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Pediatricians will play a central role in caring for children in the event of a terrorist attack

As part of a network of health responders to a terrorist attack, pediatricians will be called on to address the concerns of patients and families, recognize signs of possible exposure to a weapon of terror, and understand first-line response to such attacks. Pediatricians also need to sufficiently participate in disaster planning to ensure that the unique needs of children are satisfactorily addressed, according to Irwin Redlener, M.D., Director of the National Center for Disaster Preparedness, Columbia University Mailman School of Public Health, and David Markenson, M.D., EMT-P., Director of the Program for Pediatric Preparedness, National Center for Disaster Preparedness. Their work was supported in part by the Agency for Healthcare Research and Quality (HS13855).

In a recent article, they suggest that a curriculum to prepare pediatricians for their role during bioterrorist attacks should include several key concepts. It must consider the unique aspects of children related to terrorism and disasters. For instance, children are more susceptible to various agents (for example, their faster respiratory rates will expose them to relatively larger dosages of aerosolized agents such as sarin gas or anthrax). Also, children respond emotionally to trauma in age-specific ways, and there is limited availability of age- and weight-appropriate antidotes and treatments. For example, certain antibiotic therapies supplied in the National Pharmaceutical Stockpile, such as tetracycline, generally are not recommended for use in children.

After a disaster, pediatricians' offices or clinics may become care sites if area hospitals are unable to provide services. Pediatricians must be familiar with the chain of command and organization during hospital emergency responses, including local, State, and Federal Government authorities. Finally, pediatricians must advocate for children and families in terrorism preparedness planning.

For more information, see "Disaster and terrorism preparedness: What pediatricians need to know," by Drs. Redlener and Markenson, in Advances in Pediatrics 50, pp. 1-37, 2003.

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