Is your hospital ready to care for pediatric patients in a disaster?

Pediatric Disaster Checklist for Every Hospital

The pediatric population represents a particular challenge in disaster preparedness and planning. Children have unique and often complex physiological, psychosocial, and psychological needs that differ from adults’ and are often magnified during a disaster (National Commission on Children and Disasters, 2010) and unfortunately children are frequently involved when a disaster occurs. As a result, it is essential that hospital disaster policies include and plan for this distinctive and vulnerable population. This tool can be used to help hospital administrators and leadership incorporate essential pediatric considerations into existing hospital disaster policies.

References and Resources

OVERVIEW AND INTRODUCTION

• Hospital Preparedness Programs, Administration for Strategic Preparedness & Response
• Emergency and Disaster Resources, National Library of Medicine
• A National Assessment of Pediatric Readiness of Emergency Departments, AAP, ACEP, ENA
• 2010 National Commission on Children and Disasters Report to the President and Congress, National Commission on Children and Disasters

General Resources

• Children in Disasters: Hospital Guidelines for Pediatric Preparedness, The Centers for Bioterrorism Preparedness Planning Pediatric Task Force, NYC Department of Health Pediatric Disaster Advisory Group, & NYC Department of Health Healthcare Emergency Preparedness Program
• HHS Maternal-Child Health Emergency Planning Toolkit, - US Department of Health Human Services, & Assistant Secretary for Preparedness Response
• Neonatal Disaster Preparedness Toolkit, California Association of Neonatologists
• Pediatric Disaster Preparedness and Response Topical Collection, American Academy of Pediatrics

DOMAIN 1: PEDIATRIC DISASTER CARE COORDINATION

• Increasing Disaster Preparedness in Emergency Nurses: A Quality Improvement Initiative, Journal of Emergency Nursing 
• Nurses’ Perceived Emergency Preparedness Knowledge: An Opportunity for Improvement, American Journal of Disaster Medicine
• Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study. Prehospital and Disaster Medicine, Prehospital Disaster Medicine
• Module 1: The Pediatric Champion, EMSC Innovation and Improvement Center
• Pediatric Readiness in the Emergency Department, Annals of Emergency Medicine
• Children in Disasters: Hospital Guidelines for Pediatric Preparedness, The Centers for Bioterrorism Preparedness Planning Pediatric Task Force, NYC Department of Health Pediatric Disaster Advisory Group, & NYC Department of Health Healthcare Emergency Preparedness Program
• Maternal-Child Health Emergency Planning Toolkit, US Department of Health Human Services, & Assistant Secretary for Preparedness Response 
• Pediatric Disaster Preparedness and Response Topical Collection, American Academy of Pediatrics 
• Performance Measures, Guidance, and Reports, US Department of Health Human Services, & Office of the Assistant Secretary for Preparedness Response.
• Administration and Coordination for the Care of Children, EMSC Innovation and Improvement Center

Neonatal Intensive Care Unit

• Disaster Preparedness in Neonatal Intensive Care Units, AAP Committee on Fetus and Newborn and Disaster Preparedness Advisory Council 
• Neonatal Disaster Preparedness Toolkit, California Association of Neonatologists

DOMAIN 2: REGIONAL COALITION-BUILDING

• Chapter Websites, American Academy of Pediatrics, & Committee on Pediatric Emergency Medicine  
• Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness, US Department of Health Human Services, & Office of the Assistant Secretary for Preparedness 
• Hospital Preparedness Program, Office of the Assistant Secretary for Preparedness Response 
• Pediatric Disaster Preparedness of a Hospital Network in a Large Metropolitan Region, American Journal of Disaster Medicine 
• 2019-2023 Hospital Preparedness Program Performance Measures  Implementation Guide, US Department of Health Human Services, & Assistant Secretary for Preparedness Response
• HHS Maternal-Child Health Emergency Planning Toolkit, US Department of Health Human Services, & Assistant Secretary for Preparedness Response

