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PEDIATRIC DISASTER/MULTICASUALTY PREPAREDNESS

Children are not small adults.  They have special needs based on their physiologic, anatomic, developmental and cognitive attributes, all of which put them at increased risk during a disaster or multicasualty event.  This webpage provides information on pediatric disaster preparedness and contains links to a variety of related resources.


WHY THE NEED FOR PEDIATRIC DISASTER PREPAREDNESS    
Children are not small adults.  They have special needs based on their physiologic, anatomic, developmental and cognitive attributes, all of which put them at increased risk during a disaster or terrorist event.  Some of their unique vulnerabilities in a disaster event include:

  • Developmental and cognitive levels may impede their ability to escape danger;

  • Age and cognitive development may not be sufficiently developed to convey medical history or other pertinent information if they become separated from their parents;

  • Weight appropriate medications as well as appropriately sized equipment and supplies are essential in order to effectively treat children;

  • Children with chronic conditions and special health-care needs are particularly at risk if their survival depends upon medications or medical technology, i.e. ventilators;

  • Less blood and fluid reserves increases their risk for dehydration and shock;

  • Higher respiratory rates puts children at risk for greater exposure to aerosolized agents;

  • More permeable skin and larger skin surface to mass ratio increases their exposure risk to some biological and chemical agents; this also increases their risk for hypothermia;

  • Increased vulnerability to radiation exposure requires a more vigorous medical response than adults.

ILLINOIS AND PEDIATRIC DISASTER PREPAREDNESS    
Currently there are more than 3 million children and adolescents age 17 years and younger in Illinois, and 900,000 of those children are age 5 or younger.  Children are a growing part of our population as evidenced by the following:  the percent of Illinois children younger than the age of 18 years increased 10 percent between the last two census years (1990-2000). 

Illinois has a strong commitment to the children in our state, and to assuring preparedness and planning efforts are in place to meet the needs of children in a disaster or terrorism event.  In May 2000, the Illinois Terrorism Task Force (ITTF) was created with the primary responsibility to ensure statewide preparedness in the event of a terrorist event.  This task force established several subcommittees and workgroups to assist in meeting this responsibility. 

In 2002 the ITTF Pediatric Bioterrorism Workgroup was created.  This group is responsible for identifying best practices and developing resources to assist in assuring that the special needs of children are addressed during a disaster or terrorist event.  This pediatric workgroup is comprised of volunteer physicians, nurses, paramedics, pharmacologists, psychologists, state/local health department personnel as well as representatives from key organizations, such as the American Red Cross, Illinois Association of School Nurses, Illinois Chapter of the American Academy of Pediatrics, Illinois College of Emergency Physicians, Illinois Hospital Association, Illinois State Council of the Emergency Nurses Association, Illinois Medical Emergency Response Team, Illinois Nurse Volunteer Emergency Needs Team and Illinois Poison Center, among others.  Illinois Emergency Medical Services for Children (EMSC) is responsible for chairing and coordinating the activities of the ITTF Pediatric Bioterrorism Workgroup. 

Funding through the federal Hospital Preparedness grant program has helped support the activities of the Pediatric Bioterrorism workgroup and to fund EMSC positions.  Click here to view the activities to date of this workgroup. (46k)

HOSPITAL PREPAREDNESS FOR CHILDREN    
Since 1994, Illinois Emergency Medical Services for Children (EMSC) has worked to ensure that health care providers and health care facilities are prepared to meet the emergency care needs of children.  Beginning in 1998, the Illinois Department of Public Health initiated a Pediatric Facility Recognition program to formally recognize hospitals for their Emergency Department pediatric preparedness.  This program requires hospitals to comply with defined pediatric standards and undergo a site visit every 3-4 years.  In 2002, the Pediatric Facility Recognition program expanded to include Pediatric Critical Care preparedness in hospitals with pediatric intensive care and other pediatric specialty capabilities.  For a list of hospitals that participate in this program, click here

In 2004, IDPH/EMSC added another component to the Pediatric Facility Recognition program and began to review hospital disaster plans during the site visits.  This provides an opportunity during the site survey process to identify any areas of need and offer recommendations on incorporating children into hospital disaster plans.  These hospital disaster plan reviews, which have been conducted throughout the state, have been highly assistive in identifying a number of common areas of need that include:

  • Decontamination process for infants/small children

  • Pediatric surge capacity

  • Identification process for unaccompanied children

  • Development of a designated holding area for children pending discharge/reunification

  • Reunification process for children with their parents/designated caretakers

  • Addressing the needs of Children with Special Health Care Needs

Pediatric Facility Recognition is an initial step in being better prepared for disaster, terrorist and multicasualty events that involve children.  Click here for a set of Frequently Asked Questions (FAQ) regarding Pediatric Preparedness within the hospital setting.  

PEDIATRIC DISASTER PREPAREDNESS CHECKLIST FOR HOSPITALS    
As hospitals develop their disaster plans, there are several key areas that can assure they are better prepared to handle the unique needs of pediatric patients.  A checklist was designed to help hospitals identify their current level of pediatric preparedness and what additional areas they need to address. This checklist is also used during Facility Recognition Site Surveys to help Illinois EMSC understand the level of pediatric preparedness within hospitals and the types of technical assistance hospitals may need. Click here to view the Pediatric Disaster Preparedness Checklist.
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ILLINOIS MEDICAL EMERGENCY RESPONSE TEAM (IMERT) PEDIATRIC SPECIALTY TEAM    
In 2006 IMERT identified the need to have a more coordinated and specialized approach to children during a disaster.  At that time they took the steps to develop a Pediatric Specialty Team.  Recruitment for members to join this newly formed team are currently underway. All interested pediatricians, pediatric emergency physicians, pediatric nurse practitioners, pediatric nurses, and prehospital healthcare personnel with expertise in pediatrics are encouraged to consider joining this team.  To access more information regarding the Pediatric Specialty Team, go to the IMERT website.

PANDEMIC INFLUENZA    
The term "Pandemic" is used to describe a disease that affects people on a world wide scale. Pandemic Influenza occurs when a new (novel) strain of influenza in humans begins to spread easily from person to person causing widespread serious illness.

The Illinois Department of Public Health (IDPH) has developed a number of resources that can be accessed by clicking here.  This website contains extensive information and action plans for various segments of society (individuals; families; businesses; schools; health entities; faith-based organizations; governmental agencies).

JOURNAL PUBLICATIONS (35k)   
Currently disaster preparedness is addressed in many healthcare publications by a variety of healthcare providers who actively promote pediatric preparedness activities.  This link features journal articles pertinent to pediatric disaster preparedness.

WEB LINKS/RESOURCES    
This link connects you to a large number of other available disaster related resources.

RELATED ACTIVITIES/EVENTS    
This link provides a schedule of upcoming educational activities/venues.

 

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Last Reviewed: Aug. 15, 2014