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Surge Capacity and Health System Preparedness

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Slide Presentation by Michael Shannon, M.D.


On October 26, 2004, Dr. Shannon made a presentation in a Web conference entitled Addressing Pediatric and School-based Surge Capacity in a Mass Casualty Event.

This is the text version of Dr. Shannon's slide presentation. Select to access the PowerPoint® Slides (111 KB).


Addressing Pediatric and School-based Surge Capacity in a Mass Casualty Event

Michael Shannon, M.D.
The Center for Biopreparedness
Division of Emergency Medicine
Children's Hospital Boston
Harvard Medical School

Slide 1

Surge Capacity and Children: Key Issues

  • Every type of disaster can occur.
  • Two scenarios to consider:
    • School is a target.
    • Community disaster while school is in session.

Slide 2

Key Challenges in Consequence Management

  • EMS, fire and other public health emergencies.
  • Decontamination teams.
  • Non-pediatric hospitals emergency departments.
  • Hospital response.
  • Hospital campus security.
  • Mental health response and recovery.
  • Mass distribution of antidotes, antibiotics, and vaccines.
  • Inclement weather.

Slide 3

The Challenges of Mass Casualty Incidents Involving Children vs. Adults

  • Biological—"immature immune system" followed by an arrow pointing right toward the text "greater morbidity/mortality".
  • Chemical—difficult to assess, manage and keep warm during decontamination.
  • Radiological—significantly increased risk of cancer (e.g., thyroid).

Slide 4

The Challenges of Mass Casualty Incidents Involving Children vs. Adults

  • Blast—difficult to stabilize during the "golden hour".
  • Burns—greater likelihood of life-threatening fluid loss and susceptibility to infection.

Slide 5

School Crisis Response Manual: Guiding Principles

  • Guidelines are desperately needed.
  • General templates can be created but no one size fits all.
  • The main steps in creating a school plan are:
    • Interviews with principal.
    • Interviews with school nurse.
    • A walk through with the custodian.
    • Include after-school programs.

Slide 6

School Crisis Response Manual: Guiding Principles

  • Steps in creating a school plan—cont'd
    • Integrate into the existing plans, e.g., evacuation (fire drills).
    • All plans take weather into account.
    • New plans needed for sheltering-in and lockdown.
    • Drills, including tabletop experiences, are an important part of school readiness.

Slide 7

Role of DMAT in Disasters Involving Children

  • Currently limited because there are only 2 in the U.S.
  • Compelling need to develop more.
  • Existing DMAT teams need ongoing training in pediatric response.

Slide 8

Emergency Department Challenges in Disasters Involving Children

  • Adequate numbers of pediatric supplies.
  • Pediatric decontamination equipment and protocols.
  • Effective response to large numbers of burn victims.
  • Assessing non-verbal children.

Slide 9

Additional Emergency Department Challenges in Disasters Involving Children

  • Treating children while wearing personal protective equipment.
  • Effective systems for identification, tracking, and reunification.
  • Use of alternate sites (e.g., schools, neighborhood health centers).

Slide 10

AHRQ-Supported Pediatric Protocols Under Development

  • Completed:
    • Training Video: "The Decontamination of Children".
  • Near Complete:
    • Pediatric Aspects of Surge Capacity Planning.
    • The Role of DMAT in Pediatric MCIs.
  • In Production:
    • Effective School-based Response to Disasters and Other Public Health Emergencies.

Current as of December 2004

Internet Citation:

Addressing Pediatric and School-based Surge Capacity in a Mass Casualty Event. Text version of a slide presentation at a Web conference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/btsurgemass/shannontxt.htm

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