Unmet needs in pediatric preparedness and response

Disasters are an increasing public health concern, with an average of one disaster per week necessitating international assistance somewhere in the world. Disasters create challenges not encountered in the routine practice of emergency health care. Some of challenges include early warning systems, evacuation protocols, widespread search and rescue, on-site triage and casualty distribution, coordination among multiple jurisdictions, governmental agencies, and non-governmental organizations, and adequate response to mental health needs. These challenges require effective management to reduce damages and deaths. Additionally, certain populations may be at an increased risk from disasters because of their unique vulnerabilities. Some of the groups with unique vulnerabilities include the elderly, persons with disabilities, and children. Each of the populations commands special expertise and protocols to manage their needs. However, current literature indicates that children / pediatrics are not receiving the management of their unique needs in disaster preparedness. Eight major areas have been identified as containing significant gaps in pediatric preparedness: emergency and prehospital care; hospital care; emergency preparedness; terrorism preparedness and response; mental health needs; school preparedness and response; training and drills; and future research agenda and funding. Though federal, state, and local agencies have programs specifically directed at children, most of the current initiatives focus on a subgroup of children, i.e. those with special needs or specific chronic conditions. Furthermore, the current adult models and guidelines cannot be applied to the care of children and therefore they are in need of their own disaster management procedures and care.