The Program for Pediatric Preparedness National Center for Disaster Preparedness Pediatric Disaster...
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Transcript of The Program for Pediatric Preparedness National Center for Disaster Preparedness Pediatric Disaster...
The Program for Pediatric PreparednessNational Center for Disaster Preparedness
Pediatric Disaster andTerrorism Preparedness
David Markenson, M.D.David Markenson, M.D.Director, The Program for Pediatric Director, The Program for Pediatric
Preparedness Preparedness Deputy Director, National Center for Deputy Director, National Center for
Disaster PreparednessDisaster PreparednessMailman School of Public Health, Mailman School of Public Health,
Columbia UniversityColumbia UniversityNew York, NYNew York, NY
Unique Anatomy and Physiology
Increased Surface Area/VolumeIncreased Surface Area/Volume More absorptive surfaceMore absorptive surface More susceptible to volume lossesMore susceptible to volume losses
Increased Minute Ventilation/Lower Breathing Increased Minute Ventilation/Lower Breathing ZoneZone
Thinner Epidermis/ Under-keratinized EpidermisThinner Epidermis/ Under-keratinized Epidermis Immature Blood-brain BarrierImmature Blood-brain Barrier Procedural DifficultiesProcedural Difficulties Psychological ImmaturityPsychological Immaturity
Importance of Pediatric Considerations
Children are part of the populationChildren are part of the population 26% of the U.S. population are children and youth More than 20 million are under the age of 6 years
Ignoring children may compromise entire Ignoring children may compromise entire preparedness planpreparedness plan August 2003 SurveyAugust 2003 Survey
90% nationally and 92% in New York City, 90% nationally and 92% in New York City, reported that they would not comply with an official reported that they would not comply with an official evacuation order evacuation order
66% of the national sample; 62% of New Yorkers 66% of the national sample; 62% of New Yorkers listed concern for their children as the main reason listed concern for their children as the main reason
Pediatric Terrorism Exposure
Inadvertently (Inadvertently (Classic ThinkingClassic Thinking)) Secondary victims in terrorist attackSecondary victims in terrorist attack Catastrophic event at chemical/ nuclear plantCatastrophic event at chemical/ nuclear plant
Intentionally targeted (Intentionally targeted (New ThinkingNew Thinking))
What is Pediatric Surge?
Secondary VictimsSecondary Victims Proportion of normal censusProportion of normal census
Uniquely Pediatric EventUniquely Pediatric Event Out of proportion to normal censusOut of proportion to normal census School, day care, school bus, campSchool, day care, school bus, camp
Family UnitFamily Unit Ability to care for family without separating Ability to care for family without separating
children and adultschildren and adults
Pediatric Surge Planning Address Pediatrics out of Proportion to Normal Address Pediatrics out of Proportion to Normal
NumbersNumbers Emergency operations plansEmergency operations plans ProvidersProviders Equipment and pharmaceuticalsEquipment and pharmaceuticals Drills and exercisesDrills and exercises
Plans for Care of ChildrenPlans for Care of Children Adult providersAdult providers Adult unitsAdult units Adult equipmentAdult equipment
Plans for Care of Adults in Pediatric UnitsPlans for Care of Adults in Pediatric Units
Federal and State Resources Strategic National Stockpile (SNS)Strategic National Stockpile (SNS)
Improved but limited pediatric contentImproved but limited pediatric content Restricted to FDA indicated usagesRestricted to FDA indicated usages
Disaster Medical Assistance Team/ National Disaster Medical Assistance Team/ National Disaster Medical System (DMAT/NDMS)Disaster Medical System (DMAT/NDMS) No Pediatric requirementsNo Pediatric requirements
StaffStaff PharmaceuticalsPharmaceuticals EquipmentEquipment
2 Self-certified pediatric teams2 Self-certified pediatric teams
Federal and State Resources State StockpilesState Stockpiles
Based on SNSBased on SNS Medical Reserve Corps (MRC)Medical Reserve Corps (MRC)
No defined pediatric capabilityNo defined pediatric capability Questionable functionalityQuestionable functionality
Time DelayTime Delay Federal Federal
66――48 hours48 hours Pediatric Alternative Pediatric Alternative
UnknownUnknown
Decontamination Water pressureWater pressure
Will it injure childWill it injure child Water temperatureWater temperature
HypothermiaHypothermia Non-ambulatory childNon-ambulatory child
Infants and toddlersInfants and toddlers Children with special healthcare Children with special healthcare
needsneeds Mental health concernsMental health concerns
Will children follow instructionsWill children follow instructions Long term effectsLong term effects
What Are Some Of The Solutions?
National Advisory Committee on Children National Advisory Committee on Children and Terrorismand Terrorism
Pediatric Disaster and Terrorism Pediatric Disaster and Terrorism Preparedness: National Consensus Preparedness: National Consensus GuidelinesGuidelines
Pediatric Expert Advisory PanelPediatric Expert Advisory Panel
Pediatric Disaster and TerrorismPreparedness: National Guidelines
Preparedness and Preparedness and TreatmentsTreatments BiologicBiologic ChemicalChemical RadiologicRadiologic NPSNPS DecontaminationDecontamination
Natural DisastersNatural Disasters
Hospital PreparednessHospital Preparedness Mental Health SchoolsMental Health Schools Primary Care ProvidersPrimary Care Providers Displaced ChildrenDisplaced Children National Disaster National Disaster
Medical SystemMedical System TrainingTraining Drills and SimulationsDrills and Simulations
Pediatric Expert Advisory Panel The purpose of the The purpose of the Pediatric Expert Pediatric Expert
Advisory Panel (PEAP) Advisory Panel (PEAP) is to: is to: Discuss and analyze current issuesDiscuss and analyze current issues
Multi-disciplinaryMulti-disciplinary Governmental and non-governmental bridgeGovernmental and non-governmental bridge On-going program On-going program Ability for rapid analysisAbility for rapid analysis Dissemination of findingsDissemination of findings
• WebWeb• InfoBriefInfoBrief• Conference or SymposiaConference or Symposia
Pediatric Expert Advisory Panel Pediatric Dosage AtroPenPediatric Dosage AtroPen®®
Approved by FDA in past few monthsApproved by FDA in past few months Questions regarding:Questions regarding:
IndicationsIndications RoleRole Pediatric AtroPen or Mark IPediatric AtroPen or Mark I
• IndicationsIndications
• ProtocolsProtocols
• StockpileStockpile