Guidelines For Preparedness Research Articles

Pandemic preparedness needs for children with rare diseases and their families: A perspective of COVID-19 experiences

People living with rare diseases had a high risk of negative health outcomes due to COVID-19. Pandemic preparedness will ensure best practice procedures and optimal outcomes during future pandemic events. This paper sought to understand the needs of children with rare diseases during the COVID-19 pandemic to inform preparation for future pandemic and disaster events. First, impacts and outcomes from the COVID-19 pandemic on people living with rare disease were identified in the literature. The literature demonstrated that the COVID-19 pandemic had significant and multiple impacts on people with rare diseases. Second, a qualitative descriptive study was conducted, involving members of 17 families with a child with a rare neuromuscular disorder in 2021, to explore COVID-19 pandemic experiences. Qualitative data coded to Bronfenbrenner’s socio-ecological systems model and described impacts on the child’s physical (e.g., respiratory infections), mental (e.g., anxiety), and social (e.g., maintaining connections) health and wellbeing. Families reported resilience and risk factors in their interactions with health and therapy services, and education. Families valued diseases specific information and heightened awareness of infection control across the community. Third, public health guidelines for emergency preparedness were examined to inform recommendations for pandemic and disaster preparedness for people living with rare diseases. Guided by the literature, qualitative data and disaster management frameworks, recommendations that aim to prevent diagnostic delay, optimise coordination of health and social supports, improve education, planning and training, and maintain research and development were identified. The importance of pandemic preparedness for children with rare diseases cannot be understated. Risk and resilience factors in the context of highly individual requirements inform lessons for children living with rare diseases. This study informs future policy and procedure preparation for future pandemic events and other disasters to optimise healthcare of children with rare diseases.

SG-APSIC1062: The role of active surveillance in the primary-care setting during a pandemic in Singapore

Objectives: In response to the COVID-19 pandemic, primary care swiftly transformed and re-established patient flow in clinics to red, orange, and green zones based on a set of screening criteria. To further manage the influx of suspected COVID-19 patients and their needs safely, a list of surveillance audit criteria was developed to ensure good infection control standards. Methods: The infection control team prepared the surveillance audit criteria based on recommended CDC/WHO guidelines for pandemic preparedness. These criteria were contextualized to the primary-care polyclinic setting. The surveillance audit criteria were grouped according to their category: screening, triage, early recognition and source control, inventory management of personal protective equipment (PPE), infection control measures in the red zone, precautionary measures during collection of nasopharyngeal swabs and environmental cleaning and disinfection for premises in the red, orange, and green zones, respectively. The infection control liaison nurses in each polyclinic were trained to use the checklist to ensure consistency in interpretation of the criteria. Results: Surveillance audits were conducted biweekly in the first 3 months then monthly once the compliance rate was steady at 90%–100% for all categories. The overall average compliance rate since commencing in March 2020 for all polyclinics was sustained at 90%–100%. Common findings included inappropriate use of PPE (eg, self-contamination during removal of gown or wrong sequence of doffing), inadequate ventilation, and inadequate cleaning processes. All findings were corrected immediately, and staff education was provided. Conclusions: Primary care plays an important role during a pandemic. It is essential that both patients and healthcare workers in the primary care setting are protected from infection risk during a pandemic. Having a good surveillance audit process helps ensure that primary care services can continue for the general population. Surveillance is an essential component of the health system’s response to a pandemic.

Prehospital Preparedness for Major Incidents in Sweden: A National Survey with Focus on Mass-Casualty Incidents.

