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Pediatric Disaster Preparedness
Recent natural disasters and events of terrorism have generated a recognized need for nation- and community-wide emergency preparedness. As this relates to children, appropriate planning is essential to ensure that they receive the care they need once a disaster – natural or man-made – strikes. When exposed to chemical, radiological, or biological terrorist agents or to the infectious organisms of a public health epidemic, children have different responses than adults because of their size and physiology, and due to their cognitive development, children also have unique psychological vulnerabilities that require special attention. Consequently, the Emergency Medical Services for Children (EMSC) Program encourages its grantees to become actively involved in state and local disaster preparedness planning to be sure that children have access to the right services and support before, during, and after a disaster event.
HEALTHCARE PROVIDER RESOURCES
Emergency Medical Services for Children (EMSC) National Resource Center
American Academy of Child and Adolescent Psychiatry
American Academy of Pediatrics
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Children and Disasters. This section of the American Academy of Pediatrics’ website includes information about disaster preparedness for children, families, health care providers, teachers and others and offers a wide variety of resources including policy statements, planning kits and journal articles. (Accessed September 2008)
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AAP Disaster Preparedness Advisory Council. The American Academy of Pediatrics established the Disaster Preparedness Advisory Council in 2007 to establish a focused effort to develop and implement a strategic action plan for disaster preparedness initiatives; oversee and support disaster preparedness initiatives while working collaboratively with committees and partner organizations; strengthen advocacy efforts; and mobilize a Contact Network. (Accessed September 2008)
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The Pediatrician and Disaster Preparedness. This Policy Statement and related Technical Report of the American Academy of Pediatrics addresses the challenges of dealing with the threat of terrorism, natural disasters, and public health emergencies and considers the role of pediatricians in answering concerns of patients or families, knowing when to recognize signs of possible exposure to a weapon of terror, understanding first-line response to such attacks and participating in disaster planning. (2006)
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Psychosocial Implications of Disaster: A Guide for Pediatricians. This Clinical Report of the American Academy of Pediatrics describes children's responses to disaster situations, risk factors for adverse reactions and strategies that can be taken by pediatricians to lessen the effects of disaster on children. (2005)
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CHILDisaster Network. The Academy has developed a network of pediatric professionals available to accompany organizations responding to disasters on short-term notice. This website describes this endeavor and the application process. (Accessed September 2008)
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The Youngest Victims: Disaster Preparedness to Meet Children’s Needs. This two-page fact sheet presents information for physicians and community leaders concerning the unique medical and mental health needs of children, and ways they must be addressed as related to disasters. (2002)
American Medical Association
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Improving Health System Preparedness for Terrorism and Mass Casualty Events. The American Medical Association (AMA), in partnership with the American Public Health Association (APHA), convened multidisciplinary summit meetings involving medicine, dentistry, nursing, hospital, emergency medical services (EMS), and public health leaders to assess health system preparedness against terrorism and other potential mass casualty events and develop action-oriented recommendations (inclusive of children’s needs and consistent with the Institute of Medicine’s guidance in Emergency Care for Children: Growing Pains, 2006) to improve and sustain health system preparedness. (2007)
American Psychological Association
Association of Maternal and Child Health Programs
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State Emergency Planning and Preparedness Recommendations for Maternal and Child Health Populations. This section of the Association of Maternal and Child Health Programs’ website provides an overview of disaster preparedness and some key concepts that need to be considered such as the possible impact of emergencies on the different maternal and child health (MCH) populations, summarizes the needs state MCH programs have identified, lists current efforts to enhance MCH preparedness efforts, and identifies state accomplishments in integrating the needs of the MCH population into state plans. (Accessed September 2008)
Center for Pediatric Emergency Medicine
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Pediatric Disaster Preparedness: A Resource for Planning, Management and Provision of Out-of-Hospital Emergency Care. This resource, developed by the Center for Pediatric Emergency Medicine on behalf of the EMSC National Resource Center, focuses on the practical and essential elements of pediatric prehospital emergency care in EMS system planning for disasters and terrorism. It is designed for use by EMS agency and system medical directors and administrators, emergency managers, and any other key stakeholders who will be concerned with the functions and activities of EMS care providers during a disaster, terror event, or other public health emergency. (2008)
