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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