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PDLS :
Disaster Mitigation
 What is Disaster Mitigation?
 Steps taken prior to and after a disaster to
minimize morbidity and mortality
 Examples include:
- disaster plans: community, school, and home
- pre-designated shelters
- clean water stores, food stores
- post disaster emotional support
Introduction
 Discussion of topics specific to pediatric
disaster management
 Audience experience
 Question and answer session
Overview
 Children in disasters pose unique problems
 Attention must be paid to children's needs
while maintaining routine management
 Emotional scars from the disaster must be
managed early
Disaster Management
 Preparation
 Initial response
 Management of resources
 Recovery
Preparation: Home
 Create and discuss disaster plan for family
 Acquaint all family members with first aid
equipment in home
 Route of egress from home
 Meeting place outside
 Conduct drills
 Preparation: Home
 Keep disaster stores of food, meds, diapers,
etc.
 Have “disaster containers” in home and car
Preparation: School
 Makes disaster plan known to all
 Routes of egress from school
 Meeting place
 Drills
Hospital Interface
 Work with local and state officials to create
disaster management plan
 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
Management of Resources
 Children require unique supplies
 Hospital pediatric resuscitation equipment
should be adequately stocked
 Oral fluids, small gauge IV sets, diapers, etc.
should be stockpiled nearby
 Children's toys, books, etc. should be
accessible
Management of Resources
 Know total number of pediatric floor and ICU
beds in area
 Be prepared to transport patients and or
supplies large distances
Example: Olympic Bombing
 Grady Hospital identified as primary receiving
hospital with support from surrounding hospitals
 Personnel drilled in specific tasks during disaster
 Telephone hotline activated immediately
following bombing
 Personnel arriving at hospital in specific roles
 Over 150 patients treated for major and minor
trauma without a single mortality
Recovery Phase: Initial
 Shelters should be “kid friendly”
 Keep families together
 Personnel to organize area for orphaned and
separated children until families reunited
 Create children's groups in shelter, plenty of
toys, books, etc..
Recovery Phase: Long-term
 Psychological services early
 Be attentive to children's needs, consider
educational resources for long-term
sheltering.
 Aberrant behavior may be manifestation of
emotional trauma
Recovery Phase: Long-term
 Children must feel safe in home, community
and school; encourage this
 Learn from mistakes
Disaster Mitigation: What you can do

 Emergency physicians, Pediatric EM

physicians, Pediatricians, Nurses, other
health care professionals:
- Preparation before disaster
- Action during disaster
- Recovery phase
Before Disaster Strikes
 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
 Act as an advisor to your patients for home
disaster planning
Before Disaster Strikes
 Arrange disaster response drills
 Promote community awareness addressing
pediatric needs
During A Disaster
 Be active!!
 Institute disaster plans in your facility
 Participate in the community response to
disaster
Disaster Recovery
 Provide medical care to shelters
 Assume basic community services will be
disrupted for some time
 Attend to emotional needs of the pediatric
population effected
Emotional Problems: What To Expect

 Acting out
 Depression
 Apathy, lack of expression
 Difficulty sleeping
 Fear of thunder, wind, etc.
 Somatic complaints
Who Is Most At Risk For Emotional Problems?

 Children most directly affected by the

disaster: injured themselves, family members
killed or injured
 Children with prior emotional problems
 Children suffering a disruption in their family
Disaster Mitigation......
Plan For The Children!