Because of unique vulnerabilities of children, their special
needs should be addressed in hospital disaster planning to
ensure that health care providers and health care facilities are
prepared to meet the needs of this vulnerable population.
Developed by the National Library of Medicine’s Disaster
Information Management Research Center (DIMRC), in collaboration
with the Emergency Medical Services for Children (EMSC) Program
and the Office of the Assistant Secretary for Preparedness and
Response (ASPR), the Health Resources on Children in Disasters
and Emergencies is a compendium of online resources related to
medical and public health issues on this topic. This resource is
a compilation of multiple resources from a variety of
organizations, websites, databases, and training sites.
This guide was created to help emergency
managers/coordinators/hospitals in their efforts to develop their
own specific departmental Emergency Operations Plan (EOP) that
addresses the special needs of children and infants. This guide
is meant to drive the active planning process, not to take its
place. There is no single format that can adequately fit every
community so this document is a culmination of best practice,
expert opinions and other plans intended to assist in building
The Pediatric Surge Program was initiated following the 2009
H1N1 pandemic that disproportionately affected children and
stressed hospital systems’ capacity for pediatric intensive care
unit (PICU) beds and equipment, such as pediatric
ventilators. This project includes a countywide plan on how
each hospital within LAC would contribute to caring for
pediatric patients in the event of a surge that largely impacts
This framework was crafted over the course of several years by a
group of hospital staff and public health leaders from
across the central valley region and facilitated by Hospital
Council of Northern and Central California.
This resource is intended to serve as a basis for regional and
local community discussions about pediatric care during a
wide-scale disaster and to provide a framework for
Pediatric surge planning involves identifying knowledge gaps and
insufficiency of pediatric specific supplies. The purpose of this
Pediatric Surge Training Course is to help prepare general acute
care facilities to the challenges of pediatrics. The course is
designed for a target audience that has knowledge of disaster
The Emergency Preparedness Team at Rady Children’s Hospital
prepared this manual. This team includes physicians, nursing,
behavioral health, surgeon, safety supervisor, trauma, pharmacy,
security and disaster planning experts. The curriculum
development team conducted in-depth research of best practices
and other existing curricula to bring best practice.
The goal of this curriculum is to prepare hospitals and clinics
have the tools to respond more effectively in a disaster which
involves a surge of child victims.
This network is actively reaching out to other
coalitions to identify new opportunities for collaboration
with experienced groups. Since efforts to implement
guidance on pediatric and neonatal preparedness share common
challenges, this network is an
excellent resource for collaborating on pediatric
preparedness and planning throughout the medical
The Pediatric Disaster Resource and Training Center provides
training, resources and new models of virtual linkage with health
care centers throughout Los Angeles County. By providing a unique
environment that marshals all the forces of pediatric disaster
training, they provide excellent resources and training for the
health care community.
As a multi-disciplinary team, they come together to serve
children facing crises. Their subject matter experts work in
partnership with nurses and staff leaders to facilitate dialogue
with community leaders about best practices in regard to children
In the event of a mass casualty incident, resources for treating
pediatric victims will be limited. Staff that is
inexperienced with pediatric critical injuries or illnesses will
result in an inadequate surge capacity. As part of
preparedness, each facility should predetermine their ability to
handle pediatric victims and develop a plan to be able to
increase this capacity based on a pediatric surge. There
are typically fewer pediatric victims in the event of a disaster
based on the assumptions related to population of pediatric vs.
adult patients in the general population. A conservative
estimate of pediatric victims for the purposes of planning should
assume approximately 15-20% of the victims are pediatric (15
years or younger). There are many disasters (such as a
school bus accident) that would alter this assumption. In
the event of a pediatric disaster or disaster that involves
pediatric patients, information listed in this document can
assist with appropriate response.
The Joint Commission requires all hospitals to have a
disaster plan in place; however, the formulation of hospital
guidelines specific to pediatrics is often omitted. This
document provides an outline of the necessary components of
hospital preparedness for disasters involving children
including the roles of hospital personnel in disasters.
This guide was prepared through a collaborative effort to assist
healthcare providers assess pre-event vulnerabilities and plan
for the evacuation of medically fragile Level III NICU patients
while addressing core components of incident management, in
conjunction with the promotion of patient safety and evacuation
procedures based on lessons learned from past disasters and
All hospitals should plan for pediatric patients arriving during
a disaster. The following document addresses the issues
surrounding pediatric emergency care during a disaster.
It is presented under the supposition that all hospitals need to
recognize the potential for receiving pediatric patients during a
disaster and appropriately plan for pediatric mass casualty care.
This resource is brought to you courtesy of New York City of
Department of Health.
As a parent, you are in the best position to help your child in
the event of a disaster. Just as you talk to your child’s doctor
about his or her health, such as what to do when your child is
sick or hurt, you can also talk to your child’s doctor, mental
health professional, or someone at your child’s school who can
help you and your child after a disaster.
The American Academy of Pediatrics (AAP) developed The Pediatric
Preparedness Resource Kit in response to the 2009 H1N1 pandemic.
This resource allows for pediatricians, public health leaders and
other pediatric care providers to assess what is already
happening in their community or state, and help determine what
needs to be done before an emergency or disaster. The kit will
promote collaborative discussions and decision making about
pediatric preparedness planning.
To help address availability and inaccessibility of resources for
pediatric disaster preparedness, the EMS for Children Program
developed an information network of resources targeting health
providers, emergency and community planners, and families.
The primary purpose is to help communities achieve an optimal
level of emergency readiness for children who are involved in an
environmental, health, or man-made disaster.
The special medical needs of children make it essential that
health care facilities be prepared for both pediatric and adult
victims of bioterrorism attacks, including those resulting from
dispersal of airborne or foodborne agents.1, 2 Moreover, while
terrorist attacks on the United States have provoked the
development of guidelines for hospital responses to acts of
bioterrorism, few have focused on pediatric facilities.2
Compounding the problem is that many disaster plans that have
been designed for children’s hospitals are not designed to
accommodate large numbers of contagious individuals capable of
disseminating highly lethal infectious agents.
This document is designed to address the topic of converting
pediatric hospitals from standard operating capacity to surge
capacity in response to large numbers of children with
communicable airborne and foodborne agents.
Particular aspects of emergency care for children may be
especially difficult for rural hospitals to meet as they often
have less access to pediatric and emergency medicine trained
The attached study “Pediatric Care in Rural Hospital Emergency
Departments”, was compiled using data analysis which
compared rural and urban hospitals’ responses on various
dimensions of pediatric ED care: