Personal Disaster Preparedness Research Articles

Earthquake Preparedness and Knowledge of Recommended Self-Protective Actions: A Survey of Nursing Students.

Nurses are a vital workforce to the disaster response of an earthquake. The aim of this study was to assess preexisting knowledge in baccalaureate nursing students about disaster preparedness and self-protective behavioral responses during an earthquake. A descriptive cross-sectional survey of nursing students from a seismologically active region was conducted. Data were collected prior to earthquake preparedness education and ShakeOut drills designed to enhance personal safety. A total of 274 nursing students participated in the survey (response rate - 93%). More than half (57%) of respondents did not feel prepared for an earthquake; 88% were without a household emergency plan and 82% lacked emergency supplies. Self-protective actions of drop, cover, and hold on and stay in bed were accurately identified by 77% and 96% of respondents, respectively. Hazardous actions selected included stand in a doorway (77% of respondents) and go outside into the street (23% of respondents). These results demonstrate a lack of personal disaster preparedness in nursing students and several behavioral responses that do not promote self-preservation during seismic activity. Although existing baccalaureate nursing education addresses competencies for disaster care, actions are needed to develop curriculum that emphasizes preparedness and safety to regional environmental hazards.

Personal disaster preparedness of people with chronic obstructive pulmonary disease: Development and validation of a self-report questionnaire

RATIONALE AND OBJECTIVES: The current resources related to chronic disease and disaster preparedness focus on chronic disease in general and do not examine the unique needs and vulnerabilities of people with chronic obstructive pulmonary disease (COPD). The objective of this study was to develop a disaster-preparedness questionnaire for people with COPD, and evaluate validity, reliability, readability and feasibility. METHODS: The questionnaire was validated by pulmonary and disaster experts using the Content Validity Index method. Readability was assessed by participants with COPD, using the think-aloud method and a grade level assessment. Test-retest reliability was assessed in participants with COPD and analyzed using Kappa and prevalence-adjusted bias-adjusted Kappa (PABAK) scores. Feasibility, general and COPD-specific disaster preparedness were assessed in a separate cohort of participants with COPD. MEASUREMENTS and MAIN RESULTS: Based on the validation and readability assessments, the final version of the questionnaire included 27-items (19 general and 8 COPD-specific questions). Readability was measured at a grade 9 level. Test-retest reliability was moderate-good (overall Kappa = 0.54, overall PABAK = 0.69). Twenty-eight people with COPD completed the final questionnaire (time to complete < 15 minutes). A total of 68% reported they had food and water for 3 days; however, only 36% met the criteria for general disaster preparedness and only 37% met the criteria for COPD-specific disaster preparedness. CONCLUSIONS: The questionnaire is valid and reliable and is suitable for use by researchers and health professionals to assess disaster preparedness in people with COPD.

Prepared to Respond? Exploring Personal Disaster Preparedness and Nursing Staff Response to Disasters.

This pilot study explored personal disaster preparedness of nursing staff and their ability and willingness to respond following a disaster. All nurses from a single hospital were invited to participate; 91 completed an online survey asking them to rate their ability and willingness to report to work following the disaster scenarios and to indicate whether they had pursued various preparedness activities. Data were analyzed by descriptive and inferential statistics using Minitab 17 Statistical Software. Participants reflected a cross-section of major acute care units and nursing specialties. The majority of participants indicated being able and willing to report to work following the disaster scenarios. Personal disaster preparedness varied, with few activities pursued by the majority. Few scenarios produced a relationship between preparedness activities and ability or willingness to report to work. Despite the majority of participants indicating they would be able and willing to report to work during a disaster, they acknowledged barriers affecting them. Most disaster scenarios showed no statistically significant relationship with preparedness activities. Nurses should consider barriers that affect their own availability for work following a disaster and identify potential solutions. Future research related to mitigation of possible barriers to surge capacity would be useful.

