EIIC: Emergency Medical Services for Children | Innovation and Improvement Center

Pediatric Disaster Preparedness Toolbox

For Professionals

This toolbox features resources specific to pediatric disaster preparedness. Disaster preparedness is built on and dependent upon pediatric emergency systems of care that operate effectively day-to-day. Emergency care providers in both the prehospital and emergency department (ED) settings must have appropriate pediatric equipment and supplies, medical oversight, protocols and guidelines, and training in the care of children. Pediatric capabilities of EDs should be known and verified to facilitate initial transport or timely transfer to appropriate levels of care when needed, and transfer guidelines and agreements should be in place. Additional resources for everyday hospital pediatric readiness can be found at http://www.pediatricreadiness.org.

Health Resources on Children in Disasters and Emergencies. This site is a compendium of resources related to medical and public health issues of children in disasters and emergencies. Links are provided to both journal articles and to other documents and materials that may be useful in preparedness, mitigation, response, and recovery activities. Resources are national or international in scope. (2016)

Checklist of Essential Pediatric Domains and Considerations for Every Hospital’s Disaster Preparedness Policies (also available in an interactive version) Children have unique, often complex physiological, psychosocial, and psychological needs that differ from adults, especially during disaster situations; and unfortunately children are often involved when disasters occur. This Checklist is intended as a tool to help hospital administrators and leadership incorporate essential pediatric considerations into existing hospital disaster policies. (2014)

EMSC Pediatric Disaster Preparedness and Planning Community of Practice Launched in June 2014, the purpose of this Community of Practice (CoP) is to provide a collaborative learning environment for participants to exchange technical information, share experiences and best practices in addressing pediatric disaster planning and preparedness, hear from subject matter experts, and engage in collective problem solving. All CoP webinars are archived for later viewing. (2016)

Essential Pediatric Domains and Considerations for Hospital Disaster Preparedness: Where Do We Begin? This educational event was an in-depth discussion about the Checklist of Essential Pediatric Domains and Considerations for Every Hospital’s Disaster Preparedness Policies and how hospital leadership can use this new tool to incorporate pediatric considerations into existing hospital disaster policies. (April 2015)

Everyday Pediatric Readiness for Extraordinary Events (PowerPoint slides only) This webcast highlighted best practices and lessons learned from the Commonwealth of the Northern Mariana Islands (CNMI) where the threat of a tsunami or typhoon is an everyday reality and where routine and extraordinary often intersect. The CNMI EMSC program discussed successes and challenges in pediatric disaster preparedness and response, including: the EMS systems and resources; interagency collaboration; and community planning, practice, response, and recovery. (April 2014)

National Pediatric Readiness Project: Preparing the Emergency Department to Provide Psychosocial Support to Children and Families in A Disaster This webinar discussed short- and long-term effects of disaster on the psychological functioning, emotional adjustment, health, and developmental trajectory of children; identified key elements in the behavioral health domain essential to the provision of psychosocial support to children and families in the aftermath of disaster; and described practical ways to incorporate behavior health policies and practices into disaster plans and embed them into everyday practice. (October 2015)

ASPR TRACIE ASPR’s Technical Resources, Assistance Center, and Information Exchange (TRACIE) was created to meet the information and technical assistance needs of regional ASPR staff, healthcare coalitions, healthcare entities, healthcare providers, emergency managers, public health practitioners, and others working in disaster medicine, healthcare system preparedness, and public health emergency preparedness. (2016)

JumpSTART Pediatric MCI Triage Tool This tool was designed to help meet the needs of children and responders at disaster/mass casualty scenes. JumpSTART is now widely used for primary pediatric disaster triage in the U.S. and Canada and is gaining popularity around the world. All materials on this website may be downloaded free of charge for educational or protocol purposes. (2012)

2017-2020 Hospital Preparedness Program Performance Measures Implementation Guidance

This guidance document is framed for the primary users—awardees and healthcare coalitions (HCCs)—to foster ease of comprehension, improve information aggregation, and enable faster data collection. The intended audience for this document is any individual responsible for collecting and reporting data on awardee and HCC progress toward meeting the goals of the four capabilities detailed in the 2017-2022 Health Care Preparedness and Response Capabilities.

