Section 1 - Introduction
During a mass casualty or terrorist event, it is recognized that all hospitals, even those that are not pediatric trauma centers or specialized pediatric hospitals, might receive critically ill or injured pediatric patients. Additionally, it is acknowledged by the healthcare community that there has been limited attention to the specific needs of the pediatric population and their families in disaster response preparation. The New York City Department of Health and Mental Hygiene (NYCDOHMH) and the New York State Department of Health (NYSDOH) recognized this planning gap. As a result, the NYCDOHMH and its Centers for Bioterrorism Preparedness Planning (CBPP) developed a document entitled Hospital Guidelines for Pediatrics in Disasters.
The Department would like to acknowledge the Division of Family Health toolkit committee members for their advocacy for the needs of women and children during times of emergency and for providing leadership for this project. Without their dedication to the subject, this document would not have been possible. The goal of this effort was to provide hospitals, especially those that do not normally admit children, or have no Pediatric Intensive Care Services or Obstetric/Newborn services, with some useful, proactive planning strategies and tools for providing protection, treatment, and acute care for pediatric and obstetric patients during a disaster. The following hospital guidelines and recommendations for children in disasters initially developed by NYCDOHMH have been modified by the NYSDOH to address the needs of suburban and rural upstate hospitals and to address the needs of obstetric patients. The NYSDOH wishes to thank NYCDOHMH for their willingness to allow for adaptation of their work to provide a statewide perspective.
Focus of Guidelines
The intent of this toolkit is to provide hospitals without pediatric or obstetric services, hospitals without pediatric intensive care services, and hospitals without pediatric trauma services help in planning for the care of pediatric and obstetric patients in emergencies. Fifteen topics related to pediatric and obstetric disaster preparedness were selected:
- Decontamination of Children Planning Guidelines
- Dietary Needs of Children
- Emergency Department Surge Considerations and Inpatient Bed Assignment Security
- Emergency Preparedness for Childbirth
- Equipment for Pediatric Disasters
- Family Information & Support Center
- Infection Control Considerations
- Pharmaceutical Needs
- Psychological Needs of Children
- Planning Guidelines
- Staffing Recommendations
- Training Recommendations
- Transportation of Pediatric Patients
General guidelines and suggested educational resources for each of these fifteen topics follow.
It is recognized that the toolkit is not comprehensive with respect to all aspects of planning for the special needs of the pediatric and obstetric population. What it does provide is useful, expert-reviewed guidance documents and planning tools that should greatly reduce the amount of plan development and preparation time for each individual hospital.
NYSDOH extends its thanks to the following organizations for their willingness to allow use and adaptation of their materials:
- The New York City Department of Health and Mental Hygiene
- The Oklahoma University College of Pharmacy and Oklahoma City-County Health Department
- The Ontario Society of Nutrition Professionals in Public Health
- The American College of Nurse-Midwives