Factors Affecting the Disaster Response Competency of Emergency Medical Technicians in South Korea

PurposeThis study explored the factors influencing disaster response competency, that is, demographic and disaster-related characteristics, personal disaster (household and workplace) preparedness, disaster risk perception, and self-efficacy in handling disasters among emergency medical technicians in South Korea. MethodsThe study follows a descriptive, cross-sectional design and uses a self-reported questionnaire. Emergency medical technicians, amounting to 1,020 in all, currently working in firefighting organizations from four South Korean cities (Busan, Daegu, Daejeon, and Ulsan) participated in the study. ResultsDisaster risk perception, self-efficacy for disaster, participation experience in disaster education/training, and personal disaster (household and workplace) preparedness predicted the disaster response competency of emergency medical technicians in South Korea. ConclusionThere is a need for an antidisaster program to enhance the disaster risk perception, self-efficacy, personal disaster (household and workplace) preparedness, and the disaster education/training participation rate toward enhancing disaster response competency of emergency medical technicians in South Korea.

Using mind mapping technology for personal preparedness planning.

Organizing key information for personal disaster preparedness in an efficient and accessible format is critical to ensure practical utility. The authors examine the use of mind mapping technology to organize personal disaster preparedness information and explore the potential of mind mapping software as a tool to create individual and family preparedness resources. The general features of mind maps are considered and a sample family preparedness plan was created using TheBrain, a mind mapping software. Mind maps are a promising tool to organize personal preparedness plans with the ability to include significant amounts of varied information in a structure that emphasizes relationships between topics and enables collaborative sharing.

THE ROLE OF EDUCATION ON DISASTER PREPAREDNESS CASE STUDY OF 2012 INDIAN OCEAN EARTHQUAKES ON THAILAND’S

In this paper we investigate how well residents of the Andaman coast in Phang Nga province, Thailand, are prepared for earthquakes and tsunami. It is hypothesized that formal education can promote disaster preparedness because education enhances individual cognitive and learning skills, as well as access to information. A survey was conducted of 557 households in the areas that received tsunami warnings following the Indian Ocean earthquakes on 11 April 2012. Interviews were carried out during the period of numerous aftershocks, which put residents in the region on high alert. The respondents were asked what emergency preparedness measures they had taken following the 11 April earthquakes. Using the partial proportional odds model, the paper investigates determinants of personal disaster preparedness measured as the number of preparedness actions taken. Controlling for village effects, we find that formal education, measured at the individual, household, and community levels, has a positive relationship with taking preparedness measures. For the survey group without past disaster experience, the education level of household members is positively related to disaster preparedness. The findings also show that disaster related training is most effective for individuals with high educational attainment. Furthermore, living in a community with a higher proportion of women who have at least a secondary education increases the likelihood of disaster preparedness. In conclusion, we found that formal education can increase disaster preparedness and reduce vulnerability to natural hazards.

Learn from the Past, Prepare for the Future: Impacts of Education and Experience on Disaster Preparedness in the Philippines and Thailand

This study aims at understanding the role of education in promoting disaster preparedness. Strengthening resilience to climate-related hazards is an urgent target of Goal 13 of the Sustainable Development Goals. Preparing for a disaster such as stockpiling of emergency supplies or having a family evacuation plan can substantially minimize loss and damages from natural hazards. However, the levels of household disaster preparedness are often low even in disaster-prone areas. Focusing on determinants of personal disaster preparedness, this paper investigates: (1) pathways through which education enhances preparedness; and (2) the interplay between education and experience in shaping preparedness actions. Data analysis is based on face-to-face surveys of adults aged ≥15 years in Thailand (N = 1,310) and the Philippines (N = 889, female only). Controlling for socio-demographic and contextual characteristics, we find that formal education raises the propensity to prepare against disasters. Using the KHB method to further decompose the education effects, we find that the effect of education on disaster preparedness is mainly mediated through social capital and disaster risk perception in Thailand whereas there is no evidence that education is mediated through observable channels in the Philippines.

Disaster Preparedness of Child Care Teachers: A Cross-Sectional Study in South Korea.

We aimed to identify the differences in personal disaster preparedness and disaster risk perception among child care and preschool teachers in South Korea by using demographic characteristics and disaster-related questions. A cross-sectional self-reporting questionnaire was administered from February to October 2014. Of all the participants, 68.1% had received disaster preparedness education and training on 2 or more occasions per year; 13.2% had received no education or training. Personal disaster preparedness differed significantly by marital status (P<0.05), the number of disaster education and training sessions attended (P<0.05), and having purchased home insurance (P<0.001). Disaster risk perception differed significantly by children's age group under a teacher's care (P<0.05). The topic on which child care teachers wanted more training was "fractures and bleeding emergency care" (53.9%). The most probable disaster was considered to be a typhoon (66.0%). Disaster preparedness is important for both young children and their teachers. Field-based teacher disaster preparedness education and training should be provided so that they can respond effectively to disaster occurrence regardless of type, time, or location. (Disaster Med Public Health Preparedness. 2018; 12: 321-328).