Clinical Report: Guidance for the Clinician in Rendering Pediatric Care, Supporting the Grieving Child and Family

This clinical report offers practical suggestions on how to talk with grieving children to help them better understand what has happened and its implications and to address any misinformation, misinterpretations, or misconceptions.

Guidelines for Care of Children in the Emergency Department

This policy statement delineates guidelines and the resources necessary to prepare hospital emergency departments to serve pediatric patients. Adoption of these guidelines should facilitate the delivery of emergency care for children of all ages and, when appropriate, timely transfer to a facility with specialized pediatric services.

AAP Pediatric Preparedness Resource Kit

This kit allows for pediatricians, public health leaders, and other pediatric care providers to assess what is already happening in their community or state, and help determine what needs to be done before an emergency or disaster.

Promoting Adjustment and Helping Children Cope After Disaster and Crisis

This page contains multiple resources from AAP how to help all children during or immediately following a disaster by providing psychological first aid.

Homeland Security Exercise and Evaluation Program (HSEEP)

HSEEP provides a set of guiding principles for exercise programs, as well as a common approach to exercise program management, design and development, conduct, evaluation, and improvement planning.

CDC Public Health Grand Rounds: Addressing Preparedness Challenges for Children in Public Health Emergencies

This session of the Public Health Grand Rounds discusses strategies to address the unique vulnerabilities of children in every stage of emergency planning. It highlights the strong progress that has been made in pediatric disaster readiness as well as the collaboration that is still needed between public health professionals and pediatric care providers to improve the outcomes for children during emergencies.

EMSC Hospital Pediatric Preparedness Checklist

This checklist is designed to help hospitals identify their current level of pediatric preparedness and recognize additional opportunities for improvement. This checklist is also used during EMSC Pediatric Facility Recognition Site Surveys.

Pediatric Surge Planning Train the Trainer

The purpose of this course is to help prepare general acute care facilities to the challenges of pediatrics. The course is designed for a target audience that has knowledge of disaster planning. It is based on in-depth research of best practices and other existing curricula to bring best practice. The goal of this curriculum is to prepare hospitals and clinics have the tools to respond more effectively in a disaster which involves a surge of child victims.

Preparedness Checklist for Pediatric Practices

This checklist empowers pediatricians to be ready to provide care for their patients when normal operations are disrupted due to emergency events by having fundamental supplies to ensure self-sufficiency for at least 72 hours.

CDC Planning Resources for Pediatric Offices and Hospitals

This page contains resources that pediatric healthcare providers can use to plan for emergencies, including tool kits for pandemic flu, communication tools, and disaster plan templates.

Post-Disaster Reunification of Children: A Nationwide Approach

Reunifying unaccompanied minors and separated or missing children with their parents or legal guardians in the aftermath of a disaster is a priority. This document is designed to support overall reunification processes and procedures by establishing a fundamental baseline, assisting in identifying the roles of lead and supporting agencies and organizations, and serving as a tool to enhance reunification elements of existent emergency preparedness plans and/or help guide the development of new all-hazards reunification plan elements and procedures.

“Taking Care of Kids: Are You Prepared for an Emergency?” (Order at no-cost)

This Institute of Medicine's poster provides resources to assist parents, child care providers, schools, and pediatricians in preparing for, responding to, and recovering from disasters.

Office of Human Services Emergency Preparedness and Response, Administration of Children and Families

This site contains resources from OHSEPR, which promotes resilience for individuals, families, and communities impacted by disasters & public health emergencies by providing expertise in human services policy, planning, operations, and partnerships.

Health Resources on Children in Disasters and Emergencies from the Disaster Information Management Research Center

This site is a compendium of resources related to medical and public health issues of children in disasters and emergencies. Links are provided to both journal articles and to other documents and materials that may be useful in preparedness, mitigation, response and recovery activities. The resources target health providers, emergency and community planners, and others in the disaster workforce who work with or on behalf of children.

Coordinating Pediatric Medical Care During An Influenza Pandemic: Hospital Workbook

This workbook is intended to assist hospitals with coordinating medical care for pediatric influenza-like illness (ILI) across their community.  This tool can be adapted for use during pandemic spread of a novel influenza virus as well as H1N1.  It is presented in two sections, identified by type of hospital focus: Children’s Hospital Focus and General Hospital Focus. 

