Surge Capacity and Health System Preparedness: Addressing Surge Capacity in a Mass Casualty Event

Slide Presentation by Michael Shannon, M.D.

On October 26, 2004, Dr. Shannon made a presentation in a Web conference entitled Addressing Pediatric and School-based Surge Capacity in a Mass Casualty Event.

This is the text version of Dr. Shannon's slide presentation. Select to access the PowerPoint® Slides (111 KB).

Addressing Pediatric and School-based Surge Capacity in a Mass Casualty Event

Michael Shannon, M.D.
The Center for Biopreparedness
Division of Emergency Medicine
Children's Hospital Boston
Harvard Medical School

Slide 1

Surge Capacity and Children: Key Issues

• Every type of disaster can occur.
• Two scenarios to consider:
  • School is a target.
  • Community disaster while school is in session.

Slide 2

Key Challenges in Consequence Management

• EMS, fire and other public health emergencies.
• Decontamination teams.
• Non-pediatric hospitals emergency departments.
• Hospital response.
• Hospital campus security.
• Mental health response and recovery.
• Mass distribution of antidotes, antibiotics, and vaccines.
• Inclement weather.

Slide 3

The Challenges of Mass Casualty Incidents Involving Children vs. Adults

• Biological—"immature immune system" followed by an arrow pointing right toward the text "greater morbidity/mortality".
• Chemical—difficult to assess, manage and keep warm during decontamination.
• Radiological—significantly increased risk of cancer (e.g., thyroid).

Slide 4

The Challenges of Mass Casualty Incidents Involving Children vs. Adults

• Blast—difficult to stabilize during the "golden hour".
• Burns—greater likelihood of life-threatening fluid loss and susceptibility to infection.

Slide 5

School Crisis Response Manual: Guiding Principles

• Guidelines are desperately needed.
• General templates can be created but no one size fits all.
• The main steps in creating a school plan are:
  • Interviews with principal.
  • Interviews with school nurse.
  • A walk through with the custodian.
  • Include after-school programs.

Slide 6

School Crisis Response Manual: Guiding Principles

• Steps in creating a school plan—cont'd
  • Integrate into the existing plans, e.g., evacuation (fire drills).
  • All plans take weather into account.
  • New plans needed for sheltering-in and lockdown.
  • Drills, including tabletop experiences, are an important part of school readiness.

Slide 7

Role of DMAT in Disasters Involving Children

• Currently limited because there are only 2 in the U.S.
• Compelling need to develop more.
• Existing DMAT teams need ongoing training in pediatric response.

Slide 8

Emergency Department Challenges in Disasters Involving Children

• Adequate numbers of pediatric supplies.
• Pediatric decontamination equipment and protocols.
• Effective response to large numbers of burn victims.
• Assessing non-verbal children.

Slide 9

Additional Emergency Department Challenges in Disasters Involving Children

• Treating children while wearing personal protective equipment.
• Effective systems for identification, tracking, and reunification.
• Use of alternate sites (e.g., schools, neighborhood health centers).

Slide 10

AHRQ-Supported Pediatric Protocols Under Development

• Completed:
  • Training Video: "The Decontamination of Children".
• Near Complete:
  • Pediatric Aspects of Surge Capacity Planning.
  • The Role of DMAT in Pediatric MCIs.
• In Production:
  • Effective School-based Response to Disasters and Other Public Health Emergencies.

Current as of December 2004

Internet Citation:

Addressing Pediatric and School-based Surge Capacity in a Mass Casualty Event. Text version of a slide presentation at a Web conference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/btsurgemass/shannontxt.htm

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