A state survey of emergency department preparedness for the care of children in a mass casualty event

Authors

Tonya Thompson, MD
Kristen Lyle, MD
S. Hope Mullins, MPH
Rhonda Dick, MD
James Graham, MD

DOI:

https://doi.org/10.5055/ajdm.2009.0034

Keywords:

disaster, pediatric, emergency department

Abstract

Objective: The Institute of Medicine has issued two reports over the past 10 years raising concerns about the care of children in the emergency medical care system of the United States. Given that children are involved in most mass casualty events and there are deficiencies in the day-to-day emergency care of children, this project was undertaken to document the preparedness of hospitals in AR for the care of children in mass casualty or disaster situations.
Design: Mailed survey to all emergency department medical directors in AR. Nonresponders received a second mailed survey and an attempt at survey via phone.
Participants: Medical directors of the emergency departments of the 80 acute care hospitals in AR.
Results: Seventy-two of 80 directors responded (90 percent response rate). Only 13 percent of hospitals reported they have pediatric mass casualty protocols and in only 28 percent of hospitals the disaster plan includes pediatric-specific issues such as parental reunification. Most hospitals hold mass casualty training events (94 percent), at least annually, but only 64 percent report including pediatric patients in their disaster drills. Most hospitals include local fire (90 percent), police (82 percent), and emergency medical services (77 percent) in their drills, but only 23 percent report involving local schools in the disaster planning process. Eighty-three percent of hospitals responding reported their staff is trained in decontamination procedures.Thirty-five percent reported having warm water showers available for infant/children decontamination. Ninety-four percent of hospitals have a plan for calling in extra staff in a disaster situation, which most commonly involves a phone tree (43 percent). Ninety-three percent reported the availability of Ham Radios, walkie-talkie, or Arkansas Wireless Information Network (AWIN) units for communication in case of land line loss, but only 16 percent reported satellite phone or Tandberg units. Twelve percent reported reliance on cell phones in this situation.
Conclusions: This survey demonstrated important deficiencies in the preparedness of hospitals in AR for the care of children in disaster. Although many hospitals are relatively well prepared for the care of adults in disaster situations, the needs of children are different and hospitals in AR are not as well prepared for pediatric disaster care.

Author Biographies

Tonya Thompson, MD

Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Arkansas Children’s Hospital, Little Rock, Arkansas.

Kristen Lyle, MD

Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Arkansas Children’s Hospital, Little Rock, Arkansas.

S. Hope Mullins, MPH

Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Arkansas Children’s Hospital, Little Rock, Arkansas.

Rhonda Dick, MD

Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Arkansas Children’s Hospital, Little Rock, Arkansas.

James Graham, MD

Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Arkansas Children’s Hospital, Little Rock, Arkansas.

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Published

07/01/2009

How to Cite

Thompson, MD, T., K. Lyle, MD, S. H. Mullins, MPH, R. Dick, MD, and J. Graham, MD. “A State Survey of Emergency Department Preparedness for the Care of Children in a Mass Casualty Event”. American Journal of Disaster Medicine, vol. 4, no. 4, July 2009, pp. 227-32, doi:10.5055/ajdm.2009.0034.

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Issue

Vol. 4 No. 4 (2009): July/August

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