Pediatric Technical Resources from TRACIE

This Topic Collection contains comprehensive list of resources relevant to general pediatric disaster planning. The page also contains several additional Topic Collections with pediatric sub-categories.

Disaster Lit: Resource Guide for Disaster Medicine and Public Health

This is a database of links to disaster medicine and public health documents available on the Internet at no cost. Documents include expert guidelines, research reports, conference proceedings, training classes, fact sheets, websites, databases, and similar materials selected from over 700 organizations for a professional audience.

The National Child Traumatic Stress Network’s resources on disasters

This page contains multiple resources on providing psychological first aid to children during and following emergencies.

The Psychological First Aid Field Manual, National Child Traumatic Stress Network and the National Center for PTSD

This is an evidence-informed approach for assisting children, adolescents, adults, and families in the aftermath of disaster and terrorism.

 

For Families and Caregivers

HealthyChildren.Org

This webpage provides a variety of information and resources to help families prepare for and respond to a disaster. The site includes advice on how to talk with children about disasters, common child behaviors and special needs to consider after a disaster, and creating a family disaster plan. Health Children.org is also available in Spanish. (2015)

Emergency Information Form for Children with Special Needs

This is a printable document on which to keep all current health information with the child to inform emergency medical care providers. The form includes patient and guardian contact information, primary care and specialty physicians, medical history, baseline physical findings and vital signs, medications, allergies, and more. Although it was originally designed for children with special healthcare needs, the form can be a very useful addition to your disaster preparedness kit. (2009)

Pillowcase Project

The Pillowcase Project teaches children coping skills to help them deal with an emergency situation and also offers tips and tools to help them prepare for emergencies. (2014)

Emergency Information Form for People with Special Needs (English and Spanish)

This form was adapted from the Emergency Information Form for Children with Special Needs. It is intended for individuals of any age with special healthcare needs. This is a bi-lingual form in both English and Spanish. (2009)

Health Resources on Children in Disasters and Emergencies

A wealth of information for families, non-medical care providers, schools, teachers, and others can be found in the Special Topics section. Click on Documents and Resources under the following headings: Children with Disabilities; School and Care Providers; Resilience; Sheltering; and Patient Tracking and Family Reunification. (2014)

Disasters and Emergencies: Keeping Children and Youth Safe

This site provides helpful tools and resources to help families of children with special healthcare needs prepare for disasters and emergencies at home, school, and other places. (2015)

Get Ready. Get Safe.

his initiative is designed to help communities prepare to protect and care for children in times of crisis. The program helps generate child-focused emergency plans, provide emergency training, and ensure emergency resources are in place before crisis strikes. (2015)

Ready Wrigley activities books in English and in Spanish

This contains multiple activity books for children and families that the Centers for Disease Control and Prevention has created to offer parents and educators an interactive way to talk to kids about to prepare for multiple types of disasters.

Ready.gov and Ready.gov for Kids

Those sites contains a wealth of resources for children, parents, and educators that can help family engage in disaster preparedness activities and stay informed.

Childhood Disaster-Related Resources for Children and Families from the Administration of Children and Families

This page contains a wealth of resources (fact sheets, guides, family tools, and activities for young children) that can families prepare, respond to, and recover from disasters.

Prep Rally Family Guide, Prep Rally Child Guide, and Prep Rally Playbook

This is a fun, exciting, and engaging emergency preparedness program for children grades K-5. Covering the basics of recognizing risks, planning ahead, gathering supplies and what to do during a disaster, the Prep Rally utilizes engaging games and activities to bring concepts to life. Best of all, the curriculum is flexible, meaning you can choose the content and activities that best meet the needs of your program and community.

 

Training Resources and Courses

Pediatric Education in Disasters Manual

This is a manual for a 10-module training program that covers issues fundamental to the care of children involved in disasters. The Course structure comprises the delivery of lectures and then, the division of trainees in small workshops to develop hands-on activities, such as resolution of different scenarios and discussion of cases.

Tracking and Reunification of Children in Disasters: A Lesson and Reference for Health Professionals

The National Center for Disaster Medicine and Public Health produced this pediatric online lesson on responding to an unaccompanied child in a disaster. During this lesson, learners will absorb core material and apply their knowledge in three case studies.

