Pediatric surge planning in a large metropolitan county

Background/Purpose: A mega disaster involving large numbers of children will overwhelm pediatric resources in most communities. Thus, regions must plan for the surge in pediatric survivors following catastrophic events. We postulate that hospitals in a large urban county will have variable capacity and resources available to respond to a major natural or man-made disaster involving large numbers of children. To test this hypothesis, we examined pediatric surge capacity in Los Angeles County. Methods: A mixed methods approach was used to understand hospital capacity and capabilities. Hospitals were surveyed via Qualtrics on 48 questions regarding capacity, staffing, availability of pediatric supplies, and existing pediatric surge plans. Publically available inpatient capacity data supplemented hospital survey responses. This combined data set was analyzed for capacity, pediatric designations, and capabilities. Two stakeholder input sessions were held with a total of 84 participants. Results: Eighty-seven hospitals were included in the analysis. Forty-seven percent (41/87) of facilities provide inpatient pediatric services. Forty-four hospitals are designated as being an Emergency Department Approved for Pediatrics. Hospitals without pediatric services have varying levels of staff with pediatric training. The stakeholder groups recommended using existing supply lists and adding non-clinical supplies. The stakeholders requested advance and just in time training and reference guides to supplement the plan. Conclusions: These data support the hypothesis that pediatric surge capacity is variable. We believe that future planning should involve delineating hospitals by their capacity and capabilities to ensure a systems approach to pediatric disaster response.