University of Massachusetts Medical School

Andrew Garrett MD, MPH, FAAP

Richard Aghababian MD, FACEP

University of Massachusetts Medical School

Andrew Garrett MD, MPH, FAAP

Richard Aghababian MD, FACEP

Pediatric Disaster Life Support ©

Edition 2.0

Introduction

Andrew Garrett MD

Introduction

Andrew Garrett MD

Pediatric Disaster Life Support

WelcomeWelcome

PDLS is designed to give emergency personnel a foundation of knowledge and skills to more effectively prepare for and respond to disasters involving children

PDLS is designed to give emergency personnel a foundation of knowledge and skills to more effectively prepare for and respond to disasters involving children

Intent of PDLSIntent of PDLS

PDLS builds on the fundamental pediatric patient care skills learned in basic pediatric resuscitation courses Such as PALS, PEPP, APLS

PDLS builds on the fundamental pediatric patient care skills learned in basic pediatric resuscitation courses Such as PALS, PEPP, APLS

What is a disaster?What is a disaster?

Many definitions exist For this purposes of this course

An exceptional event that disrupts community functioning, causes human suffering or fatalities, and/or creates needs that the victims can not alleviate without assistance

Says nothing about the cause

Many definitions exist For this purposes of this course

An exceptional event that disrupts community functioning, causes human suffering or fatalities, and/or creates needs that the victims can not alleviate without assistance

Says nothing about the cause

Why PDLS?Why PDLS?

Disasters by our definition affect communities “Community” in public health means any

collection of people sharing an environment where they have something in common

Most communities contain infants, children, and adolescents Towns, cities, states, nations Schools, camps, daycare facilities

Disasters by our definition affect communities “Community” in public health means any

collection of people sharing an environment where they have something in common

Most communities contain infants, children, and adolescents Towns, cities, states, nations Schools, camps, daycare facilities

Care for the Entire CommunityCare for the Entire Community

To take care of a community means to take care of the children contained within it

As a new specialty area, Disaster Medicine (along with Prehospital Care/EMS) was initially based on taking care of adult patients Why is this? Much of the science grew out of military research and

military operations These focus was on young, healthy adults

To take care of a community means to take care of the children contained within it

As a new specialty area, Disaster Medicine (along with Prehospital Care/EMS) was initially based on taking care of adult patients Why is this? Much of the science grew out of military research and

military operations These focus was on young, healthy adults

Children as a Special PopulationChildren as a Special Population For years, pediatric patients were

underemphasized in Disaster Medicine

In the last decade, there has been increased interest in how to better care for children before they get to the hospital

This can be difficult, since “children are not just little adults” and they do not fit the traditional mold of preparing for and treating children in a disaster

For years, pediatric patients were underemphasized in Disaster Medicine

In the last decade, there has been increased interest in how to better care for children before they get to the hospital

This can be difficult, since “children are not just little adults” and they do not fit the traditional mold of preparing for and treating children in a disaster

Children as a Special PopulationChildren as a Special Population A major focus of PDLS is the difference between

children and adults

Children have unique medical and psychological needs that must be taken into account during disaster preparedness and response planning

We will focus on the special vulnerabilities of children during disaster

A major focus of PDLS is the difference between children and adults

Children have unique medical and psychological needs that must be taken into account during disaster preparedness and response planning

We will focus on the special vulnerabilities of children during disaster

The Science AdvancesThe Science Advances PDLS reflects the advancements in the science of

pediatric care during disasters

Incorporates the information that we have learned during the past decade, such as: Oklahoma City bombing (1995) 9/11 terrorist attacks (2001) Anthrax attacks (2001) Beslan School seige (2004) Indian Ocean tsunami (2004) Hurricane Katrina (2005)

PDLS reflects the advancements in the science of pediatric care during disasters

Incorporates the information that we have learned during the past decade, such as: Oklahoma City bombing (1995) 9/11 terrorist attacks (2001) Anthrax attacks (2001) Beslan School seige (2004) Indian Ocean tsunami (2004) Hurricane Katrina (2005)