Radiation Issues in Children: Knowledge Check, Primer, & Case-Based Activity

This course discusses the unique needs of pediatric patients during and after exposure to radiation. This primer is targeted to healthcare providers who may be responsible for the medical assessment and management of pediatric patients affected by a radiation disaster, particularly a nuclear detonation.

Psychosocial Impacts of Disasters on Children

This course addresses the unique psychosocial needs of children in disasters. It is geared towards all health professionals. The lesson includes "In the Field", which provide examples of how healthcare practitioners applied concepts related to the psychosocial welfare of children after an event.

Just In Time Disaster Training - Preparing a Disaster Plan - Child Care Facilities

Just In Time Disaster Training - Church Nursery Emergency Response Planning

Just In Time Disaster Training - Cleaning and Disinfecting in the School Environment

Just In Time Disaster Training - Dangers of Contaminated Dirt in Playgrounds

Just In Time Disaster Training - Head Start Program - Emergency Planning

Just In Time Disaster Training - Isolating a Sick Child in a Child Care Facility

Just In Time Disaster Training - School Lockdown

Just In Time Disaster Training - Search and Rescue for Teachers - Finding the Victims

Just In Time Disaster Training - Triage for Teachers - Sorting the Victims

Just In Time Disaster Training - Reunification - Reuniting Students and Parents Following an Emergency

Just In Time Disaster Training - School Active Shooter Response

Pediatric Disaster Response And Emergency Preparedness Courses

IS-362.A: Multi-Hazard Emergency Planning for Schools

IS-366.A: Planning for the Needs of Children in Disasters

IS-36: Multihazard Planning for Childcare

 

Articles and Reports

Clinical Report Providing Psychosocial Support to Children and Families in the Aftermath of Disasters and Crises

This clinical report provides pediatricians with practical suggestions on how to identify common adjustment difficulties in children in the aftermath of a disaster and to promote effective coping strategies to mitigate the impact of the disaster as well as any associated bereavement and secondary stressors.

National Commission on Children and Disasters 2010 Report to the President and Congress

The President and Congress charged the National Commission on Children and Disasters with carrying out the first-ever comprehensive review of Federal disaster-related laws, regulations, programs, and policies to assess their responsiveness to the needs of children and make recommendations to close critical gaps.

Pediatric Hospital Surge Capacity in Public Health Emergencies

This review provides recommendations for clinicians and hospital administrators to develop unique responses to mass casualty events involving pediatric patients and addresses consequence management after a public health emergency, such as pandemic influenza.

Ensuring the Health of Children in Disasters, Policy Statement

This is a policy statement from the American Academy of Pediatrics on ensuring the health and well-being of children in disasters.

2012-2013 Report of the Children’s HHS Interagency Leadership on Disasters (CHILD) Working Group: Update on Departmental Activities and Areas for Future Consideration

This report describes the progress HHS has made since 2011 and highlights three new focus areas (pregnant and breastfeeding women and newborns, children at heightened risk, and interdepartmental and non-governmental organization collaboration).

National Preparedness Efforts to Address the Medical Needs of Children in a Chemical, Biological, Radiological, or Nuclear Incident

This report from GAO examines (1) the percentage of CBRN medical countermeasures in the SNS that are approved for pediatric use; (2) the challenges HHS faces in developing and acquiring CBRN medical countermeasures for the pediatric population, and the steps it is taking to address them; and (3) the ways that HHS has addressed the dispensing of pediatric medical countermeasures in its emergency response plans and guidance, and ways that state and local governments have addressed this issue.

Medical Countermeasures for Children in Public Health Emergencies, Disasters, or Terrorism, Policy Statement

This policy statement provides recommendations to close the remaining gaps for the development and use of MCMs in children during public health emergencies or disasters.

Preparedness, Response, and Recovery Considerations for Children and Families, Workshop Summary

A summary from the National Academy of Medicine on the workshop on disaster considerations for children.

Curriculum Recommendations for Disaster Health Professionals: The Pediatric Population

The disaster health core competencies were developed through an ongoing disaster health curriculum recommendations project based on the article, "Core Competencies for Disaster Medicine and Public Health." in Disaster Medicine and Public Health Preparedness. It identifies 11 core competencies for all potential Emergency Support Function #8 (ESF-8) health system responders.

