Joseph SullivanMentor: Dr. Christa-Marie Singleton

Centers for Disease ControlOffice of Public Health Emergency Preparedness and Response

Division of State and Local Readiness

Pediatric Planning for a Public Health Emergency

Office of Public Health Preparedness and Response

Division of State and Local Readiness

Introduction

For the purposes of this project, pediatric emergency preparedness planning is preparing a community for a disaster that could potentially affect children

Office of Public Health Preparedness and Response

Division of State and Local Readiness

Background

25% of the population, approximately 74 million people, are under the age of 18.

These children are a vulnerable population

They are dependant on their caregiver(s).

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1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.

Importance

In a Public Health emergency: Children could be separated from family Sick children may not be able to receive necessary

care Children’s caregivers could die, become injured,

quarantined or incapacitated for a long period of time

If any of the above occurs, there could be potential economic impact.

Hurricane Katrina

“Before Hurricane Katrina, the cost of transporting neonates and children out of a disaster-impacted area was viewed by many as not being financially or operationally viable”

2. Baldwin, Steve, Andria Robinson, Pam Barlow, and Crayton Fargason. "Interstate Transfer of Pediatric Patients During Hurricane Katrina." 117. (2006): 68-72. Web. 31 July 2011. <http://www.aap.org/advocacy/releases/hurrkatsupp.pdf>.

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Public Health Emergency Preparedness

The Public Health Preparedness Capabilities: National Standards for State and Local Planning document cited pediatric planning as a priority

The PHEP capabilities reference pediatric planning in 3 areas: 1 Community Preparedness 2 Medical Surge

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3. Community Preparedness, Function 4 Medical Surge, Function 1 and 2

Criteria

If the awardees are supposed to include pediatric planning in their emergency plans:

How many awardees are conducting pediatric planning?

What is the state of the pediatric planning?

Methodology

June 2011 review of 57 of the 62 PHEP awardees

The review of the documents indicated that only 27 awardees included pediatric planning and met the criteria, 30 did not.

BarriersLimitation/Barrier Awardee

Pediatric Planning not included/addressed AR, GU, ME, NV, NJ, OK, PA, TX, VT

Lack of funding VI

Lack of Resources HI, FM, PW

Lack of communication and coordination AK, MT

Lack of treatment (rural areas) HI, MT, PW, VI, FM

Lack of training AK, CA, DC

No process to identify gaps and access pediatric providers IA, HI, MH, MT, NM, OH, PR, SC, WV

Process of establishing plans without any barriers AL, GA, KY, MA, ND, OR

Pediatric Planning not Addressed

Why do emergency plans not address children's needs even though the preparedness capabilities cite this as a priority?

I recommend consulting the “Child Care and Early Education” section of the “National Commission on Children and Disasters.”

1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.

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Lack of Funding

Which component is not being addressed due to a lack of funding?

Lack of Resources

Lack of medicine?

Lack of beds?

Lack of equipment?

I recommend having the awardees better define the specific resources they need and looking into “Globalmedia’s telemedicine solution” to form a network with other healthcare facilities.

4. Barthelemy, Joel, Michael Harris, Brad Schmidt, Bruce Adams, and Jay Culver. "How to Get Started." (2002-2011): n. pag. Web. 30 July 2011. <http://www.globalmed.com/training-education/how-to-get-started.php>.

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Lack of Communication and Coordination

Lack of coordination and communication between whom?

Why is there not coordination of activities regarding pediatric providers?

I recommend consulting the “Emergency Medical Services and Pediatric Transport” section of the “National Commission on Children and Disasters.”

1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.

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Lack of Treatment (Rural Areas)

Lack of care providers?

Lack of healthcare facilities?

Lack of maintaining a large capacity?

I recommend having the awardees better define the specific type of treatment they need and consulting the “Child Physical Health and Trauma” section of the “National Commission on Children and Disasters.”

11. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.

Lack of Training

Lack training regarding the Incident Command System?

Lack of care provider training?

I recommend having awardees better define what type of training they need and consulting the “Federal Emergency Management Agency’s Emergency Management Institute” website.

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5. U.S. Department of Homeland Security. Independent Study Complete Course List. Emmitsburg: , 2011. Web. 1 Aug 2011. <http://training.fema.gov/IS/crslist.asp>.

No Processes to identify Gaps and Access Pediatric Providers

Why have processes to identify gaps in pediatric care not been developed?

Why have processes to access pediatric providers not been developed?

I recommend consulting the “Disaster Management and Recovery” section of the National Commission on Children and Disasters.”

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1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.

Process of Establishing Plans

I recommend consulting the “Emergency Medical Services and Pediatric Transport” section of the “National Commission on Children and Disasters.”

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1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.

Questions