, 2004)
From page 238...
... Although difficult for disaster planners to address, these issues must be considered. Conducting Pediatric Disaster Drills It is widely believed that medical professionals do not receive as much disaster preparedness training as they should (AAMC, 2003; NASEMSD, 2005)
From page 239...
... SUMMARY OF RECOMMENDATIONS 6.1 Federal agencies (the Department of Health and Human Ser vices, the National Highway Traffic Safety Administration, and the Department of Homeland Security) , in partnership with state and regional planning bodies and emergency care providers, should con vene a panel with multidisciplinary expertise to develop strategies for addressing pediatric needs in the event of a disaster.
From page 240...
... Academic Emergency Medicine 11(5)
From page 241...
... 95:1–3. Illinois EMS-C (Illinois Emergency Medical Services for Children)
From page 242...
... :201–209. NASEMSD (National Association of State Emergency Medical Services Directors)
From page 243...
... 1993. The Avianca plane crash: An emergency medical system's response to pediatric survivors of the disaster.


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