Developing Pediatric Emergency Preparedness Performance Measures

This article offers recommendations for government agencies at the federal, regional, and local levels, public health departments, and health care institutions to aid in the development of pediatric emergency management performance measures.

Joint Policy Statement—Guidelines for Care of Children in the Emergency Department, American Academy of Pediatrics, Committee on Pediatric Emergency Medicine, American College of Emergency Physicians, Pediatric Committee, Emergency Nurses Association Pediatric Committee

Pediatric Aspects of Hospital Preparedness

This article emphasizes key emergency response aspects of hospital preparedness for disasters involving children, in particular (1) hospital-based incident command, (2) strategies for operational continuity, (3) pediatric principles of surge capacity, (4) development of decontamination protocols, (5) infection control, (6) sheltering in place, and (7) evacuation strategies.

Unaccounted For: A National Report Card on Protecting Children in Disasters

This sixth annual state-by-state assessment conducted by Save the Children looks at preparedness and safety standards for children in child care facilities and schools in the U.S. This year, the organization gives an ‘unsatisfactory’ mark to the country for gaps in preparedness that are putting children at risk.

Still at Risk: U.S. Children 10 Years After Hurricane Katrina 2015, National Report Card on Protecting Children in Disasters

This report by Save the Children represents the first formal review of these recommendations. In each key area, the report provides a snapshot of progress to date – and gaps that remain – in meeting these recommendations.

 

Example Practices

District of Columbia EMSC Program

In 2015, the District of Columbia (DC) EMSC Program worked with Children’s National Health System and the DC Department of Health to establish the nation’s first Pediatric Medical Reserve Corps (PMRC). A national network of nearly 1,000 MRC organizations has been developed across the country, however, until now, none has focused solely on the specific care needs of children. The mission of the DC-PMRC is to provide pediatric support services to the DC community in preparation for, response to, and recovery from disaster, pandemic, special events, and mass-casualty events involving children and families. The primary goals are to identify, organize, and train a multi-disciplinary team of community volunteers specializing in all-hazards pediatric disaster preparedness, response, and recovery. (2015)

Illinois EMSC Program

Since the 1990s, the Illinois EMSC Program has included disaster preparedness among its core mission areas. Beginning in 1998, the Illinois Department of Health (IDPH) initiated a Pediatric Facility Recognition program to formally recognize hospitals for their ED preparedness. This program requires hospitals to comply with defined pediatric standards and undergo a site visit every three to four years. In 2002, the Pediatric Facility Recognition program expanded to include Pediatric Critical Care preparedness in hospitals.

In 2004, IDPH/EMSC added another component to its Pediatric Facility Recognition program and began to review hospital disaster plans during the site visits. This provides an opportunity during the site survey process to identify any areas of need and offer recommendations on incorporating children into hospital disaster plans. These hospital disaster plan reviews, which have been conducted throughout the state, have been highly assistive in identifying a number of common areas of need such as:

  • Decontamination process for infants/small children
  • Pediatric surge capacity
  • Identification process for unaccompanied children
  • Development of a designated holding area for children pending discharge/reunification
  • Reunification process for children with their parents/designated caretakers
  • Addressing the needs of children with special health care needs

Illinois EMSC also maintains a webpage on pediatric disaster preparedness that contains links to a wide variety of useful resources and tools including:

  • A Pediatric Disaster Preparedness Checklist for Hospitals;
  • Information on the Illinois Medical Emergency Response Pediatric Specialty Team;
  • Specifics on the activities of the Illinois Terrorism Task Force’s Bioterrorism Workgroup
  • The Pediatric Preparedness newsletter; and
  • A list of web-based disaster preparedness resources. (Accessed January 2016)

 

Websites

Disaster Information Management Research Center

National Center for Disaster Medicine and Public Health

American Academy of Pediatrics Children & Disasters

National Pediatric Disaster Coalition

Children and Disasters (AAP)

Children and Disasters (FEMA)

The National Association of State EMS Officials

National Association of Emergency Medical Technicians

National Emergency Management Association

National Association of EMS Physicians

National Association of EMS Educators

Emergency Nurses Association

Pediatric Emergency Care Applied Research Network

 

 

Contact information

AAP Chapter Contacts for Disaster Preparedness

AAP Disaster Preparedness Advisory Council

EMSC Grantee Program State and Territorial Contacts

ASPR Regional Emergency Coordinators