Alfred P. Murrah Federal Building

Alfred P. Murrah Federal Building

An Unfortunate RealityAn Unfortunate Reality

Children as an intentional target of terrorism increases the need for PDLS Oklahoma City bombing daycare center Tel Aviv Dolphinarium disco bombing School Mass Murders:

Columbine, Red Lake, Ma’alot

Dubrovka Theater Seige Beslan School hostage crisis

Children as an intentional target of terrorism increases the need for PDLS Oklahoma City bombing daycare center Tel Aviv Dolphinarium disco bombing School Mass Murders:

Columbine, Red Lake, Ma’alot

Dubrovka Theater Seige Beslan School hostage crisis

Beslan, Russia 9/1/04Beslan, Russia 9/1/04

Over 1000 children taken as hostages in a politically-motivated seige at a Beslan school

Seige lasted one week Unmeetable demands made Children packed into gymnasium rigged

with explosives

Over 1000 children taken as hostages in a politically-motivated seige at a Beslan school

Seige lasted one week Unmeetable demands made Children packed into gymnasium rigged

with explosives

Beslan, Russia 9/1/04Beslan, Russia 9/1/04

Day 3- terrorists suddenly begin shooting hostages and set off explosions in gymnasium

Rescuers storm school Hundreds injured or killed Resources limited due to remote location

and prolonged event

Day 3- terrorists suddenly begin shooting hostages and set off explosions in gymnasium

Rescuers storm school Hundreds injured or killed Resources limited due to remote location

and prolonged event

The Rescue Attempt BeginsThe Rescue Attempt Begins

A Sudden Influx of PatientsA Sudden Influx of Patients

A Sudden Influx of PatientsA Sudden Influx of Patients

A Sudden Influx of PatientsA Sudden Influx of Patients

A Sudden Influx of PatientsA Sudden Influx of Patients

Beslan, Russia 9/1/04Beslan, Russia 9/1/04

Who should receive the efforts of a limited number of providers and medical facilities?

Does this meet our definition of disaster? An exceptional event that disrupts community functioning,

causes human suffering or fatalities, and/or creates needs that the victims can not alleviate without assistance

Who should receive the efforts of a limited number of providers and medical facilities?

Does this meet our definition of disaster? An exceptional event that disrupts community functioning,

causes human suffering or fatalities, and/or creates needs that the victims can not alleviate without assistance

Mass Casualty IncidentsMass Casualty Incidents

MCI’s may or may not represent disasters to a community, based on the level of preparedness in the community Why is that?

Many of the same priorities, knowledge and tools in PDLS still apply when responding to an MCI

MCI’s may or may not represent disasters to a community, based on the level of preparedness in the community Why is that?

Many of the same priorities, knowledge and tools in PDLS still apply when responding to an MCI

Natural DisastersNatural Disasters

As if terrorism was not enough… Some experts think that the numbers of

natural disasters are increasing Increased numbers at risk due to

globalization and development of at-risk areas

As if terrorism was not enough… Some experts think that the numbers of

natural disasters are increasing Increased numbers at risk due to

globalization and development of at-risk areas

Earthquakes and TsunamiEarthquakes and Tsunami

Earthquakes and TsunamiEarthquakes and Tsunami

Nias, Indonesia 4/05

HurricanesHurricanes

TornadoesTornadoes

FloodsFloods

Volcanoes, Mudslides, LaharsVolcanoes, Mudslides, Lahars

The Risk ExistsThe Risk Exists

No community is exempt from the risk of a disaster

As healthcare providers we have a responsibility to prepare for the care of children and adults- the whole community

PDLS is a starting point

No community is exempt from the risk of a disaster

As healthcare providers we have a responsibility to prepare for the care of children and adults- the whole community

PDLS is a starting point

OutlineOutline

PDLS has two core lectures: Fundamental Concepts in Pediatric Disaster

Medicine Practical Issues in Pediatric Disaster

Medicine

Followed by a field training exercise that will give you an opportunity to practice some of the skills presented in PDLS

PDLS has two core lectures: Fundamental Concepts in Pediatric Disaster

Medicine Practical Issues in Pediatric Disaster

Medicine

Followed by a field training exercise that will give you an opportunity to practice some of the skills presented in PDLS