Interfacility Toolkit

• Interfacility Transfer Toolkit, EMSC Innovation and Improvement Center

Telehealth

• Telehealth Toolkit, EMSC Innovation and Improvement Center
• Telehealth in Pediatric Emergency Medicine, Current Problems in Pediatric and Adolescent Health Care 

DOMAIN 3: PEDIATRIC SURGE CAPACITY

• Pediatric Hospital Surge Capacity in Public Health Emergencies, Agency for Healthcare Research and Quality
• Introduction and Executive Summary: Care of the Critically Ill and Injured During  Pandemics and Disasters: CHEST Consensus Statement, Chest Journal
• Using a Geographic Information System (GIS) to Assess Pediatric Surge Potential After an Earthquake, Disaster Medicine Public Health Preparedness
• Minnesota Pediatric Surge Primer and Template Plan, Minnesota Department of Health. 
• 2010 Report to the President and Congress: Standards and Indicators for Disaster Shelter Care for Children (Appendix E), National Commission on Children and Disasters
• Patient Surge in Disasters: A Hospital Toolkit for Expanding Resources in Emergencies, NYC Department of Health and Mental Hygiene, & Office of Emergency Preparedness and Response 
• Design and Evaluation of a Disaster Preparedness Logistics Tool, American Journal of Disaster Medicine
• Strategic National Stockpile (SNS), Administration for Strategic Preparedness & Response
• Healthcare Coalition Pediatric Surge Annex, US Department of Health Human Services, & Office of the Assistant Secretary for Preparedness and Response
• Pediatric Surge Playbook, Western Regional alliance for Pediatric Emergency Management 

DOMAIN 4: TRIAGE, INFECTION CONTROL, AND DECONTAMINATION

Triage

• 60 Seconds to Survival: Disaster Triage Game, Cicero, MX. 
• JumpSTART Pediatric Triage Algorithm, US Department of Health and Human Services, & Chemical Hazards Emergency Medical Management. 

Decontamination

• Disaster preparedness:  hospital decontamination and the pediatric patient—guidelines for hospitals and emergency planners, Prehospital and Disaster Medicine 
• Principles of Pediatric Decontamination, Clinical Pediatric Emergency Medicine 
• Pediatric Decontamination Checklist, Illinois EMS for Children Program
• Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities, US Department of Homeland Security 

DOMAIN 5: EVACUATION

• Child Life Disaster Relief, Organization website
• Evacuating the Special Needs Population, Federal Emergency Management Agency (FEMA) 
• Preplanning Disaster Triage for Pediatric Hospitals: TRAIN Toolkit, Stanford Children’s Health
• Triage Scoring Systems, Severity of Illness Measures, and Mortality Prediction Models in Pediatric Trauma, Critical Care Medicine

DOMAIN 6: PEDIATRIC PATIENT TRACKING & FAMILY REUNIFICATION

• Family Reunification Following Disasters: A Planning Tool for Health Care Facilities, AAP Disaster Preparedness Advisory Council, Reunification Subcommittee 
• Post-Disaster Reunification of Children: A Nationwide Approach, Federal Emergency Management Agency
• Family Reception Center Plan, Texas Children’s Hospital
• Topic Collection: Family Reunification and Support, The US Department of Health & Human Services, Office of the Assistant Secretary for Preparedness and Response, & Technical Resources, Assistance Center, and Information Exchange

DOMAIN 7: LEGAL AND ETHICAL CONSIDERATIONS

• Understanding Liability Risks and Protections for Pediatric Providers During Disasters, Pediatrics 
• Navigating Legalities in Crisis Standards of Care, Maryland Journal of Health Care Law and Policy 
• Legal Resource Guide, Western Regional Alliance for Pediatric Emergency Management 
• Ethical Framework for Transitions Between Conventional, Contingency, and Crisis Conditions in Pervasive or Catastrophic Public Health Events with Medical Surge Implications, Minnesota Department of Health 
• Post-Disaster Reunification of Children: A Nationwide Approach, Federal Emergency Management Agency