Children’s Hospital Los Angeles
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Pediatric Disaster Resource and Training Center. The Resource and Training Center’s website provides resources to support hospitals working to ensure that coordinated, effective medical care is delivered to pediatric disaster victims and to inform and assist other hospitals in treating youngsters who arrive at their door in response to a large-scale incident. (Accessed September 2008)
Children’s National Medical Center’s International Center To Heal Our Children
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Handbook of Frequently Asked Questions Following Traumatic Events: Violence, Disasters, and Terrorism. This publication is designed to support schools, children's hospitals, community centers, ambulance services, rural hospitals, EMS services, mental health professionals, and parents with information about how to recognize normal child reactions to stress; recognize and understand the stages of grief in children and adolescents; identify children who need help and are at risk for long-term stress related conditions; and provide guidelines to answer common questions children and adults ask following acts of violence, disasters, and terrorism. A Spanish version is also available. (2002)
Florida Emergency Medical Services for Children (EMSC)
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Guidelines for Pediatric Equipment Inventories in EMS Disaster Response Trailers. Developed by the Florida Emergency Medical Services for Children (EMSC) project, this list offers guidelines for essential pediatric equipment to be stocked in EMS Disaster Response trailers. (2004)
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Hospital Pediatric Equipment Inventories for Disaster Response. Created by the Florida Emergency Medical Services for Children (EMSC) project, this list is a compilation of key pediatric equipment and supplies hospitals should stock to ensure adequate emergency disaster response resources for children. (2004)
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K.I.D. (Kids in Disasters) Kit. A product of the Florida Emergency Medical Services for Children (EMSC) project, the Kit provides child- and family-centered materials addressing disaster triage, the Broselow-Luten principles of color-coding children, tools for responding to incidents involving agents of chemical warfare, and several other aspects of pediatric disaster planning and preparedness – with some materials also available in Spanish. (2007)
Illinois Emergency Medical Services for Children (EMSC)
Kentucky Board of Emergency Medical Services
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Pediatric Terrorism Awareness-Level Training. This online training program is designed to provide education to federal, state and local public safety, law enforcement, emergency response, nurses, emergency medical (including hospital emergency facilities) personnel, agencies, and authorities. (Accessed September 2008)
Minnesota Emergency Medical Services for Children (EMSC)
Missouri Department of Health and Human Services, Emergency Response and Terrorism
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Disaster Communications Guidebook. This guide provides preparedness strategies that improve resilience and foster greater coping skills, for all populations, in a disaster event. By integrating this information into disaster readiness campaigns and programs, organizations can help minimize fear and improve emotional well-being in the face of terrorism or catastrophic disasters. (2006)
National Association of Child Care Resource and Referral Agencies
National Association of Pediatric Nurse Practitioners
National Association of School Nurses
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Disaster Preparedness: School Nurse Role. This Position Statement of the National Association of School Nurses affirms the key role school nurses can play in disaster and emergency preparedness. (2006)
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School Nurse Role in Bioterrorism Emergency Preparedness and Response. A Position Statement of the National Association of School Nurses, this document states that school nurses should be designated and recognized as, and given authority to act as, first responders to mass casualty emergencies, including those resulting from bioterrorist events. (2005)
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Disaster Preparedness Guidelines for School Nurses. This National Association of School Nurses publication provides guidelines to help school nurses understand their role in preparing for disasters and major emergencies. The guidelines are suitable for planning for a variety of emergency and disaster situations. (2007)
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Disaster Preparedness for School Nurses. Originally developed through the Federal Emergency Medical Services for Children (EMSC) Program, this National Association of School Nurses online continuing education course is designed to provide school nurses with the knowledge and skills to prepare for and respond to a school disaster. (Accessed September 2008)
National Center for Disaster Preparedness: Columbia University Mailman School of Public Health
National Children’s Advocacy Center
National Child Traumatic Stress Network
