1. PDLS © : Disaster Mitigation

2. What is Disaster Mitigation? What is Disaster Mitigation? Steps taken prior to and after a disaster to minimize morbidity and mortality Steps taken prior to and after a disaster to minimize morbidity and mortality Examples include: Examples include: - disaster plans: community, school, and home - pre-designated shelters - clean water stores, food stores - post disaster emotional support

3. Introduction Discussion of topics specific to pediatric disaster management Discussion of topics specific to pediatric disaster management Audience experience Audience experience Question and answer session Question and answer session

4. Overview Children in disasters pose unique problems Children in disasters pose unique problems Attention must be paid to children's needs while maintaining routine management Attention must be paid to children's needs while maintaining routine management Emotional scars from the disaster must be managed early Emotional scars from the disaster must be managed early

5. Disaster Management Preparation Preparation Initial response Initial response Management of resources Management of resources Recovery Recovery

6. Preparation: Home Create and discuss disaster plan for family Create and discuss disaster plan for family Acquaint all family members with first aid equipment in home Acquaint all family members with first aid equipment in home Route of egress from home Route of egress from home Meeting place outside Meeting place outside Conduct drills Conduct drills

7. Preparation: Home Preparation: Home Keep disaster stores of food, meds, diapers, etc. Keep disaster stores of food, meds, diapers, etc. Have “disaster containers” in home and car Have “disaster containers” in home and car

8. Preparation: School Makes disaster plan known to all Makes disaster plan known to all Routes of egress from school Routes of egress from school Meeting place Meeting place Drills Drills

9. Hospital Interface Work with local and state officials to create disaster management plan Work with local and state officials to create disaster management plan Local EMS should have plans for all schools, Daycares, etc.. in area Local EMS should have plans for all schools, Daycares, etc.. in area Practice interface between school, EMS, and hospital with drills at least once a year Practice interface between school, EMS, and hospital with drills at least once a year

10. Management of Resources Children require unique supplies Children require unique supplies Hospital pediatric resuscitation equipment should be adequately stocked Hospital pediatric resuscitation equipment should be adequately stocked Oral fluids, small gauge IV sets, diapers, etc. should be stockpiled nearby Oral fluids, small gauge IV sets, diapers, etc. should be stockpiled nearby Children's toys, books, etc. should be accessible Children's toys, books, etc. should be accessible

11. Management of Resources Know total number of pediatric floor and ICU beds in area Know total number of pediatric floor and ICU beds in area Be prepared to transport patients and or supplies large distances Be prepared to transport patients and or supplies large distances

12. Example: Olympic Bombing Grady Hospital identified as primary receiving hospital with support from surrounding hospitals Grady Hospital identified as primary receiving hospital with support from surrounding hospitals Personnel drilled in specific tasks during disaster Personnel drilled in specific tasks during disaster Telephone hotline activated immediately following bombing Telephone hotline activated immediately following bombing Personnel arriving at hospital in specific roles Personnel arriving at hospital in specific roles Over 150 patients treated for major and minor trauma without a single mortality Over 150 patients treated for major and minor trauma without a single mortality

13. Recovery Phase: Initial Shelters should be “kid friendly” Shelters should be “kid friendly” Keep families together Keep families together Personnel to organize area for orphaned and separated children until families reunited Personnel to organize area for orphaned and separated children until families reunited Create children's groups in shelter, plenty of toys, books, etc.. Create children's groups in shelter, plenty of toys, books, etc..

14. Recovery Phase: Long-term Psychological services early Psychological services early Be attentive to children's needs, consider educational resources for long-term sheltering. Be attentive to children's needs, consider educational resources for long-term sheltering. Aberrant behavior may be manifestation of emotional trauma Aberrant behavior may be manifestation of emotional trauma

15. Recovery Phase: Long-term Children must feel safe in home, community and school; encourage this Children must feel safe in home, community and school; encourage this Learn from mistakes Learn from mistakes

16. Disaster Mitigation: What you can do Emergency physicians, Pediatric EM physicians, Pediatricians, Nurses, other health care professionals: Emergency physicians, Pediatric EM physicians, Pediatricians, Nurses, other health care professionals: - Preparation before disaster - Action during disaster - Recovery phase

17. Before Disaster Strikes Involve yourself in the local EMS and area disaster plan: help to develop systems that keep children's’ needs in mind Involve yourself in the local EMS and area disaster plan: help to develop systems that keep children's’ needs in mind Work with schools, daycares and local hospitals to develop integrated disaster plans Work with schools, daycares and local hospitals to develop integrated disaster plans Act as an advisor to your patients for home disaster planning Act as an advisor to your patients for home disaster planning

18. Before Disaster Strikes Arrange disaster response drills Arrange disaster response drills Promote community awareness addressing pediatric needs Promote community awareness addressing pediatric needs

19. During A Disaster Be active!! Be active!! Institute disaster plans in your facility Institute disaster plans in your facility Participate in the community response to disaster Participate in the community response to disaster

20. Disaster Recovery Provide medical care to shelters Provide medical care to shelters Assume basic community services will be disrupted for some time Assume basic community services will be disrupted for some time Attend to emotional needs of the pediatric population effected Attend to emotional needs of the pediatric population effected

21. Emotional Problems: What To Expect Acting out Acting out Depression Depression Apathy, lack of expression Apathy, lack of expression Difficulty sleeping Difficulty sleeping Fear of thunder, wind, etc. Fear of thunder, wind, etc. Somatic complaints Somatic complaints

22. Who Is Most At Risk For Emotional Problems? Children most directly affected by the disaster: injured themselves, family members killed or injured Children most directly affected by the disaster: injured themselves, family members killed or injured Children with prior emotional problems Children with prior emotional problems Children suffering a disruption in their family Children suffering a disruption in their family

23. Disaster Mitigation...... Plan For The Children!