Major incidents (MIs) put great demands on the medical response to effectively organize and redistribute resources and personnel, in prehospital care as well as hospital care, and coordinating functions. Studies indicate that regular training and well-established contingency plans are vital for the medical response to MIs. Previous assessments have concluded that Swedish disaster preparedness requires improved organization and coordination. There is currently no method to easily follow-up the preparedness work of the prehospital medical response organizations for MIs in Sweden. The aim of the study was to assess qualifications and training requirements for central individual roles, to examine frequency and focus of training and simulation, as well as to examine current regional routines for MIs in Sweden. The aim was also to identify, to evaluate, and to investigate areas for improvement in prehospital health care preparedness for MIs in Sweden. Descriptive comparative study of Sweden's prehospital organization, planning, education, and training for MIs through a web-based survey sent to all 21 regions in Sweden. The survey included 64 questions and was based on national legislation and guidelines for preparedness and previous investigations of real MIs. A total of 37 answers to the survey were collected representing 17/21 regions (80.9%) from which Regional Management Individuals (RMIs) were selected from 15 regions and used as representative primary responses. The initial routines regarding alarm and establishment of management functions were mainly in-line with national guidelines. Staffing and qualification requirements for certain leadership roles differed substantially between regions. The requirements for the health care staff's knowledge of the contingency plan were generally low and routines for follow-up were often lacking. The frequency of exercises in certain areas were deficient. The results of the study showed several potential areas for improvement within the prehospital emergency medical preparedness for MIs in Sweden. Methodology and adherence of national guidelines for medical response preparedness differ between regions in Sweden, which motivates recurring assessments. It is possible to use a well-prepared questionnaire study to follow-up and to examine parts of the regional prehospital preparedness work and organization for MIs.

Perception of Global Participants of ITEC Nations on Country's Preparedness and Response to COVID-19 Pandemic.

BackgroundThe Coronavirus disease 2019 (COVID-19) pandemic has exposed the public health preparedness and response system across the world. The current study was conducted to gauge the perception of public health professionals of Indian Technical and Economic Cooperation (ITEC) countries regarding the preparedness and responses of their countries in mitigating the COVID-19 pandemic.MethodologyThree capacity-building programs, namely “Managing COVID-19 Pandemic–Experience and Best practices of India” were conducted by PGIMER, Chandigarh, for public health professionals from ITEC countries from April to May 2021 in which 97 participants from 13 countries have participated. The tools used in the study were adapted from WHO's COVID-19 Strategic Preparedness and Response (SPRP), Monitoring and Evaluation Framework, interim guidelines for Critical preparedness, readiness and response actions for COVID-19, and a strategic framework for emergency preparedness, and finalized using Delphi technique. The overall preparedness of managing COVID-19 was rated using five-point Likert scale, whereas the overall score for the country in combating the COVID-19 pandemic was assessed using 10 point scale.ResultsWe found that the perception of public health professionals to government response regarding COVID-19 for fostering improvement on COVID-19 situation was “moderate” with respect to transmission and surveillance mechanism, uniform reporting mechanism, and availability of adequate personal protective equipment (PPE) for health workers. However, the participants rated government response as “poor” in the availability of multisectoral national operational plan, human resource capacity, availability of trained rapid response team (RRT), preparedness in prevention and clinical management, training of healthcare workers, communication and community engagement strategies, facilities to test samples of patients, and transparent governance and administration.ConclusionA poor level of preparedness of countries in diverse domains of managing the COVID-19 pandemic was observed. As the global threat of COVID-19 is still looming, great efforts on building a robust preparedness and response system for COVID-19 and similar pandemics are urgently required.

A strategic response map for cascading pandemics: Lessons learned from the response to COVID-19 in the Republic of Korea

COVID 19 is a still on-going fatal risk that affects the whole world. COVID-19 pandemic has been characterized as a systemic risk. Accordingly, this paper aims to identify the features of systemic risk of COVID-19 and draw policy implications for effective response. For this, we traced the COVID-19 related risk in Korea from January 2020 to August 2021 by utilizing the official data of the Korea Disease Control and Prevention Agency. Analyzing the relationship between anticipated, emerging, amplified, and lingering risk and response measure through actual data, it was revealed that the risk flow model for cascading risk proposed by the author can be readily applied. In addition, through the analysis of actual response measures against the risks for 1 year and 8 months, the authors proposed a strategic response map against cascading pandemics. Five policy implication derived through this study can be extended for identifying strategic approach against cascading pandemics and for developing guidelines for effective preparedness, risk reduction, and resilience building.

