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- 1. Pediatric Planning for a Public Health Emergency Joseph Sullivan Mentor: Dr. Christa-Marie Singleton Centers for Disease Control Office of Public Health Emergency Preparedness and Response Division of State and Local Readiness Office of Public Health Preparedness and Response Division of State and Local Readiness
- 2. Introduction For the purposes of this project, pediatric emergency preparedness planning is preparing a community for a disaster that could potentially affect children Office of Public Health Preparedness and Response Division of State and Local Readiness
- 3. Background 25% of the population, approximately 74 million people, are under the age of 18. These children are a vulnerable population They are dependant on their caregiver(s). 1 1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.
- 4. Importance In a Public Health emergency: Children could be separated from family Sick children may not be able to receive necessary care Children’s caregivers could die, become injured, quarantined or incapacitated for a long period of time If any of the above occurs, there could be potential economic impact.
- 5. Hurricane Katrina “Before Hurricane Katrina, the cost of transporting neonates and children out of a disaster-impacted area was viewed by many as not being financially or operationally viable” 2 2. Baldwin, Steve, Andria Robinson, Pam Barlow, and Crayton Fargason. "Interstate Transfer of Pediatric Patients During Hurricane Katrina." 117. (2006): 68-72. Web. 31 July 2011. <http://www.aap.org/advocacy/releases/hurrkatsupp.pdf>.
- 6. Public Health Emergency Preparedness The Public Health Preparedness Capabilities: National Standards for State and Local Planning document cited pediatric planning as a priority The PHEP capabilities reference pediatric planning in 3 areas: 1 Community Preparedness 2 Medical Surge 3 3. Community Preparedness, Function 4 Medical Surge, Function 1 and 2
- 7. Criteria If the awardees are supposed to include pediatric planning in their emergency plans: How many awardees are conducting pediatric planning? What is the state of the pediatric planning?
- 8. Methodology June 2011 review of 57 of the 62 PHEP awardees The review of the documents indicated that only 27 awardees included pediatric planning and met the criteria, 30 did not.
- 9. Barriers
- 10. Pediatric Planning not Addressed Why do emergency plans not address children's needs even though the preparedness capabilities cite this as a priority? I recommend consulting the “Child Care and Early Education” section of the “National Commission on Children and Disasters.” 1 1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.
- 11. Lack of Funding Which component is not being addressed due to a lack of funding?
- 12. Lack of Resources Lack of medicine? Lack of beds? Lack of equipment? I recommend having the awardees better define the specific resources they need and looking into “Globalmedia’s telemedicine solution” to form a network with other healthcare facilities. 4 4. Barthelemy, Joel, Michael Harris, Brad Schmidt, Bruce Adams, and Jay Culver. "How to Get Started." (2002-2011): n. pag. Web. 30 July 2011. <http://www.globalmed.com/training-education/how-to-get-started.php>.
- 13. Lack of Communication and Coordination Lack of coordination and communication between whom? Why is there not coordination of activities regarding pediatric providers? I recommend consulting the “Emergency Medical Services and Pediatric Transport” section of the “National Commission on Children and Disasters.” 1 1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.
- 14. Lack of Treatment (Rural Areas) Lack of care providers? Lack of healthcare facilities? Lack of maintaining a large capacity? I recommend having the awardees better define the specific type of treatment they need and consulting the “Child Physical Health and Trauma” section of the “National Commission on Children and Disasters.” 1 1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.
- 15. Lack of Training Lack training regarding the Incident Command System? Lack of care provider training? I recommend having awardees better define what type of training they need and consulting the “Federal Emergency Management Agency’s Emergency Management Institute” website. 5 5. U.S. Department of Homeland Security. Independent Study Complete Course List. Emmitsburg: , 2011. Web. 1 Aug 2011. <http://training.fema.gov/IS/crslist.asp>.
- 16. No Processes to identify Gaps and Access Pediatric Providers Why have processes to identify gaps in pediatric care not been developed? Why have processes to access pediatric providers not been developed? I recommend consulting the “Disaster Management and Recovery” section of the National Commission on Children and Disasters.” 1 1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.
- 17. Process of Establishing Plans I recommend consulting the “Emergency Medical Services and Pediatric Transport” section of the “National Commission on Children and Disasters.” 1 1. National Commission on Children and Disasters. 2010 Report to the President and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. October 2010.
- 18. Questions
Editor's Notes
- Hello everyone, My name is Joe Sullivan and my presentation is on Pediatric Planning for a Public Health Emergency.
- For the purposes of this project, pediatric emergency preparedness planning is preparing a community for a disaster that could potentially affect children.
- 25% of the population, approximately 74 million people, are under the age of 18. These children are a vulnerable population, which means they are dependant on their caregiver(s). They will not be able to take care of themselves during a public health emergency and will need to rely on their caregiver for food and safety.
