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

Collaborating Agencies Responding to Disasters (CARD) programs. The CARD programs
(established in 1994 after the Northridge earthquake in Los Angeles) were originally
organized to provide services for vulnerable and underserved populations (e.g., homeless
individuals, veterans, at-risk youth, people with special needs). This group of agencies has
extended its services to develop disaster preparedness plans. This kind of program has the
advantage of linking culturally sensitive community services and preparedness, thereby
addressing ongoing issues such as homelessness, cardiopulmonary resuscitation (CPR)
training, and maintaining a set structure and mission. The clusters of service teams provide
support services such as transportation, counseling, shelter and housing, health services, and
commodities. Conceivably, this structure could accommodate a pediatric focus in
collaboration with community-based pediatric health care professionals.
Policies and procedures. Office-based physicians should be aware of the emergency
numbers and protocols of their local department of health. These policies should be included
in the overall office practice manual for easy reference. If practices are affiliated with a
hospital, also being aware of those policies and procedures will facilitate collaboration. When
they exist, current best practices can be adopted with respect to emergency response plans
and to physician and nurse training for disasters.
Communicating Directly with Children and Families
The pediatrician plays a central role in disaster and terrorism preparedness with families and
children. Families view pediatricians as their expert resource, and most expect pediatricians
to be knowledgeable in areas of concern. Providing expert guidance entails both educating
families in anticipation of events and responding to questions during and after actual events.
In many areas of the country, the threat of natural disasters is ongoing, and guiding and
educating families on home disaster preparedness can be done in the pediatrician’s office or
as a community focus. Family preparedness may include training in cardiopulmonary
resuscitation, rendezvous points, lists of emergency telephone numbers, and an out-of-thearea
friend or relative whom all family members can contact after the event to report their
whereabouts and condition. Home preparedness (such as installing storm shutters or
earthquake-proofing the home) should be covered. Parents should maintain emergency
supplies of food, water, and medicine; a first-aid kit; and clothing. Family members should
know the safest place in the home, make special provisions, know community resources, and
have a plan to reunite. Medications for chronic illness and resources for children who depend
on technological means for survival should be included in the plan (see also the AAP Family
Readiness Kit at www.aap.org/family/frk/frkit/htm).
Answering questions during events. During any event, children and families will receive
good and bad information from a multitude of sources, including friends, media, and public
officials. The problems caused by panic, overreaction, and overwhelming the emergency
health care system with anxious families cannot be overstated. A well-educated and available
pediatrician who can appropriately respond to numerous and varied questions can be of great
service.
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