Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home
Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home
Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home
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injured or killed (see also Chapter 8, Mental Health Issues). <strong>Pediatric</strong>ians should be able<br />
to recognize potential symptoms of adjustment reactions <strong>and</strong> PTSD <strong>and</strong> to give parents<br />
coping strategies <strong>and</strong> referrals. The role of pediatricians in the mental health care of<br />
children after terrorism <strong>and</strong> disasters is described in a recent article, “Psychosocial<br />
implications of disaster or terrorism on children: A guide for the pediatrician,” which is<br />
available at http://www.pediatrics.org/cgi/content/full/116/3/787.<br />
The pediatrician’s perspective is well-suited to assist in the community planning process.<br />
<strong>Pediatric</strong>ians have an appreciation for children as part of families that comprise<br />
communities that become regions, States, <strong>and</strong> so on. This perspective is valuable, but<br />
pediatricians may have limited knowledge <strong>and</strong> skill in planning <strong>and</strong> response.<br />
<strong>Pediatric</strong>ians should educate themselves, acknowledge their limitations, <strong>and</strong>/or obtain<br />
outside expert input. The role of the pediatrician has been comprehensively described <strong>and</strong><br />
defined in the AAP Policy Statement The <strong>Pediatric</strong>ian’s Role in <strong>Disaster</strong> <strong>Preparedness</strong><br />
prepared by the Committee on <strong>Pediatric</strong> Emergency Medicine<br />
(http://pediatrics.aappublications.org/cgi/content/full/99/1/130).<br />
<strong>Pediatric</strong>ians are respected advocates for children. In this role, pediatricians should<br />
advocate for resources <strong>and</strong> products that currently do not exist for children, especially for<br />
children with special health care needs (including the chronically ill <strong>and</strong> technologically<br />
dependent). For example, children cannot always be decontaminated in adult<br />
decontamination units. Skin decontamination showers that are safe for adults may cause<br />
hypothermia in children unless warming equipment (e.g., heating lamps) is provided.<br />
Decontamination systems should be designed for use with children of all ages, for the<br />
child unaccompanied by a parent, for the nonambulatory child, <strong>and</strong> for the child with<br />
special health care needs. Little protective gear is available for children; when its use has<br />
been attempted, such as with gas masks, mish<strong>and</strong>ling has led to fatalities from<br />
suffocation.<br />
Vaccines for anthrax <strong>and</strong> plague are not approved for use in children. The frequency of<br />
serious complications after administration of smallpox <strong>and</strong> yellow fever vaccines is<br />
higher in children than in adults; development <strong>and</strong> approval of safer vaccines are needed<br />
(see also Chapter 4, Biological <strong>Terrorism</strong>). Antidote kits for use after nerve agent<br />
exposure such as the Mark-1 kit (for adults) have only recently been developed for<br />
children (see Chapter 5, Chemical <strong>Terrorism</strong>). Common systems for determining drug<br />
dosages in children do not include dosages for antidotes. Recently, a liquid preparation of<br />
potassium iodide (65 mg/cc) has come on the market for use in preventing radiationinduced<br />
thyroid effects after radiation exposure (see also Chapter 6, Radiological <strong>and</strong><br />
Nuclear <strong>Terrorism</strong> <strong>and</strong> the AAP Policy Statement on Radiation <strong>Disaster</strong>s <strong>and</strong> Children at<br />
www.aap.org/policy/s040208.html).<br />
Planning <strong>and</strong> preparation for terrorism <strong>and</strong> disasters can be both daunting <strong>and</strong><br />
challenging. For all, but especially for children, there are many recognized gaps in<br />
knowledge, resources, <strong>and</strong> professional education. This resource has been provided to<br />
increase pediatric expertise of those taking on the challenge of preparation <strong>and</strong> planning.<br />
This resource will be invaluable, not only for pediatricians, but also for other pediatric<br />
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