- In a Public Health emergency:Children could become separated from their family,Sick children may not be able to receive necessary care,Or children’s caregivers could die, become injured, quarantined or incapacitated for a long period of timeIf any of the above occurs, there could be potential economic impact.Children who become ill or injured from an incident may likely require caregivers to take time off from work to care for them.Therefore, if the adult caregivers are not able to work, there could be a potential loss of family income, which could cause economic loss.Businesses may not be able to function at full potential without the adult caregivers, which could also lead to economic loss
- Hurricane Katrina was the “costliest natural disaster as well as one of the deadliest hurricanes in the history of the United States.” Most of the hospitals and places of pediatric care reached their capacity quickly and many children had to be transported to another hospital in the southeastern region of the U.S.As you can see from the quote, transporting children out of disaster-impacted areas is not financially viable.Even the secretary of the U.S. Department of Homeland Security agrees to take action and develop future plans to prepare for another possible Public Health emergency. I quote “improving the capacity to deal with large-scale medical emergencies is paramount” (Secretary Napolitano Issues Action Directives on First Responder Health Surge Capacity and Hurricane Katrina, 2009).The interstate transfer of pediatric patients during Hurricane Katrina would have been facilitated and better coordinated if pediatric plans were installed before the Public Health Emergency and they included processes to identify gaps and access pediatric providers.
- Understanding the importance of pediatric planning, The Public Health Preparedness Capabilities: National Standards for State and Local Planning document cited pediatric planning as a priority.This means that the awardees are supposed to include pediatric planning in their emergency plans.I read through 3 of the 15 capabilities that deal with pediatric emergency planning. One of the capabilities deals with community preparedness and the other two deal with medical surge.
- This brings me to the questions of :How many awardees are conducting pediatric planning?…And What is the state of the pediatric planning?These questions address whether each awardee meets the criteria of successfully including pediatric planning.
- Interested in researching whether other states are just as unprepared as Louisiana was. I conducted a June 2011 review of 57 of the 62 PHEP awardees using the capabilities Plan Resource Elements Narrativeto determine how many of the awardees have pediatric planning included in their emergency plans.I discovered that only 27 awardees included pediatric planning and met the criteria, 30 did not.
- I then wanted to investigate why 30 out of 57 awardees did not include pediatric planning even though the PHEP cited it as a priority.After researching the topic, I determined a list of the barriers affecting the awardees.I read through the 30 awardees without pediatric planning and grouped them based on which barrier they are affected by.I discovered that the lack of processes to identify gaps and access pediatric providers is the most common barrier.And the lack of funding is the least common barrier.I decided to take this data and create a conceptual model based off of the barriers.I created questions to better understand each of the barriers and make recommendations to the awardees.
- For the barrier Pediatric Planning is not addressed,I created the question, Why do emergency plans not address children's needs even though the preparedness capabilities cite this as a priority?I recommend consulting the “Child Care and Early Education” article to show the awardees the importance of pediatric planning and why they should include it in their emergency plans. This article also provides information with regards to addressing and establishing pediatric planning.
- For the barrier Lack of funding,I created the question, Which component is not being addressed due to a lack of funding?
- For the barrier Lack of Resources,I created the questions:Is there a lack of medicine?Is there a lack of beds?And is there a lack of equipment?I recommend having the awardees better define the specific resources they need to aid the CDC in developing a narrow recommendation to mitigate this barrier. I also recommend looking into “Globalmedia’s telemedicine solution” to form a network with other healthcare facilities.
- For the barrier Lack of communication and coordination,I created the questions:Who is the Lack of coordination and communication between?And why is there not coordination of activities regarding pediatric providers?I recommend consulting the “Emergency Medical Services and Pediatric Transport” article to better understand proper communication and how to coordinate pediatric plans.
- For the barrier Lack of Treatment,I created the questions:Is there a lack of care providers?Is there a lack of healthcare facilities?And is there a lack of maintaining a large capacity?I recommend having the awardees better define the specific type of treatment they need and consulting the “Child Physical Health and Trauma” article to learn about the availability of and access to pediatric medical countermeasures at the state level.
- For the barrier Lack of Training,I created the questions:Is there a lack of training regarding the ICS system?And is there a lack of care provider training?I recommend having awardees better define what type of training they need and consulting the “Federal Emergency Management Agency’s Emergency Management Institute” website to match the type of training they need with a Federal Emergency Management Agency training course and utilize that course to train.
- For the barrier lack of processes to identify gaps and access pediatric providers,I created the questions:Why have processes to identify gaps in pediatric care not been developed?And why have processes to access pediatric providers not been developed?I recommend consulting the “Disaster Management and Recovery” article to better understand their gaps and know how to address them. The article will also inform the awardees of integrating the needs of children across all inter and intra governmental disaster management activities and operations.
- And for the barrier the process of establishing plans,I recommend consulting the “Emergency Medical Services and Pediatric Transport” article to learn more about implementing pediatric planning.
- Thank you. I will now answer any questions you might have.