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Psychological First Aid Field Operations Guide, 2nd Edition. The National Child Traumatic Stress Network and the National Center for Post-Traumatic Stress Disorder developed this resource and its accompanying handouts to serve as an evidence-informed approach for assisting children, adolescents, adults and families in the aftermath of disaster and terrorism. (Accessed September 2008)
National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities
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Preparedness Resource Guide. This section of the Center’s website features numerous online resources including publications, newsletters and reports, preparedness issues as they relate to culturally and linguistically diverse communities. (Accessed September 2008)
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National Consensus Statement and Guiding Principles on Emergency Preparedness and Cultural Diversity. The National Consensus Panel on Emergency Preparedness and Cultural Diversity has issued the Nation’s first blueprint for integrating racially and ethnically diverse communities into emergency preparedness. An initiative of the Drexel University School of Public Health’s Center for Health Equality and the U.S. Department of Health and Human Services’ Office of Minority Health, the National Consensus Panel is comprised of national, state and local organizations united to define a unified set of priorities for preparing and responding to culturally diverse communities in public health emergencies. (2008)
PandemicFlu.gov
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Health Care Planning. Health-care providers play a crucial role in the event of a pandemic and planning for pandemic influenza is key. This website of the US Department of Health and Human Services includes checklists, toolkit, and guidelines to assist healthcare providers and service organizations in planning for a pandemic outbreak. (Accessed September 2008)
Tennessee Emergency Medical Services for Children (EMSC)
University of Arkansas, National Center for Rural Law Enforcement
University of New Mexico Health Sciences Center, Division of Pediatric Emergency Medicine
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Virtual School Nurse and EMS Module Series. This online series focuses on school nurse emergency preparedness and uses streaming video technology to provide enhanced learning. Modules available for nurses are approved by the New Mexico Nurse Association, an American Nurses Association nationally accredited approver of nursing continuing education, and include: emergency preparedness program planning; EMS continuum of care; medical response plans; assessment and triage; and emergency care of the airway, spine, and musculosketetal. (2007)
US Department of Education
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Emergency Planning. This section of the US Department of Education’s website provides information that can help school leaders plan for any emergency, including natural disasters, violent incidents and terrorist acts. (Accessed September 2008)
US Department of Health and Human Services, Agency for Healthcare Research and Quality
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Pediatric Terrorism and Disaster Preparedness: A Resource for Pediatricians. This comprehensive practical resource provides hospitals, especially those that do not normally admit children and hospitals that do admit children but do not have Pediatric Intensive Care Services, some useful planning strategies and tools for providing protection, treatment, and acute care for pediatric patients during a disaster. (2006)
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Decontamination of Children: Preparedness and Response for Hospital Emergency Departments. The Agency for Healthcare Research and Quality (AHRQ) has released a 27-minute video that demonstrates for emergency responders and hospital emergency department staff how to safely decontaminate children who have been exposed to hazardous chemicals, including those from a bioterrorist attack. (2005)
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Pediatric Anthrax: Implications for Bioterrorism Preparedness. This report describes a literature search about children and anthrax to describe their clinical course, treatment responses, and the predictors of disease progression and mortality, and to differentiate any requirements specific to children in the case of a terrorist attack utilizing anthrax. (2006)
US Department of Health and Human Services, Assistant Secretary for Preparedness and Response
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Disasters and Emergencies. This section of the US Department of Health and Human Services’ website provides information to healthcare providers and the general public on planning and preparing for and responding to natural and man-made disasters and emergencies. (Accessed September 2008)
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National Disaster Medical System. This website offers information about the Office of the Assistant Secretary for Preparedness and Response’s role related to bioterrorism and other public health emergencies. Specifically highlighted are the efforts of the National Disaster Medical System (NDMS), a federally coordinated system that augments the Nation's medical response capability. (Accessed September 2008)
US Department of Health and Human Services, Centers for Disease Control and Prevention
US Department of Health and Human Services, Food and Drug Administration
