Pediatric issues in disaster management, Part 2: Evacuation centers and family separation/reunification

Sharon E. Mace, MD, Ghazala Sharieff, MD, Andrew Bern, MD, Lee Benjamin, MD, Dave Burbulys, MD, Ramon Johnson, MD, Merritt Schreiber, PhD

Abstract


Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients.We discuss key components of disaster planning and management for pediatric patients including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs, mental health issues, and overcrowding/surge capacity. Specific policy recommendations and an appendix with detailed practical information and algorithms are included. The first part of this three part series on pediatric issues in disaster management addresses the emergency medical system from the field to the hospital and surge capacity including the impact of crowding. The second part addresses the appropriate set up and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: the special healthcare needs patient and mental health issues.

Keywords


disaster, pediatric disasters, pediatrics, children and infants

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References


Pitts SR, Niska RW, Xu J, et al.: National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary. Natl Health Stat Report. 2008; 7: 1-38.

Burt CW, Middleton KR: Factors associated with ability to treat pediatric emergencies in US hospitals. Pediatr Emerg Care. 2007; 23(10): 681-689.

Warden G, Altman S, Asplin B, et al.: The Institute of Medicine’s Report: Emergency care for children: Growing pains. National Academies Press, 2007.Available at www.nap.edu.Accessed March 27, 2010.

Warden G, Altman S, Asplin B, et al.: The Institute of Medicine’s Report: Hospital-based emergency care: At the breaking point, 2007. Available at www.nap.edu. Accessed March 27, 2010.

Gausche-Hil M, Schmitz C, Lewis RJ: Pediatric preparedness of US emergency departments: A 2003 survey. Pediatrics. 2007; 120(6): 1229-1237.

Middleton KR, Burt CW: Availability of pediatric services and equipment in emergency departments: United States 2002-2003. Adv Data. 2006; 367: 1-16.

Goodman DC: The pediatric subspecialty workforce: Time to test our assumptions. Pediatrics. 2006; 118(6): 2545-2547.

Mayer ML: Are we there yet? Distance to care and relative supply among pediatric medical subspecialties. Pediatrics. 2006; 118(6): 2313-2321.

Gaskin DJ, Mitchell JM: Health status and access to care for children with special health care needs. J Ment Health Policy Econ. 2005; 8(1): 29-35.

Mace SE, Bern AI: Needs assessment: Are DMATs up for the challenge of a pediatric disaster. Am Emerg Med. 2007; 25: 762-769.

Markenson D, Redlener I: Pediatric terrorism preparedness national guidelines and recommendations: Findings of an evidencebased consensus process. Biosecur Bioterror. 2004; 2(4): 301-319.

Ginter PM,Wingate MS, Rucks AC, et al.: Creating a regional pediatric disaster preparedness network: Imperative and issues. Matern Child Health J. 2006; 10(4): 391-396.

Curry MD, Larson PG, Mansfield CJ, et al.: Impacts of a flood disaster on an ambulatory pediatric clinic population. Clin Pediatrics. 2001; 40: 571-574.

Mace SE, Jones JJ, Bern AI: An analysis of disaster medical assistance team (DMAT) deployment in the United States. Prehosp Emerg Care. 2007; 11: 30-35.

Dolan MA, Krug SE: Pediatric disaster preparedness in the wake of Katrina: Lessons to be learned. Clin Pediatr Emerg Med. 2006; 7(1): 59-66.

Markenson D, Reynolds S: The pediatrician and disaster preparedness. Pediatrics. 2006; 117(2): e340-e362.

Foltin GL, Schonfeld DJ, Shannon MW: American Academy of Pediatrics. Pediatric Terrorism and disaster preparedness: A Resource for Pediatricians. AHRQ Publication No. 06-0056-EF. Rockville, MD: Agency for Healthcare Research and Quality, October 2006.

American Academy of Pediatrics: How to prepare for disasters. Available at http://www.aap.org/family/frk/frkit.htm. Accessed January 24, 2007.

US Department of Homeland Security: Ready kids. Available at http://www.ready.gov/kids/_downloads/familylist.pdf. Accessed January 24, 2007.

American Red Cross: Available at http://www.redcross.org/ prepare/ECCard.pdf. Accessed January 24, 2007.

