Abstract
Children and adolescents are victims of most terror and natural disaster events.1 Recent examples of this include the day care fire in Mexico in June 2009, claiming 44 lives and producing 30 burn victims requiring intensive long-term treatment. The neonatal ward fire in Romania in August 2010 resulted in the nightmare of multiple burned premature babies. The Institute of Medicine has identified that pediatric disaster preparedness is a specialized area needing inclusion into the standard adult-focused disaster plans.2 As our field develops national burn disaster preparedness procedures,3 special care must be taken to include preparation for the horrific possibility of a mass burn casualty event involving children. The American Burns Association Committee for the Organization and Delivery of Burn Care has identified children as a group that requires special needs in the development of a national burn disaster preparedness program. Elements of pediatric disaster preparedness have been described4,5 and include appropriate personnel trained in pediatric emergency techniques, pharmacology, and perinatology. Specialized supplies and equipment such as appropriately sized lines and tubes (foley catheters, feeding tubes, endotracheal tubes, tracheostomy tubes, chest tubes, etc.), pediatric and neonatal intubation equipment and ventilators, and warming units to include warmed decontamination showers are required. Pharmacists, nutritionists, and critical care personnel need to be familiar with pediatric practice. The issue of parental reunification and family-centered care needs to be addressed. Mental health and counseling has a large and vital role in the outcome of these events.6 The disaster plan must include procedures to identify available pediatric beds. A complete pediatric disaster plan also includes disaster- and venue-specific exercises and training. In a recent report, only 13% of hospitals in Arkansas had pediatric mass casualty protocols, and only 28% of hospitals surveyed had plans that included pediatric-specific issues such as parental reunification.2
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