Survey of Hospital Employees' Personal Preparedness and Willingness to Work Following a Disaster.

Little is known about the personal readiness of hospital staff for disasters. As many as 30% of hospital staff say that they plan not to report for work during a large-scale disaster. We sought to understand the personal disaster preparedness for hospital staff. Surveys were distributed to the staff of a large academic tertiary-care hospital by either a paper-based version distributed through the departmental safety coordinators or a Web-based version distributed through employee e-mail services, depending on employee familiarity with and access to computer services. Surveys assessed the demographic variables and characteristics of personal readiness for disaster. Of the individuals who accessed the survey, 1334 (95.9%) enrolled in it. Women made up 75% of the respondents, with a mean age of 43 years. Respondents had worked at the hospital an average of 9 years, with the majority (90%) being full-time employees. Most households (93%) reported ≤4 members, 6% supported a person with special medical needs, and 17% were headed by a single parent. A small number (24%) of respondents reported an established meeting place for reuniting households during a disaster. Many reported stockpiling a 3-day supply of food (86%) and a 3-day supply of water (51%). Eighteen percent of respondents were not aware of workplace evacuation plans. Most respondents were willing to report to work for natural disasters (eg, tornado, snowstorm; all categories >65%), but fewer respondents were willing to report during events such as an influenza epidemic (54%), a biological outbreak (41%), a chemical exposure, (40%), or a radiation exposure (39%). Multivariate analysis revealed being female, having a child in the household younger than 6 years old, and having a child in school lowered the likelihood of being willing to report to work in two or more event types, whereas pet ownership, being a clinical healthcare worker, and being familiar with the work emergency plan increased the likelihood. Despite being employed at the same facility for a prolonged period, employees reported being willing to report for work at a low rate in a variety of disasters. Subjects reported suboptimal personal preparedness for disaster, which may further limit the number of staff who will report for work. Hospitals should promote personal disaster preparedness for staff and explore staffing models with an understanding of reduced staff availability during disasters.

Learn from the Past, Prepare for the Future: Impacts of Education and Experience on Disaster Preparedness in the Philippines and Thailand

This study aims at understanding the role of education in promoting disaster preparedness. Strengthening resilience to climate-related hazards is an urgent target of Goal 13 of the Sustainable Development Goals. Preparing for a disaster such as stockpiling of emergency supplies or having a family evacuation plan can substantially minimize loss and damages from natural hazards. However, the levels of household disaster preparedness are often low even in disaster-prone areas. Focusing on determinants of personal disaster preparedness, this paper investigates: (1) pathways through which education enhances preparedness; and (2) the interplay between education and experience in shaping preparedness actions. Data analysis is based on face-to-face surveys of adults aged ≥15 years in Thailand (N = 1,310) and the Philippines (N = 889, female only). Controlling for socio-demographic and contextual characteristics, we find that formal education raises the propensity to prepare against disasters. Using the KHB method to further decompose the education effects, we find that the effect of education on disaster preparedness is mainly mediated through social capital and disaster risk perception in Thailand whereas there is no evidence that education is mediated through observable channels in the Philippines. This suggests that the underlying mechanisms explaining the education effects are highly context-specific. Controlling for the interplay between education and disaster experience, we show that education raises disaster preparedness only for those households that have not been affected by a disaster in the past. Education improves abstract reasoning and anticipation skills such that the better educated undertake preventive measures without needing to first experience the harmful event and then learn later. In line with recent efforts of various UN agencies in promoting education for sustainable development, this study provides a solid empirical evidence showing positive externalities of education in disaster risk reduction.

Influences of Preparedness Knowledge and Beliefs on Household Disaster Preparedness.

