PDLS © : Disaster Mitigation. What is Disaster Mitigation? What is Disaster Mitigation? Steps taken prior to and after a disaster to minimize morbidity.

PDLSPDLS©©::Disaster MitigationDisaster Mitigation

What is Disaster Mitigation?What is Disaster Mitigation?

Steps taken prior to and after a disaster to Steps taken prior to and after a disaster to minimize morbidity and mortalityminimize morbidity and mortality

Examples include:Examples include:

- disaster plans: community, school, and homedisaster plans: community, school, and home

- pre-designated shelterspre-designated shelters

- clean water stores, food storesclean water stores, food stores

- post disaster emotional supportpost disaster emotional support

Introduction Introduction

Discussion of topics specific to pediatric Discussion of topics specific to pediatric disaster managementdisaster management

Audience experienceAudience experience

Question and answer sessionQuestion and answer session

Overview Overview

Children in disasters pose unique problemsChildren in disasters pose unique problems

Attention must be paid to children's needs Attention must be paid to children's needs while maintaining routine managementwhile maintaining routine management

Emotional scars from the disaster must be Emotional scars from the disaster must be managed earlymanaged early

Disaster ManagementDisaster Management

PreparationPreparation

Initial responseInitial response

Management of resourcesManagement of resources

RecoveryRecovery

Preparation: HomePreparation: Home

Create and discuss disaster plan for familyCreate and discuss disaster plan for family

Acquaint all family members with first aid Acquaint all family members with first aid equipment in homeequipment in home

Route of egress from homeRoute of egress from home

Meeting place outsideMeeting place outside

Conduct drillsConduct drills

Preparation: HomePreparation: Home

Keep disaster stores of food, meds, diapers, Keep disaster stores of food, meds, diapers, etc.etc.

Have “disaster containers” in home and carHave “disaster containers” in home and car

Preparation: SchoolPreparation: School

Makes disaster plan known to allMakes disaster plan known to all

Routes of egress from schoolRoutes of egress from school

Meeting placeMeeting place

DrillsDrills

Hospital InterfaceHospital Interface

Work with local and state officials to create Work with local and state officials to create disaster management plandisaster management plan

Local EMS should have plans for all schools, Local EMS should have plans for all schools, Daycares, etc.. in areaDaycares, etc.. in area

Practice interface between school, EMS, and Practice interface between school, EMS, and hospital with drills at least once a yearhospital with drills at least once a year

Management of ResourcesManagement of Resources

Children require unique suppliesChildren require unique supplies

Hospital pediatric resuscitation equipment Hospital pediatric resuscitation equipment should be adequately stockedshould be adequately stocked

Oral fluids, small gauge IV sets, diapers, etc. Oral fluids, small gauge IV sets, diapers, etc. should be stockpiled nearbyshould be stockpiled nearby

Children's toys, books, etc. should be Children's toys, books, etc. should be accessibleaccessible

Management of ResourcesManagement of Resources

Know total number of pediatric floor and ICU Know total number of pediatric floor and ICU beds in areabeds in area

Be prepared to transport patients and or Be prepared to transport patients and or supplies large distancessupplies large distances

Example: Olympic BombingExample: Olympic Bombing

Grady Hospital identified as primary receiving Grady Hospital identified as primary receiving hospital with support from surrounding hospitalshospital with support from surrounding hospitals

Personnel drilled in specific tasks during disasterPersonnel drilled in specific tasks during disaster

Telephone hotline activated immediately Telephone hotline activated immediately following bombingfollowing bombing

Personnel arriving at hospital in specific rolesPersonnel arriving at hospital in specific roles

Over 150 patients treated for major and minor Over 150 patients treated for major and minor trauma without a single mortalitytrauma without a single mortality

Recovery Phase: InitialRecovery Phase: Initial

Shelters should be “kid friendly”Shelters should be “kid friendly”

Keep families togetherKeep families together

Personnel to organize area for orphaned and Personnel to organize area for orphaned and separated children until families reunitedseparated children until families reunited

Create children's groups in shelter, plenty of Create children's groups in shelter, plenty of toys, books, etc..toys, books, etc..

Recovery Phase: Long-termRecovery Phase: Long-term

Psychological services earlyPsychological services early

Be attentive to children's needs, consider Be attentive to children's needs, consider educational resources for long-term educational resources for long-term sheltering.sheltering.

Aberrant behavior may be manifestation of Aberrant behavior may be manifestation of emotional traumaemotional trauma

Recovery Phase: Long-termRecovery Phase: Long-term

Children must feel safe in home, community Children must feel safe in home, community and school; encourage thisand school; encourage this

Learn from mistakes Learn from mistakes

Disaster Mitigation: What you can doDisaster Mitigation: What you can do

Emergency physicians, Pediatric EM Emergency physicians, Pediatric EM physicians, Pediatricians, Nurses, other physicians, Pediatricians, Nurses, other health care professionals:health care professionals:

- Preparation before disasterPreparation before disaster

- Action during disasterAction during disaster

- Recovery phaseRecovery phase

Before Disaster StrikesBefore Disaster Strikes

Involve yourself in the local EMS and area Involve yourself in the local EMS and area disaster plan: help to develop systems that disaster plan: help to develop systems that keep children's’ needs in mindkeep children's’ needs in mind

Work with schools, daycares and local Work with schools, daycares and local hospitals to develop integrated disaster planshospitals to develop integrated disaster plans

Act as an advisor to your patients for home Act as an advisor to your patients for home disaster planningdisaster planning

Before Disaster StrikesBefore Disaster Strikes

Arrange disaster response drillsArrange disaster response drills

Promote community awareness addressing Promote community awareness addressing pediatric needspediatric needs

During A DisasterDuring A Disaster

Be active!! Be active!!

Institute disaster plans in your facilityInstitute disaster plans in your facility

Participate in the community response to Participate in the community response to disasterdisaster

Disaster RecoveryDisaster Recovery

Provide medical care to sheltersProvide medical care to shelters

Assume basic community services will be Assume basic community services will be disrupted for some timedisrupted for some time

Attend to emotional needs of the pediatric Attend to emotional needs of the pediatric population effectedpopulation effected

Emotional Problems: What To ExpectEmotional Problems: What To Expect

Acting outActing out

DepressionDepression

Apathy, lack of expressionApathy, lack of expression

Difficulty sleepingDifficulty sleeping

Fear of thunder, wind, etc.Fear of thunder, wind, etc.

Somatic complaintsSomatic complaints

Who Is Most At Risk For Emotional Problems?Who Is Most At Risk For Emotional Problems?

Children most directly affected by the Children most directly affected by the disaster: injured themselves, family members disaster: injured themselves, family members killed or injuredkilled or injured

Children with prior emotional problemsChildren with prior emotional problems

Children suffering a disruption in their familyChildren suffering a disruption in their family

Disaster Mitigation......Disaster Mitigation......

Plan For The Children!Plan For The Children!