The Pediatrician and Disaster Preparedness

PEDIATRICS (Impact Factor: 5.47). 03/2006; 117(2):e340-62. DOI: 10.1542/peds.2005-2752
Source: PubMed


For decades, emergency planning for natural disasters, public health emergencies, workplace accidents, and other calamities has been the responsibility of government agencies on all levels and certain nongovernment organizations such as the American Red Cross. In the case of terrorism, however, entirely new approaches to emergency planning are under development for a variety of reasons. Terrorism preparedness is a highly specific component of general emergency preparedness. In addition to the unique pediatric issues involved in general emergency preparedness, terrorism preparedness must consider several additional issues, including the unique vulnerabilities of children to various agents as well as the limited availability of age- and weight-appropriate antidotes and treatments. Although children may respond more rapidly to therapeutic intervention, they are at the same time more susceptible to various agents and conditions and more likely to deteriorate if they are not monitored carefully. This article is designed to provide an overview of key issues for the pediatrician with respect to disaster, terrorism, and public health emergency preparedness. It is not intended to be a complete compendium of didactic content but rather offers an approach to what pediatricians need to know and how pediatricians must lend their expertise to enhance preparedness in every community. To become fully and optimally prepared, pediatricians need to become familiar with these key areas of emergency preparedness: unique aspects of children related to terrorism and other disasters; terrorism preparedness; mental health vulnerabilities and development of resiliency; managing family concerns about terrorism and disaster preparedness; office-based preparedness; hospital preparedness; community, government, and public health preparedness; and advocating for children and families in preparedness planning.

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    • "For example, HCPs were the first to recognize early cases of inhalation anthrax in 2001 [12] and first to identify dengue outbreaks in Hawaii, Florida and Texas between 2001–2011 [13]. In an emergency, public health agencies rely on HCPs as both frontline responders and as trusted and preferred communicators of health information to the public during an emergency [14-16]. "
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    ABSTRACT: Health care providers play a significant role in large scale health emergency planning, detection, response, recovery and communication with the public. The effectiveness of health care providers in emergency preparedness and response roles depends, in part, on public health agencies communicating information in a way that maximizes the likelihood that the message is delivered, received, deemed credible and, when appropriate, acted on. However, during an emergency, health care providers can become inundated with alerts and advisories through numerous national, state, local and professional communication channels. We conducted an alert fatigue study as a sub-study of a larger randomized controlled trial which aimed to identify the most effective methods of communicating public health messages between public health agencies and providers. We report an analysis of the effects of public health message volume/frequency on recall of specific message content and effect of rate of message communications on health care provider alert fatigue. Health care providers enrolled in the larger study (n=528) were randomized to receive public health messages via email, fax, short message service (SMS or cell phone text messaging) or to a control group that did not receive messages. For 12 months, study messages based on real events of public health significance were sent quarterly with follow-up telephone interviews regarding message receipt and topic recall conducted 5-10 days after the message delivery date. During a pandemic when numerous messages are sent, alert fatigue may impact ability to recall whether a specific message has been received due to the "noise" created by the higher number of messages. To determine the impact of "noise" when study messages were sent, we compared health care provider recall of the study message topic to the number of local public health messages sent to health care providers. We calculated the mean number of messages that each provider received from local public health during the time period around each study message and provider recall of study message content. We found that recall rates were inversely proportional to the mean number of messages received per week: Every increase of one local public health message per week resulted in a statistically significant 41.2% decrease (p < 0.01), 95% CI [0.39, .87] in the odds of recalling the content of the study message. To our knowledge, this is the first study to document the effects of alert fatigue on health care providers' recall of information. Our results suggest that information delivered too frequently and/or repetitively through numerous communication channels may have a negative effect on the ability of health care providers to effectively recall emergency information. Keeping health care providers and other first-line responders informed during an emergency is critical. Better coordination between organizations disseminating alerts, advisories and other messages may improve the ability of health care providers to recall public health emergency messages, potentially impacting effective response to public health emergency messages.
    Full-text · Article · Aug 2013 · BMC Health Services Research
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    • "The Psychosocial Working Group (PWG) (2003) suggests that participation itself is psychologically bene¢cial because it helps to restore dignity and a sense of control, especially following overwhelming experiences (Hobfoll, et al., 2007). Child participation in the aftermath of disaster will help them to regain a sense of agency and security, and ultimately foster resilience (Markenson & Reynolds, 2006). Similarly, a study conducted by Hart (2004) suggested that child participation in humanitarian action can open doors for enhanced protection. "
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    ABSTRACT: There is increasing attention given to participatory projects with marginalized children and young people, in the absence of child protection. In Nepal, a process was developed to provide a framework for more systematic participation of children in psycho-social programming, geared towards facilitating the reintegration for former child soldiers.The pro-cess development followed seven steps with the chil-dren, including culturally grounded concepts of psychosocial wellbeing and problems, desired out-comes, utilization of existing resources, responsive activities and development of indicators in order to monitor project activities. The result was a series of Child Led Indicators (CLI), which represented markers of psychosocial wellbeing that children prioritized, recognized in others, and could monitor throughout a project cycle. Development and imple-mentation of the CLI tool revealed a number of challenges to the implementation and e¡ectiveness of participatory tools for children, which echo the growing the critique of participatory programming. This paper will describe the framework as well as the results of a pilot CLI implementation.
    Full-text · Article · Jul 2009 · Intervention
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    ABSTRACT: Los últimos atentados terroristas y acontecimientos aéreos han convertido a la medicina en catástrofes en un tema de interés público. Tanto los organismos gubernamentales como la comunidad esperan que los Servicios de Urgencias de los Hospitales estén prepa- rados para afrontar todo tipo de catástrofes. Desde un punto de vista sanitario se puede definir una catástrofe como la situación o acontecimiento en que se produce en un breve periodo de tiempo un aumento del número de pacientes que deben ser atendidos por los servicios sanitarios, sobre todo a través del servicio de urgencias, afectados de una determinada patología médica o quirúrgica, adquirida conjuntamente 1 . La clave
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