In response to concern about strengthening the nation's ability to protect its population and way of life (i.e., security) and ability to adapt and recover from emergencies (i.e., resilience), the President of the United States issued Presidential Policy Directive 8: National Preparedness (PPD-8) (1). Signed on March 30, 2011, PPD-8 is a directive for the U.S. Department of Homeland Security to coordinate a comprehensive campaign across government, private and nonprofit sectors, and individuals to build and sustain national preparedness. Despite efforts by the Federal Emergency Management Agency (FEMA) and other organizations to educate U.S. residents on becoming prepared, growth in specific preparedness behaviors, including actions taken in advance of a disaster to be better prepared to respond to and recover, has been limited (2). In 2012, only 52% of U.S. residents surveyed by FEMA reported having supplies for a disaster (2), a decline from 57% who reported having such supplies in 2009 (3). It is believed that knowledge influences behavior, and that attitudes and beliefs, which are correlated with knowledge, might also influence behavior (4). To determine the association between knowledge and beliefs and household preparedness, CDC analyzed baseline data from Ready CDC, a personal disaster preparedness intervention piloted among Atlanta- and Morgantown-based CDC staff members during 2013–2015. Compared with persons with basic preparedness knowledge, persons with advanced knowledge were more likely to have assembled an emergency kit (44% versus 17%), developed a written household disaster plan (9% versus 4%), and received county emergency alert notifications (63% versus 41%). Similarly, differences in household preparedness behaviors were correlated with beliefs about preparedness. Persons identified as having strong beliefs in the effectiveness of disaster preparedness engaged in preparedness behaviors at levels 7%–30% higher than those with weaker preparedness beliefs. Understanding the influences of knowledge and beliefs on household disaster preparedness might provide an opportunity to inform messages promoting household preparedness.

Working after a tornado: a survey of hospital personnel in Joplin, Missouri.

In 2011, an EF5 tornado hit Joplin, MO, requiring complete evacuation of 1 hospital and a patient surge to another. We sought to assess the resilience of healthcare workers in these hospitals as measured by number reporting to work, willingness to work, personal disaster preparedness, and childcare responsibilities following the disaster. In May 2013, a survey was distributed to healthcare workers at both Joplin hospitals that asked them to report their willingness to work and personal disaster preparedness following various disaster scenarios. For those with childcare responsibilities, scheduling, costs, and impact of hypothetical alternative childcare programs were considered in the analyses. A total of 1,234 healthcare workers completed the survey (response rate: 23.4%). Most (87.8%) worked the week following the Joplin tornado. Healthcare workers report more willingness to work during a future earthquake or tornado compared to their pre-Joplin tornado attitudes (86.2 vs 88.4%, t=-4.3, p<.001; 88.4 vs 90%, t=-3.1, p<.01, respectively), with no change during other scenarios. They expressed significantly higher post-tornado personal disaster preparedness, but only preevent preparedness was a significant predictor of postevent preparedness. Nearly half (48.5%, n=598) had childcare responsibilities; 61% (n=366) had childcare needs the week of the tornado, and 54% (n=198) required the use of alternative childcare. If their hospital had provided alternative childcare, 51% would have used it and 42% felt they would have been more willing to report to work. Most healthcare workers reported to work following this disaster, demonstrating true resilience. Disaster planners should be aware of these perceptions as they formulate their own emergency operation plans.

Public health-specific personal disaster preparedness training: An academic-practice collaboration

To measure the following three relevant outcomes of a personal preparedness curriculum for public health workers: 1) the extent of change (increase) in knowledge about personal preparedness activities and knowledge about tools for conducting personal preparedness activities; 2) the extent of change (increase) in preparedness activities performed post-training and/or confidence in conducting these tasks; and 3) an understanding of how to improve levels of personal preparedness using the Extended Parallel Process Model (EPPM) framework. Cross-sectional preinterventional and postinterventional survey using a convenience sample. During 2010, three face-to-face workshops were conducted in three locations in West Virginia. One hundred thirty-one participants (baseline survey); 69 participants (1-year resurvey)-representing West Virginia local health department (LHD) and State Health Department employees. A 3-hour interactive, public health-specific, face-to-face workshop on personal disaster preparedness. Change in 1) knowledge about, and tools for, personal preparedness activities; 2) preparedness activities performed post-training and/or confidence in conducting these activities; and 3) the relationship of EPPM categories to personal preparedness activities. One year postworkshop, 77 percent of respondents reported having personal emergency kits (40 percent at baseline) and 67 percent reported having preparedness plans (38 percent at baseline) suggesting some participants assembled supply kits and plans postworkshop. Within the context of EPPM, respondents in high-threat categories agreed more often than respondents in low-threat categories that severe personal impacts were likely to result from a moderate flood. Compared to respondents categorized as low efficacy, respondents in high-efficacy categories perceived confidence in their knowledge and an impact of their response on their job success at higher rates. Personal disaster preparedness trainings for the LHD workforce can yield gains in relevant preparedness behaviors and attitudes but may require longitudinal reinforcement. The EPPM can offer a useful threat and efficacy-based lens to understand relevant perceptions surrounding personal disaster preparedness behaviors among LHD employees.