Advances in Epidemic Control Laws COVID-19 Pandemic in India: A Medico-Legal Analysis

This paper deals with the efficacy of the Epidemic Diseases Act, 1897 and Epidemic Diseases AmendmentAct, 1937 in the context of Covid-19 pandemic. The colonial mould of epidemic control laws reviewedthe World Health Organization (WHO) legal guidelines for disease preparedness and response. The publichealth strategies of epidemic-pandemic control need juristic innovation, and blanket application of Britishenactment fall short of the expectation of the right based approach health and equity. The enforcement ofthe Epidemic Diseases Act, 1897 during dengue, swine flu, influenza and COVID-19 criticized by the Indianmedico-legal community in India. The emerging discourse can be tailor-made to suit the magnitude of theCovid-19 and pandemics needs a careful analysis. Though the WHO Revision of the International HealthRegulations, 2005 offers new paradigm the Indian government resort to the Epidemic Diseases AmendmentOrdinance, 2020 needs a critical appraisal in COVID-19 pandemic in India.

Assessing the preparedness of hospitals facing disasters using the rough set theory: guidelines for more preparedness to cope with the COVID-19

Disasters are severe disruptions occurring at a specific time, causing widespread human, material, economic or environmental loss that exceeds the affected society or community's ability to endure using its resources. The occurrence of pandemics like COVID-19 demonstrates a lack of proper preparation in hospitals. This study aims to evaluate hospitals' operational readiness levels in disaster management emphasizing the admission, care, and treatment of COVID-19 patients. The article proposes a framework for preparedness of hospitals and establishes a new approach based on the rough set theory to evaluate the preparedness of the referral hospitals infected byCOVID-19. The concept of the upper and lower control limits (UCL and LCL) is used to define preparedness classes. This approach is applied for a case study of 25 hospitals in Tehran, one of Asia's largest cities with a population near 20 million people. Finally, some proper rules areextracted and analysed to determine the preparedness level of hospitals. Moreover, ten suitable rules are introduced which highlight the necessities to get allocated to the highest preparedness class. Finally, the most critical indicators that have the most decisive role in determining the level of functional preparedness in hospitals are suggested .

Evacuation after a nuclear accident: Critical reviews of past nuclear accidents and proposal for future planning

Standards and guidelines for preparedness and response in the case of a nuclear accident cover radiation protection, health management and communication with affected populations. Decision makers use these recommendations to decide on measures that protect people residing around a nuclear power plant that suffers an accident from radiation exposure; for example, sheltering, evacuation and relocation. While technological and radiological criteria exist for these protective measures, studies on past radiological and nuclear emergencies have shown that evacuation and relocation result in serious health effects; this needs to be considered in accident preparedness and responses in the future. Within the framework of the Nuclear Emergency Situations Improvement of Medical and Health Surveillance (SHAMISEN) (Ohba et al., 2020), a critical review of recommendations and experiences of previous major nuclear accidents was conducted, and the current paper focuses on the lessons learned about evacuation and relocation. We reviewed the contents of official documents and literature relating to the evacuation and relocation of residents, and to the evacuation of medical and other facilities in the three largest nuclear accidents to date: the Three Mile Island accident, Chernobyl accident, and Fukushima accident. We developed recommendations classified into the preparedness phase, early and intermediate phases, and recovery phase after an accident. In the cases of Three Mile Island and Fukushima, the evacuation area was set at 8–10 km from the nuclear power plant in the disaster prevention plan, and emergency responses, such as information provision and evacuation, had been developed only in this area. When the Fukushima accident occurred, evacuation beyond this area was urgently planned or instructed, resulting in marked confusion, such as forced multiple evacuations and relocations for long periods. Furthermore, information was lacking, and personal protective measures such as respiratory protection and iodine prophylaxis were not applied to evacuees. In hospital and facility evacuation, it became more difficult to implement evacuation owing to a lack of advance planning and support in the event of the accident. In Fukushima, more than 60 people in hospitals and nursing care facilities died during or soon after evacuation. In long-term relocation, in addition to continuing adverse mental effects, there were health effects relating to relocation, such as lifestyle-related disease. The return of residents to the evacuation area required many issues, such as a delayed recovery of the living environment, to be overcome in addition to measures to reduce the effects of radiation. Recommendations for evacuation in the SHAMISEN framework were developed (SHAMISEN Consortium, 2017; Liutsko et al., 2020) from these lessons of previous accidents.

