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

Medical staffs need to know what will be expected of them and their facilities in the event of a
large-scale infectious disease outbreak. Because of their unique knowledge base, physicians,
especially pediatricians, can be very valuable sources of information to law enforcement and
public health policymakers in helping to identify and isolate the source of an outbreak and
providing guidance on the need for isolation, quarantine, and treatment.
Planning and prevention are closely related and work hand-in-hand. The people doing the
planning cannot be strangers. It is important that they routinely and regularly meet and speak
with each other to facilitate communication during a crisis. Communication is a key element for
success. If managers cannot communicate successfully during routine circumstances, they cannot
be expected to effectively communicate during times of crisis.
Plans should be developed and then tested and refined, over and over again. For a plan to work
efficiently and effectively during a crisis, it must be well rehearsed. Plans that have been tested
on a regular basis enable the responders to know and understand their roles. During a crisis is not
the time to find out that a vital component is missing or nonfunctional.
Response plans must be shared with the people who will be doing the actual responding. Periodic
in-service training should be conducted, including tabletop exercises with key players and fullscale
field exercises. Pediatricians should be proactive in providing input regarding the unique
needs of children during disasters and ensure that children’s issues are included in all
preparedness activities. Lessons learned from either actual responses or from the exercises and
discussions should be incorporated into existing plans and then tested and evaluated again.
Planners need to ask themselves over and over again: “Are we ready?” Plans must be constantly
changing and evolving to meet changing circumstances, and no matter how well prepared we
think we may be, we can always be more prepared. Careful review and personal communication
with all involved in both incident management and potential response can always identify more
opportunities for improvement. Because disasters are dynamic events, plans must be flexible so
that they can be adapted to an incident as it develops. People involved in the planning process
should stay current regarding new trends, technologies, and intelligence information that become
available. Planning done in a vacuum cannot be successful.
Actual Response to the Event
The next phase is the response to the actual event. Response activities provide emergency
assistance for casualties, reduce the probability of secondary damage, and speed recovery.
Response activities include activating public warning systems, notifying public authorities,
mobilizing emergency personnel and equipment, providing emergency medical assistance,
manning emergency operation centers, declaring disasters, evacuating the public, mobilizing
security forces, providing search and rescue operations, and suspending laws on an emergency
basis.
Response to a mass casualty incident (MCI) begins at the scene by first responders. An integral
role of the first responder is coordination with agencies able to recognize characteristics of MCI
secondary to bombs or to biological, chemical, or radiological agents, such that ongoing risk is
minimized. First responders collect casualties, triage survivors, institute treatment (including
28