What about Us? Reported Experiences of Disabled People Related to the Christchurch Earthquakes

Internationally there is limited research on the experiences of people with disabilities during and following a major disaster. This research explores the reported experiences of disabled people related to the 2010-2011 Christchurch, New Zealand earthquake series. MethodsQualitative inquiry involving purposive sampling and face to face interviews with 23 disabled people living in Christchurch during the earthquakes. The qualitative research was followed by a pilot quantitative survey involving 25 disabled people living in Christchurch during the earthquakes and 10 people who work in the disability sector. Qualitative interview material was analysed using thematic analysis while quantitative data was analysed using descriptive statistics. ResultsDisabled people preferred to shelter in place as their homes are organised to suit their specific needs. Our research suggests that urban disaster risk reduction strategies are needed that enhance opportunities for disabled people to maintain autonomy in an emergency situation. Key factors identified by participants that increase earthquake vulnerability among disabled people include a lack of personal disaster preparedness, public information that is not disability accessible and social isolation. Resilience was enhanced through disaster preparedness planning and good support networks. Implications: Individuals, communities and responding agencies could learn from the experiences of disabled people in order to improve preparation and response to disasters for vulnerable groups. Disaster recovery should be seen as an opportunity to reduce risk through avoiding recreating the conditions of vulnerability that may have existed previously.

Level of Disaster Preparedness in Patients Visiting the Emergency Department: Results of the Civilian Assessment of Readiness for Disaster (CARD) Survey

Patients seeking care in public hospitals are often resource-limited populations who have in past disasters become the most vulnerable. The objective of this study was to determine the personal disaster preparedness of emergency department (ED) patients and to identify predictors of low levels of preparedness. It was hypothesized that vulnerable populations would be better prepared for disasters. A prospective cross-sectional survey was conducted over a one-year period of patients seeking care in a public university hospital ED (census 65,000). Exclusion criteria were mentally impaired, institutionalized, or non-English speaking subjects. Subjects completed an anonymous survey detailing the 15 personal preparedness items from the Federal Emergency Management Agency's disaster preparedness checklist as well as demographic characteristics. Summary statistics were used to describe general preparedness. Chi-square tests were used to compare preparedness by demographics. During the study period, 857/1000 subjects completed the survey. Participants were predominantly male (57%), Caucasian (65%), middle-aged (mean 45 years), and high school graduates (83%). Seventeen percent (n = 146) reported having special needs and 8% were single parents. Most participants were not prepared: 451 (53%) had >75% of checklist items, 393 (46%) had food and water for 3 days, and 318 (37%) had food, water, and >75% of items. Level of preparedness was associated with age and parenting. Those aged 44 and older were more likely to be prepared for a disaster compared to younger respondents. (43.3% vs 31.1%, P = .0002). Similarly, single parents were more likely to be prepared than dual parenting households (47.1 vs 32.9%, P = .03). This study and others have found that only the minority of any group is actually prepared for disaster. Future research should focus on ways to implement disaster preparedness education, specifically targeting vulnerable populations, then measuring the effects of educational programs to demonstrate that preparedness has increased as a result.