DOMAIN 8: BEHAVIORAL HEALTH 

• Pediatric Disaster Preparedness in the Medical Setting: Integrating Mental Health, American Journal of Disaster Medicine
• Death of a Child in the Emergency Department, American Academy Of Pediatrics Committee on Pediatric Emergency Medicine, American College Of Emergency Physicians Pediatric Emergency Medicine Committee,& Emergency Nurses Association Pediatric Committee
• Pediatric Medical Traumatic Stress Health Care Toolbox, National Child Traumatic Stress 
• Supporting the Grieving Child and Family, Pediatrics 
• PsySTART, Psychological Simple Triage and Rapid Treatment
• The Emotional Impact of Disaster on Children and Families, The Menominee Indian Tribe of Wisconsin
• Disaster Technical Assistance Center Supplemental Research Bulletin. Stronger Together: An In-Depth Look at Selected Community-Level Approaches to Disaster Behavioral Health, Substance Abuse and Mental Health Services Administration. 
• Psychological First Aid (PFA) and Skills for Psychological Recovery (SPR), The National Child Traumatic Stress Network

DOMAIN 9: CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS

• Emergency Information Forms and Emergency Preparedness for Children With Special Health Care Needs, Pediatrics 
• Planning for an Emergency: Strategies for Identifying and Engaging At-Risk Groups. A guidance document for Emergency Managers, Centers for Disease Control and Prevention 
• Be Ready: Tips for Families of Children and Youth with Special Healthcare Needs, EMSC Innovation and Improvement Center
• Disaster and Families of Children with Disabilities:What Every Health Care Provider Needs to Know, EMSC Innovation and Improvement Center
• Evacuating the Special Needs Population, Federal Emergency Management Agency 
• National Care Coordination Standards for Children and Youth with Special Health Care Needs, National Academy for State Health Policy
• Capacity-Building Toolkit for including Aging & Disability Networks in Emergency Planning, National Association of County and City Health Officials, & Association of State and Territorial Health Officials
• Individuals with Disabilities, Federal Emergency Management Agency

DOMAIN 10: EXERCISES, DRILLS, AND TRAINING

• Pediatric Disaster Drills, Advocate Health Care & Advocate Good Shepherd Hospital
• Pediatric Tabletop Exercise Resource Kit and Other Key Resources for Disaster Preparedness, American Academy of Pediatrics
• Hospital-based Disaster Preparedness for Pediatric Patients: How to Design a Realistic Set of Drill Victims, American Journal of Disaster Medicine 
• Training Medical Staff for Pediatric Disaster Victims: A Comparison of Different Teaching Methods, American Journal of Disaster Medicine
• Disaster Management Among Pediatric Surgeons: Preparedness, Training and Involvement, American Journal of Disaster Medicine
• Disaster Drill Exercise Documentation and Management: Are we Drilling to Standard?, Journal of Emergency Nursing
• Emergency Drills and Exercises in Healthcare Organizations: Assessment of Pediatric Population Involvement Using After-action Reports, American Journal of Disaster Medicine
• Addressing the Needs of Children in Disaster Preparedness Exercises 2nd Edition, Illinois Emergency Medical Services for Children Program
• Pediatric Disaster Response & Emergency Preparedness, Texas A&M Engineering Extension Service (TEEX)
• Pediatric Disaster Preparedness Toolkit -Training Resources & Courses, EMSC Innovation and Improvement Center

DOMAIN 11: RECOVERY AND RESILIENCY

• Understanding Youth’s Disaster-Recovery: The Vital Role of People, Places and Activities, International Journal of Disaster Risk Reduction
• National Bereavement Resource Guide, Eluna Network
• The Pediatrician and Disaster Preparedness, Pediatrics
• Multisystem Resilience for Children and Youth in Disaster: Reflections in the Context of COVID-19, Adversity and Resilience Science
• Community Health Resilience Report, National Biodefense Science Board 
• Recovery & Resiliency, National Center for Disaster Preparedness at Columbia Climate School
• Coalition to Support Grieving Students, National Center for School Crisis and Bereavement
• Supporting the Grieving Child and Family, Pediatrics
• Death of a Child in the Emergency Department, Pediatrics