Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home

Chapter 9. Integrating Terrorism and Disaster
Preparedness into Your Pediatric Practice
Relevance for Office-Based Pediatricians
Emergency preparedness should be exercised at all organizational levels, and office-based
physicians (either in the hospital or free-standing practice) should understand the role of their
specific office in the general system response to disasters. Integrating the office’s response to
disaster within the overall Federal, State, regional, and community response is essential.
Office-based policies and procedures ideally should be specific to the location of the practice
and its characteristics and be consistent with the policies of affiliate institutions and public
and governmental agencies.
Preparedness for disaster by office-based physicians can be subdivided into two broad
categories:
• Internal operations of the practice.
• External operations related to communication and coordination with other agencies,
institutions, and the community.
Internal Operations of the Practice: Office Readiness
Framework for disaster preparedness. A child-oriented, comprehensive, emergency care
system maintains the concept of systematic intervention in response to disasters while
viewing the needs of the child in the context of family and community. This framework is
particularly suited to the office-based physician, who attends to the whole child. Pediatric
health care professionals bring knowledge about responses and needs of children involved in
disasters and should work across public systems to render effective medical, educational, and
community interventions. The objective is to ensure that the biological and psychological
needs of children are addressed before, during, and after trauma.
Basic office readiness. There are several aspects to basic office readiness. They involve
facilities, equipment and supplies, and records.
Facilities. In the face of a natural or manmade disaster, two modes of mitigating the results
have been termed “hard” or “soft.” Soft mitigation refers to emergency preparedness or
emergency response as discussed throughout this chapter. Hard mitigation refers to
engineering efforts in the built environment to withstand destruction. These include building
standards for structures to withstand destruction from earthquakes, hurricanes, floods, fires,
technological hazards, etc., and on-site permanent emergency systems such as fire
suppression systems, uninterruptible power supplies, and standby generators.
Office-based physicians should be aware of the particular vulnerabilities of free-standing
practice buildings based on geographic location, and their practices should comply with strict
building code regulations and be equipped with emergency system back-ups. In the event of
structural damage to the practice, there should be a plan for its relocation (e.g., by making
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