Committee on Pediatric Emergency Medicine—American Academy of Pediatrics: The pediatrician’s role in disaster preparedness. American Academy of Pediatrics Committee on Pediatric Emergency Medicine. Pediatrics. 1997; 99(1): 130-133.

APLS: The Pediatric Emergency Medicine Resource. Revised Fourth Edition. ACEP and American Academy of Pediatrics, 2006.

Centers for Disease Control: Emergency preparedness and response—Information for disaster evacuation centers—Diapering stations. Available at http://www.bt.cdc.gov/disastershurricanes/ diaperingguidelines.asp. Accessed January 19, 2007.

Centers for Disease Control: Emergency preparedness and response—Infection centre guidance for community evacuation centers following disasters—General infection prevention for residental evacuation centers. Available at http://www/bt.cdc.gov/disasters/ commshelters/asp. Accessed January 19, 2007.

Centers for Disease Control:Emergency preparedness and response— Guidelines for the management of acute diarrhea after a disaster. Available at http://www.bt.cdc.gov/disasters/hurricanes/dguidelines.asp. Accessed June 3, 2010.

Centers for Disease Control: Emergency prepardness and response—Preventing violence after a disaster—Prevent youth violence. Available at http://www.bt.edc.gov/disasters/communityshelters. 1997.

Centers for Disease Control: Emergency preparedness and response—Animals and insects—Animals in public evacuation centers. Available at http://www.bt.cdc.gov/disasters/animalpubevac.asp. Accessed January 19, 2007.

Centers for Disease Control: Emergency prepardness and response—Guidelines for evacuation center play areas.Available at http://www/bt.cdc.gov/disasters/hurricanes/Katrina/shelterplayareas. asp. Accessed January 19, 2007.

Saulny S: Storm and crisis: “But I just want to know, where’s my baby?” New York Times. September 10, 2005.

National Center for Missing & Exploited Children: Available at www.ncmec.org. Accessed May 27, 2007.

UNICEF: Alternative care for children without primary caregivers in tsunami-affected countries. Indonesia, Malaysia, Myanmar, and Thailand. Available at http://www.unicef.org/eapro/Alternative_ care_for_children.pdf. Accessed May 27, 2007.

Kaur R: Child protection intervention after the Bam earthquake. UNICEF. Available at http://www.unicef.org/iran/IRN_ resources_CPBam.doc. Accessed May 27, 2007.

Bass R: Institute of medicine report “Emergency care crisis: A nation’s unprepared for public health disasters” before the subcommittee on emergency preparedness, science, and technology. Committee on Homeland Security. US House of Representatives July 26, 2006. Available at http://www.7nationalacademies.org/ ocga/testimony/A_Nations_Unprepared_for_Pub_Health_Disasters. asp. Accessed May 27, 2007.

United Nations Convention on the Rights of the Child. 1989:UN general assembly document A/RES/44/25. Available at http://www. ohchr.org/english/law/pdf/crc/pdf. Accessed May 27, 2007.

International Committee of the Red Cross Central Tracing Agency and Protection Division: Inter-agency guiding principles on unaccompanied and separated children. ICRC, UNHCR, UNICEF,World Vision International, Save the Children UK & International Rescue Committee, 2004.Available at http://www.icrc.org/Web/Eng/siteen0.nsf/htmlall/ p1101. $File/ICRC_002_1011.PDF!Open.Accessed May 27, 2007.

Family Readiness Kit: Preparing to handle disasters. available at http://www.aap.org/family/frk/frkit.htm. Accessed May 27, 2007.

US Department Of Homeland Security:Available at http://www. ready.gov/kids/step2/index.html. Accessed May 27, 2007.

Brandenburg MA, Watkins SM, Brandenburg KL: Operation child-ID: Reunifying children with their legal guardians after Hurricane Katrina. Disasters. 2007; 31(3): 277-287.

Brandenburg MA, Ogle MB,Washington BA, et al.: “Operation child-safe”: A strategy for preventing unintentional pediatric injuries at a Hurricane Katrina Evacuee shelter. Prehosp Disaster Med. 2006; 21(5): 359-365.

BBC: Tsunami “Baby 81” goes back home. Available at http:// news.bbc.co.uk/2hi/south_asia/4268453.stm. Accessed May 30, 2007.




DOI: https://doi.org/10.5055/ajdm.2010.0019

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