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Drug Preparedness and Response to Bioterrorism. To help prepare for possible bioterrorism attacks, the Agency is working to make sure adequate supplies of medicine and vaccines are available to the Nation. This website provides guidance on current information on drug therapy and vaccines, including a section on pediatric counter-terrorism measures. (Accessed September 2008)
US Department of Health and Human Services, Office of the US Surgeon General
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Office of the Civilian Volunteer Medical Reserve Corps. The Office of the Civilian Volunteer Medical Reserve Corps (OCVMRC) is housed in the Office of the US Surgeon General and functions as a clearinghouse for information and best practices to help communities establish, implement, and maintain medical reserve corps units nationwide. (Accessed September 2008)
US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
US Department of Homeland Security
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National Incident Management System (NIMS) Guides, Tools and Templates. The National Incident Management System (NIMS) establishes standardized incident management processes, protocols, and procedures that all responders – federal, state, tribal, and local – will use to coordinate and conduct response actions. (Accessed September 2008)
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National Response Framework. This document presents the guiding principles that enable all response partners to prepare for and provide a unified national response to disasters and emergencies. It establishes a comprehensive, national, all-hazards approach to domestic incident response. (2008)
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Office of Medical Readiness. This section of the US Department of Homeland Security’s website profiles the role of the Office of Medical Readiness, which is charged with promoting the integration of state and local medical response capabilities and assisting the Department in addressing medical first responder requirements to prepare for and respond to catastrophic incidents. (Accessed September 2008)
EXAMPLE PRACTICES
Children’s Hospital Boston
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Center for Biopreparedness. The Center for Biopreparedness, a national Center of Excellence, focuses on biological, chemical or radiation disasters affecting children and their caregivers as well as all pediatric aspects of public health preparedness and consequence management after acts of terrorism and other disasters. The Center works to establish response guidelines for emergency medical responders, schools, neighborhood health centers, parents and hospitals; develop training protocols for Emergency Department physicians and staff; and develop syndromic surveillance and reporting tools to identify significant patterns in emergency cases and catch potential outbreaks early. (Accessed September 2008)
Illinois Emergency Medical Services for Children (EMSC)
Miami Children’s Hospital
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JumpSTART Pediatric Multicasualty Triage Tool. The START rapid triage system is one of the most widely recognized formal triage systems and is built around the premise that rapid primary triage, based on assessment of respirations, perfusion, and mental status (RPM) is effective in maximizing limited resources. In an effort to compose a rapid triage system for children, JumpSTART has taken the same basic RPM approach and created an algorithm modeled after the START system. (1995)
National Association of School Psychologists
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PREPaRE Training Curriculum. The PREPaRE curriculum , developed by the National Association of School Psychologists (NASP), is designed to provide leadership in evidence-based resources and consultation related to school crisis prevention and response. PREPaRE is a model emphasizes that, as members of a school crisis team, school mental health professionals must be involved in the following specific hierarchical and sequential set of activities: prevent, reaffirm, evaluate, provide and respond and examine. (Accessed September 2008)
New York City Department of Health and Mental Hygiene
US Department of Health and Human Services, Centers for Disease Control and Prevention
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The Model Communities Initiative. Through its Terrorism Injuries Information, Dissemination and Exchange (TIIDE) Project, the Centers’ National Center for Injury Prevention and Control (NCIPC), Division of Injury Response (DIR) has identified communities as best practice models of how emergency medical services (EMS) can work with other safety and public health agencies in times of disaster. (Accessed September 2008)
FAMILY AND CAREGIVER RESOURCES
American Academy of Pediatrics
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Family Readiness Kit: Preparing to Handle Disasters, 2nd Edition. This kit is for parents to use at home to help prepare for most kinds of disasters. It includes information on understanding disasters; steps to take to prepare for a disaster involving your family; family disaster supplies list; disaster fact sheets addressing hurricanes, earthquakes, floods, tornadoes, tsunamis, winter storms, and terrorism, and is also available in Spanish. (Accessed September 2008)
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Children and Disasters. This section of the American Academy of Pediatrics’ website includes information about disaster preparedness for children, families, teachers and others and offers a wide variety of resources including planning kits and reference materials. (Accessed September 2008)
American Red Cross
