Critical Concepts for Children in Disasters Identified by Hands-on Professionals: Summary of Issues Demanding Solutions Before the Next One

Abstract

This supplement contains many hands-on experiences of pediatricians and others who cared for children during the Hurricane Katrina disaster. They have all offered significant insightful suggestions to help planners better prepare for care of children during the next disaster. This summary focuses on a few of the key lessons learned. All too often, planners assume that any hospital and any licensed health care provider can care for the full range of pediatric needs, including in times of crisis. Even for those who do recognize that seriously ill or injured children need to be cared for by pediatricians and pediatric subspecialists, it is sometimes assumed that existing hospitals are, in fact, sufficiently staffed and equipped to handle unlimited numbers of such cases. Few planners recognize the limited supply of pediatric hospital beds in their area and, therefore, do not prepare before a disaster for the potential transfer of children to distant facilities as needed, even if it requires consideration of out-of-state hospitals. More study is required to determine when and how adult-oriented providers and facilities can, in fact, care for children. Special protocols and understandings for the care of children in the midst of disasters need to be refined. Surge capacity is exceeded when the number of children requiring inpatient care exceeds the number of beds, staff, and equipment available. Obviously, with Katrina, all of the pediatric beds in Louisiana were overwhelmed, demonstrating the need to plan for care (including evacuation) of existing pediatric inpatients as well as new patients requiring admission within an impacted area. Disaster plans for children should include regional capacity and … Address correspondence to Carden Johnston, MD, FAAP, FRCP, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Ave S, Birmingham, AL 35233. E-mail: cjohnston{at}aap.org