Personal Disaster and Pandemic Preparedness of U.S. Human Resource Professionals

Abstract Background: All citizens need to have a personal disaster plan, but past studies indicate poor preparedness. Predictors of preparedness need to be clearly defined so interventions can be developed. Methods: Human resource (HR) professionals were sent an online survey in May-July, 2011 that assessed their personal/family disaster plan for natural disasters and pandemics, determinants of preparedness, and attitudes and beliefs regarding disaster preparedness. Linear regressions were used to describe factors associated with higher preparedness scores. Chi squares compared attitudes and beliefs about preparedness by whether or not their employer encouraged them to have a personal plan. Results: 471 HR professionals from 33 states participated. Average scores for personal and pandemic preparedness were 12.6 (0 - 20 range) and 4.5 (0- 9 range), respectively. One-third (35.3%, n = 100) had half or fewer preparedness measures, and half (47%, n = 133) had 4 or fewer of the 9 possible pandemic preparedness measures. Determinants of personal preparedness included high perception of personal preparedness for natural disasters and pandemics, having fewer years of work experience, being encouraged by the employer to have a personal preparedness plan, having received disaster preparedness training during the past two years, and not having children in the household. From linear regression, determinants of pandemic preparedness were high perception of personal preparedness for both natural disasters and pandemics, not having children in the household, being male, and having received disaster preparedness training during the past two years. HR professionals whose employer encouraged him/her to have a personal disaster plan had significantly higher perceived importance for family and business preparedness, and higher perceived preparedness compared to those whose employers have not encouraged them to have a personal plan (p<.001 for all). Conclusion: HR professionals will play a critical role during a disaster, but many lack personal preparedness.

Personal Disaster Preparedness: An Integrative Review of the Literature

Experts generally agree that individuals will require partial or complete self-sufficiency for at least the first 72 hours following a disaster. In the face of pervasive environmental and weather hazards, emerging biological threats, and growing population densities in urban areas, personal preparedness is critical. However, disaster planners and policymakers require further information to create meaningful improvements to this aspect of disaster preparedness. A systematic review of the literature was conducted to determine the state of evidence concerning personal disaster preparedness. The purpose of this integrative review is to describe and analyze the professional literature as an intended basis for advancing the field of disaster management research and practice. Included in the review were 36 studies that met the predetermined inclusion criteria. The current evidence indicates that factors influencing preparedness attitudes and behaviors are complex and multifaceted, including demographic characteristics, trust in government efforts, previous exposure to a disaster, and number of dependents in a household. Furthermore, certain population groups, households, and individuals have different disaster preparedness needs and vulnerabilities. This constellation of findings has significant implications for community and national emergency planning and policymaking.

398 Personal Disaster Preparedness of Emergency Department Staff

398 Personal Disaster Preparedness of Emergency Department Staff

Personal Disaster Preparedness of Dialysis Patients in North Carolina

Dialysis patients are among the most vulnerable patients during a disaster because they are sensitive to a lapse in treatment. Although thorough preparation could mitigate disaster effects, we hypothesized that dialysis patients' personal and medical disaster preparedness was inadequate. This prevalence study surveyed mentally competent adults requiring care at six regional dialysis centers. We asked questions regarding demographics, general disaster preparedness utilizing Homeland Security recommended item lists, dialysis-specific preparation for an individual to shelter in place, and preparatory steps for a forced evacuation. To determine if preparedness differed by demographic variables (gender, race, age, and education) chi-squared tests were used. Four hundred forty-two patients were approached, and 311 (70%) completed the survey. Participants were 54% male, 60% black, average age was 58 (± 15) years, and although 79% completed high school, 50% of our sample had marginal or low health literacy. Although all units had a disaster preparedness program in place, the general disaster preparedness of most participants was poor. Age, gender, race, education, literacy, and socioeconomic status did not affect general disaster preparedness. However, home peritoneal dialysis patients were significantly more likely to be prepared for a disaster compared with hemodialysis patients. No other significant associations were noted. Irrespective of sociodemographic characteristics, most subjects were unprepared for a disaster. Dialysis patients were poorly prepared to shelter in place or to evacuate in the face of a disaster. Education regarding personal and dialysis-specific disaster preparedness is warranted.

Paediatric disaster preparedness: essential concepts for paramedics

Children are the world's most valuable resource and its best hope for the future (John F Kennedy, 1963). Recent natural disasters and terrorist attacks have shown how imperative it is that communities and nations address the needs of children to ensure that they thrive in the face of adversity. As first responders and front line workers during disasters involving children, paramedics have a unique and important role in planning paediatric disaster preparedness as well as facilitating personal disaster preparedness. Paediatric disaster preparedness on all levels, from individual to institutional, will lead to improved outcomes in disasters involving children. Although different medical, legal, and administrative structures exist between the UK and the US, some of the lessons learned in the US can enhance paediatric disaster preparedness in all countries. This article aims discuss how paramedics and other first responders can close the gap between available and needed paediatric providers. Specifically, we review how paramedic primary and continuing education can target deficiencies identified by various supervising organizations, and how training can be performed using several successful high fidelity models produced through these resource centres