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Masters of Disasters. This online resource is divided into educational areas for teachers and children and includes a family readiness kit, games and other informational resources to assist children in learning how to prepare for disasters. (Accessed September 2008)
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Children and Disasters. This section of the American Red Cross’ website offers resources for families and caregivers relating to disaster preparedness and children including the collaborative American Red Cross and Federal Emergency Management Agency (FEMA) document, Preparing for Disasters. (Accessed September 2008)
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Pediatric Disaster Preparedness Coloring Books. Be Ready 1-2-3 helps children ages 5 to 8 learn about home fires, earthquakes, and winter storms through activities and demonstrations led by "experts" Cool Cat (Home Fires), Ready Rabbit (Winter Storms), and Disaster Dog (Earthquakes). A second coloring book is also available for children ages 3-10. (1993)
Florida Institute for Family Involvement
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Disaster Preparedness for Families of Children with Special Needs. Planning is critical in minimizing the effects of disasters and emergencies. Emergencies or disasters are difficult for most families, but for those with special needs, the ability to manage can become more difficult. This publication, also available in Spanish, includes some resources and links to assist families in preparing and reacting to disasters and emergencies. (Accessed September 2008)
National Association of Child Care Resource and Referral Agencies
NYU Child Study Center
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Bioterrorism: Talking with Kids About Threats They Can’t See. This online resource answers a variety of questions parents might have regarding how to explain bioterrorism to children, including how children might react, what children are most worried about, how to make a family safety plan and how to reassure children and help them deal with their worry and concern. (Accessed September 2008)
PandemicFlu.gov
Texas Department of State Health Services
US Department of Health and Human Services, National Institutes of Health
US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
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Disaster Technical Assistance Center. This section of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) website offers a variety of resources to support parents and caregivers in addressing children’s mental health issues resulting from a disaster experience. (Accessed September 2008)
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Reaction of Children to a Disaster. This fact sheet, which is broken down by age, describes the ways in which children react to a disaster and what adults can do to help. (2003)
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Tips for Talking to Children after a Disaster: A Guide for Parents and Teachers. This booklet explains how children and adolescents may respond to a crisis event. The resource is intended to help parents and teachers be informed, recognize problems and respond appropriately to the needs of children. (2005)
US Department of Homeland Security
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Federal Emergency Management Agency (FEMA) for Kids. This website teaches children how to prepare for disasters and prevent disaster damage. Resources include information on what causes disasters, online educational games and stories (Adventures of Julie and Robbie –The Disaster Twins) as well as materials for parents and teachers. (Accessed September 2008)
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DisasterHelp.gov. This website offers individuals and families resources to assist them in preparing for disasters including natural and man-made events and features preparation publications such as the Federal Emergency Management Agency’s (FEMA), Are You Ready? An In-depth Guide to Citizen Preparedness. (Accessed September 2008)
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Ready.gov. This US Department of Homeland Security website provides individuals and families information through its Ready America campaign, which seeks to help citizens prepare for disasters. Resources available include family emergency materials such as the Just in Case – Family Plan, supply lists and links to state and local entities responsible for disaster preparedness. Listo.Gov is the Spanish language version of the site. (Accessed September 2008)
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Ready Kids. A component of Ready.gov, this interactive website helps children work with their families to prepare for disasters. It includes guidance on how to create a disaster kit and make an emergency plan, and features detailed information on tornados, earthquakes, fire emergencies, flooding, tsunamis, hurricanes and terrorism. (Accessed September 2008)
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Listen, Protect and Connect: Psychological First Aid for Children and Parents. This publication provides information to parents and caregivers on how to address the psychological vulnerabilities of children and youth after they experience a disaster. (2006)
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Helping Children Cope with Disaster. Developed by the Federal Emergency Management Agency (FEMA) and the American Red Cross, this booklet offers parents, caregivers and other adults suggestions on how to help children cope with the effects of disaster, as well as how to be prepared before a disaster strikes. (2004)
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