Background
In part because we have had so little experience with Mass Casualty involving
Pediatric Victims and this is an area we seem to avoid contemplating, there
appear to be holes in our pediatric response plans at the local, county, state
and federal level. This is particularly so with regard to a hazardous materials
event. A few examples illustrate this:
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there are no protocols for moving young children
through a decontamination shower line in the field or at a hospital,
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there are no specific instructions or methods for
getting infants decontaminated in the field or at the hospital,
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children's greater vulnerability to the effects of
toxins and to hypothermia require that they be decontaminated faster than
their adult counterparts, yet there are no standardized methods for how to
achieve this (decontamination triage),
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there are no protocols or methods or training to
address communicating with the victim's family either in the field or at the
hospital,
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there is dreadfully inadequate
training, education, drilling and stress inoculation of responders,
receivers and care providers,
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there is no guidance available for planners to use in
anticipating and handling the mental health needs of children and families
who will be in acute crisis during the mass casualty event.
There are three key issues that prompted the development
of the material you see on this site:
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There is reason to believe, based on extrapolation
from known adult reactions to toxins, that there will be greater morbidity
and mortality for child victims of a Hazmat event unless children are
decontaminated faster in the field and at the hospital.
-
A Mass Casualty Event, whether accidental or
intentional, actual or a ruse, will trigger acute stress reactions in
victims, their families and the community. Critical Incident Debriefing and
PTSD counseling are useful interventions after the fact. There is a need for
intervention in the moment that will decrease
the level, intensity and aftermath of emotional devastation for all
affected.
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There are highly charged ethical/moral issues that
flow from experience of being a responder or receiver of pediatric (and
adult) victims in a mass casualty event. These issues tend to not be openly
discussed or planned for and need our attention before the event.
There are three papers and two manuals available to you on this website. The
papers review the literature and offer a vision of "best practices" for
pediatric victims with regard to the three issues described above.
Since Pediatric Response is a new and evolving area, your reactions to the
material and input will be most welcome. Feel free to e-mail or call with your
comments, corrections and questions.