COVID-19 in pastoral contexts in the greater Horn of Africa: Implications and recommendations

COVID-19 is a global pandemic that continues to spread around the world, including to Africa where cases are steadily increasing. The African Centres for Disease Control and Prevention is leading the pandemic response in Africa, with direction from the World Health Organization guidelines for critical preparedness, readiness, and response actions. These are written for national governments, lacking nuance for population and local differences. In the greater Horn of Africa, conditions unique to pastoralists such as inherent mobility and limited health and service infrastructure will influence the dynamics of COVID-19. In this paper, we present a One Health approach to the pandemic, consisting of interdisciplinary and intersectoral collaboration focused on the determinants of health and health outcomes amongst pastoralists. Our contextualized public health strategy includes community One Health teams and suggestions for where to implement targeted public health measures. We also analyse the interaction of COVID-19 impacts, including those caused directly by the disease and those that result from control efforts, with ongoing shocks and vulnerabilities in the region (e.g. desert locusts, livestock disease outbreaks, floods, conflict, and development displacement). We give recommendations on how to prepare for and respond to the COVID-19 pandemic and its secondary impacts on pastoral areas. Given that the full impact of COVID-19 on pastoral areas is unknown currently, our health recommendations focus on disease prevention and understanding disease epidemiology. We emphasize targeting pastoral toponymies with public health measures to secure market access and mobility while combating the direct health impacts of COVID-19. A contextualized approach for the COVID-19 public health response in pastoral areas in the Greater Horn of Africa, including how the pandemic will interact with existing shocks and vulnerabilities, is required for an effective response, while protecting pastoral livelihoods and food, income, and nutrition security.

Distribution of cold wave mortalities over India: 1978–2014

The present study explores the spatial and temporal pattern of cold wave related mortalities over India. The data for this study has been obtained from the annual reports pertaining to ‘Disastrous Weather Events’ published by India Meteorological Department, Pune for 37-years (1978–2014). The analysis reveals that a total of 8520 mortalities have been caused by 606 cold wave events, with an average of 230 mortalities per year. Only two states i.e. Bihar (44%) and Uttar Pradesh (31%) account for approximately 75% of total cold waves mortalities, while eleven states namely, Arunachal Pradesh, Assam, Goa, Karnataka, Kerala, Manipur, Mizoram, Nagaland, Sikkim, Tamil Nadu and Tripura have never experienced cold wave events and mortalities. Interestingly, each cold wave event has caused approximately 43 mortalities alone in Bihar state. Furthermore, mortality (standardized by population) and density rates (standardized by area) in India have been observed to be 0.24 and 2.65, respectively. In temporal terms, cold wave events and mortalities have shown large interannual variations without any significant increasing or decreasing trend. Most of the cold wave events and mortalities have been observed in January and December months. Males have been found to be more severely affected by the cold waves than females and children. Overall, the results of this research may provide an understanding to develop effective disaster management guidelines for temperature extremes safety and preparedness.

Home is not always a haven: The domestic violence crisis amid the COVID-19 pandemic.

The novel coronavirus (SARS-CoV-2) and the associated disease it causes, COVID-19, have caused unprecedented social disruption. Due to sweeping stay-at-home orders across the United States and internationally, many victims and survivors of domestic violence (DV), now forced to be isolated with their abusers, run the risk of new or escalating violence. Numerous advocates, organizations, and service centers anticipated this: Upticks in domestic violence were reported in many regions soon after stay-at-home directives were announced. In this commentary, we delineate some of the recent events leading up to the reported spike in DV; review literature on previously documented disaster-related DV surges; and discuss some of the unique challenges, dilemmas, and risks victims and survivors face during this pandemic. We conclude with recommendations to allocate resources to DV front-liners and utilize existing DV guidelines for disaster preparedness, response, and recovery. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Covid-19 preparedness for Orthopaedic practice in public health care system

The impact of COVID – 19 has a challenge to balance the work of combating the virus on one hand and continuing to treat the routine non-covid problems on the other hand. Apart from trauma and other emergencies which require immediate surgery, there are a lot of acute and chronic painful conditions along with post-operative follow up cases which cannot be postponed from orthopaedic consultation for a long time. Universal guidelines for COVID-19 preparedness stands good for both private and public health care systems, but addressing social distancing, personal hygiene and health awareness among patients attending public hospitals pose a great challenge. Due to the huge patient load in public hospitals, compared to private hospitals, these government run institutions are particularly at risk of becoming a hotspot for virus transmission if adequate precautions are not taken. In this article, we discuss feasible cost-effective strategies against COVID transmission to continue treating orthopedic patients in a safe environment.

