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

Advice for families of children with special health care needs. Pediatricians should
provide guidance to families of children with special health care needs. This may include the
following:
• Notifying utility companies to provide emergency support during a disaster.
• Maintaining a supply of medications and equipment in case availability is disrupted
during a disaster.
• Knowing how to obtain additional medications and equipment during times of a
disaster.
• Training family members to assume the role of in-home health care providers who
may not be available during a disaster.
• Keeping an up-to-date emergency information form to provide health care workers
with the child’s medical information in case the regular care provider is unavailable.
• Knowing back-up hospitals/providers in the region in case primary
hospital/specialists/providers become unusable or are unavailable.
• Providing advice on power of attorney, living wills, advance directives, and other
important legal tasks/documents.
Relevance for Hospital-Based Pediatricians
In mass casualty incidents, including those involving chemical and biological agents,
casualties among children and adults could be significant. Because children are likely to
become victims in many disaster events, pediatricians should assist in preparedness planning
to ensure coordinated responses of local hospitals that may in fact each have limited pediatric
resources. In addition, health care facilities could be a primary or secondary target
themselves. Also, facilities may be overwhelmed by massive numbers of anxious individuals
and families. Pediatricians working in or supporting hospitals can play a vital role in ensuring
the enhanced care of the pediatric disaster victim by participating in all levels of disaster
preparedness planning.
Emergency Department Readiness
The hospital disaster alert system is designed to triage victims in the field and carefully
distribute them among available resources to keep a single facility from being overwhelmed.
However, in many crisis situations, facilities are vulnerable to inundation with patients who
arrive in large numbers without EMS transport and pre-entry triage. Pediatricians working in
or supporting hospitals should interact with the planning committee to ensure adequate
training and preparation of supplies and treatment areas in the emergency department.
Pediatricians working in hospitals can be key facilitators between emergency department
services, critical care services, and regular inpatient services. Coordination with the local
community should involve primary/prehospital/infrastructure response (with liaison planning
to State and Federal agencies) and community/citizen response. Considerations should be
made as usual referral patterns may not typically include accepting pediatric patients.
Primary/prehospital/infrastructure response includes the following:
• EMS.
• Fire.
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