Learning from the past: did experience with previous epidemics help mitigate the impact of COVID-19 among spine surgeons worldwide?

PurposeSpine surgeons around the world have been universally impacted by COVID-19. The current study addressed whether prior experience with disease epidemics among the spine surgeon community had an impact on preparedness and response toward COVID-19.MethodsA 73-item survey was distributed to spine surgeons worldwide via AO Spine. Questions focused on: demographics, COVID-19 preparedness, response, and impact. Respondents with and without prior epidemic experience (e.g., SARS, H1NI, MERS) were assessed on preparedness and response via univariate and multivariate modeling. Results of the survey were compared against the Global Health Security Index.ResultsTotally, 902 surgeons from 7 global regions completed the survey. 24.2% of respondents had prior experience with global health crises. Only 49.6% reported adequate access to personal protective equipment. There were no differences in preparedness reported by respondents with prior epidemic exposure. Government and hospital responses were fairly consistent around the world. Prior epidemic experience did not impact the presence of preparedness guidelines. There were subtle differences in sources of stress, coping strategies, performance of elective surgeries, and impact on income driven by prior epidemic exposure. 94.7% expressed a need for formal, international guidelines to help mitigate the impact of the current and future pandemics.ConclusionsThis is the first study to note that prior experience with infectious disease crises did not appear to help spine surgeons prepare for the current COVID-19 pandemic. Based on survey results, the GHSI was not an effective measure of COVID-19 preparedness. Formal international guidelines for crisis preparedness are needed to mitigate future pandemics.

Radiology Department Preparedness in the Coronavirus Disease 2019 (COVID-19) Postshutdown Environment.

Radiology Department Preparedness in the Coronavirus Disease 2019 (COVID-19) Postshutdown Environment.

Policies and Guidelines for COVID-19 Preparedness: Experiences from the University of Washington.

The coronavirus disease 2019 (COVID-19) pandemic initially manifested in the United States in the greater Seattle area and has rapidly progressed across the nation in the past 2 months, with the United States having the highest number of cases in the world. Radiology departments play a critical role in policy and guideline development both for the department and for the institutions, specifically in planning diagnostic screening, triage, and management of patients. In addition, radiology workflows, volumes, and access must be optimized in preparation for the expected surges in the number of patients with COVID-19. In this article, the authors discuss the processes that have been implemented at the University of Washington in managing the COVID-19 pandemic as well in preparing for patient surges, which may provide important guidance for other radiology departments who are in the early stages of preparation and management.

Policies and Guidelines for COVID-19 Preparedness: Experiences from the University of Washington.

The Coronavirus Disease 2019 (COVID-19) pandemic initially presented in the United States in the greater Seattle area, and has rapidly progressed across the nation in the past 2 months, with the United States having the highest number of cases in the world. Radiology departments play a critical role in policy and guideline development both for the department and for the institutions, specifically in planning diagnostic screening, triage, and management of patients. In addition, radiology workflows, volumes and access must be optimized in preparation for the expected COVID-19 patient surges. This article discusses the processes that have been implemented at the University of Washington in managing the COVID-19 pandemic as well in preparing for patient surges, which may provide important guidance for other radiology departments who are in the early stages of preparation and management.

Disaster Preparedness Among Michigan's Licensed Child Care Programs.

This study aimed to assess if Michigan child care directors have created disaster management plans, and if local resources were used to develop and implement plans. From December 2013 to March 2014, the Early Childhood Investment Corporation conducted a survey of licensed child care programs in Michigan. An online survey regarding disaster preparedness and training resources was distributed to the directors of a convenience sample of registered child care centers among the Early Childhood Investment Corporation's statewide network of 11 resource centers. A total of 210 child care programs responded. Most (91%) of respondents had a disaster plan, but 40% did not include accommodations for special needs children, 51% did not have a family/child identification or reunification plan, and 67% did not have car safety devices and a predetermined route for evacuation. Fewer than 9% made disaster plans available online. Few collaborated with local fire (22%), police (27%), or pediatric or emergency medicine organizations (11%). Online modules were the most desirable training format. In a state without mandated child care guidelines for disaster preparedness, a substantial proportion of child care programs were missing critical components of disaster planning. Future interventions must focus on increasing partnerships with local organizations and developing guidelines and training to include plans for special needs children, family/child identification and reunification, and evacuation/relocation.

Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector.

Context:During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).Objective:In this study, we evaluated experiences in preparedness among stakeholders of both curative and public health sectors to formulate recommendations for optimizing preparedness protocols. Timeliness of referred patients with suspected EVD was used as indicator for preparedness.Design:In focus group sessions and semistructured interviews, experiences of curative and public health stakeholders about the regional and national process of preparedness and response were listed. Timeliness recordings of all referred patients with suspected EVD (13) were collected from first date of illness until arrival in the referral academic hospital.Results:Ebola preparedness was considered extensive compared with the risk of an actual patient, however necessary. Regional coordination varied between regions. More standardization of regional preparation and operational guidelines was requested, as well as nationally standardized contingency criteria, and the National Centre for Infectious Disease Control was expected to coordinate the development of these guidelines. For the timeliness of referred patients with suspected EVD, the median delay between first date of illness until triage was 2.0 days (range: 0-10 days), and between triage and arrival in the referral hospital, it was 5.0 hours (range: 2-7.5 hours). In none of these patients Ebola infection was confirmed.Conclusions:Coordination between the public health sector and the curative sector needs improvement to reduce delay in patient management in emerging infectious diseases. Standardization of preparedness and response practices, through guidelines for institutional preparedness and blueprints for regional and national coordination, is necessary, as preparedness for emerging infectious diseases needs a multidisciplinary approach overarching both the public health sector and the curative sector. In the Netherlands a national platform for preparedness is established, in which both the curative sector and public health sector participate, in order to implement the outcomes of this study.

Compliance of colleges and universities in the United States with nationally published guidelines for emergency and disaster preparedness.

The aim of this study was to determine the compliance of colleges and universities in the United States with nationally published guidelines by the Federal Emergency Management Agency and the U.S. Department of Education for emergency and disaster preparedness at institutions of higher education. A questionnaire was electronically distributed to the director of security personnel of 1167 institutions between January 2010 and August 2011. Two hundred twenty-three questionnaires were available for analysis. Although 96% of the institutions had an official emergency and disaster plan, 10% do not practice the plan, 27% have not conducted tabletop exercises, and 20% do not perform after-action reports. Ninety-two percent of the institutions have a campus-wide communication system. Approximately half of the institutions include disaster preparedness as part of student/faculty employment orientation. Sixteen percent of the institutions have not included their local fire/police/emergency medical services in the development and implementation of their plan, and 31% of the institutions have not discussed preparedness with their local hospital. Whereas 96% of the institutions have established evacuation procedures, 19% have never practiced these procedures, 24% have not designated safe locations on campus, 44% have not designated safe locations in the surrounding community, and 50% do not have methods of transportation in the event of a campus-wide evacuation. Although most of the institutions in our study reported having an emergency and disaster plan based on national recommendations, areas for improvement were identified.

Emergency Preparedness in High School–Based Athletics: A Review of the Literature and Recommendations for Sport Health Professionals

Approximately 7.6 million high school students in the United States participate in sports. Although most sport-related injuries in adolescents are considered minor emergencies, life-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus and exercise-induced asthma, catastrophic brain injuries, cervical spine injuries, heat- and cold-related illness, blunt chest/abdominal injuries, and extremity fractures resulting in compartment syndrome. Emergency preparedness in athletics involves the identification of and planning for medical services to promote the safety of the athlete, to limit injury, and to provide medical care at the site of practice or competition. Several national organizations have published guidelines for emergency preparedness in school-based athletics. Our article reviews guidelines for emergency preparedness put forth by the Sideline Preparedness collaboration (comprised of 6 major professional associations, including the American Academy of Family Physicians, American Academy of Orthopedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine), the National Athletic Trainers' Association, the American Academy of Pediatrics' Committee on School Health, and the American Heart Association. Additionally, we review published data examining compliance of US high schools with these recommendations for emergency preparedness in school-based athletics, determine deficiencies, and provide recommendations for improvement based on these deficiencies.