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University of Massachusetts Medical School
Andrew Garrett MD, MPH, FAAP
Richard Aghababian MD, FACEP
University of Massachusetts Medical School
Andrew Garrett MD, MPH, FAAP
Richard Aghababian MD, FACEP
Pediatric Disaster Life Support ©
Edition 2.0
Introduction
Andrew Garrett MD
Introduction
Andrew Garrett MD
Pediatric Disaster Life Support
WelcomeWelcome
PDLS is designed to give emergency personnel a foundation of knowledge and skills to more effectively prepare for and respond to disasters involving children
PDLS is designed to give emergency personnel a foundation of knowledge and skills to more effectively prepare for and respond to disasters involving children
Intent of PDLSIntent of PDLS
PDLS builds on the fundamental pediatric patient care skills learned in basic pediatric resuscitation courses Such as PALS, PEPP, APLS
PDLS builds on the fundamental pediatric patient care skills learned in basic pediatric resuscitation courses Such as PALS, PEPP, APLS
What is a disaster?What is a disaster?
Many definitions exist For this purposes of this course
An exceptional event that disrupts community functioning, causes human suffering or fatalities, and/or creates needs that the victims can not alleviate without assistance
Says nothing about the cause
Many definitions exist For this purposes of this course
An exceptional event that disrupts community functioning, causes human suffering or fatalities, and/or creates needs that the victims can not alleviate without assistance
Says nothing about the cause
Why PDLS?Why PDLS?
Disasters by our definition affect communities “Community” in public health means any
collection of people sharing an environment where they have something in common
Most communities contain infants, children, and adolescents Towns, cities, states, nations Schools, camps, daycare facilities
Disasters by our definition affect communities “Community” in public health means any
collection of people sharing an environment where they have something in common
Most communities contain infants, children, and adolescents Towns, cities, states, nations Schools, camps, daycare facilities
Care for the Entire CommunityCare for the Entire Community
To take care of a community means to take care of the children contained within it
As a new specialty area, Disaster Medicine (along with Prehospital Care/EMS) was initially based on taking care of adult patients Why is this? Much of the science grew out of military research and
military operations These focus was on young, healthy adults
To take care of a community means to take care of the children contained within it
As a new specialty area, Disaster Medicine (along with Prehospital Care/EMS) was initially based on taking care of adult patients Why is this? Much of the science grew out of military research and
military operations These focus was on young, healthy adults
Children as a Special PopulationChildren as a Special Population For years, pediatric patients were
underemphasized in Disaster Medicine
In the last decade, there has been increased interest in how to better care for children before they get to the hospital
This can be difficult, since “children are not just little adults” and they do not fit the traditional mold of preparing for and treating children in a disaster
For years, pediatric patients were underemphasized in Disaster Medicine
In the last decade, there has been increased interest in how to better care for children before they get to the hospital
This can be difficult, since “children are not just little adults” and they do not fit the traditional mold of preparing for and treating children in a disaster
Children as a Special PopulationChildren as a Special Population A major focus of PDLS is the difference between
children and adults
Children have unique medical and psychological needs that must be taken into account during disaster preparedness and response planning
We will focus on the special vulnerabilities of children during disaster
A major focus of PDLS is the difference between children and adults
Children have unique medical and psychological needs that must be taken into account during disaster preparedness and response planning
We will focus on the special vulnerabilities of children during disaster
The Science AdvancesThe Science Advances PDLS reflects the advancements in the science of
pediatric care during disasters
Incorporates the information that we have learned during the past decade, such as: Oklahoma City bombing (1995) 9/11 terrorist attacks (2001) Anthrax attacks (2001) Beslan School seige (2004) Indian Ocean tsunami (2004) Hurricane Katrina (2005)
PDLS reflects the advancements in the science of pediatric care during disasters
Incorporates the information that we have learned during the past decade, such as: Oklahoma City bombing (1995) 9/11 terrorist attacks (2001) Anthrax attacks (2001) Beslan School seige (2004) Indian Ocean tsunami (2004) Hurricane Katrina (2005)
Alfred P. Murrah Federal Building
Alfred P. Murrah Federal Building
An Unfortunate RealityAn Unfortunate Reality
Children as an intentional target of terrorism increases the need for PDLS Oklahoma City bombing daycare center Tel Aviv Dolphinarium disco bombing School Mass Murders:
Columbine, Red Lake, Ma’alot
Dubrovka Theater Seige Beslan School hostage crisis
Children as an intentional target of terrorism increases the need for PDLS Oklahoma City bombing daycare center Tel Aviv Dolphinarium disco bombing School Mass Murders:
Columbine, Red Lake, Ma’alot
Dubrovka Theater Seige Beslan School hostage crisis
Beslan, Russia 9/1/04Beslan, Russia 9/1/04
Over 1000 children taken as hostages in a politically-motivated seige at a Beslan school
Seige lasted one week Unmeetable demands made Children packed into gymnasium rigged
with explosives
Over 1000 children taken as hostages in a politically-motivated seige at a Beslan school
Seige lasted one week Unmeetable demands made Children packed into gymnasium rigged
with explosives
Beslan, Russia 9/1/04Beslan, Russia 9/1/04
Day 3- terrorists suddenly begin shooting hostages and set off explosions in gymnasium
Rescuers storm school Hundreds injured or killed Resources limited due to remote location
and prolonged event
Day 3- terrorists suddenly begin shooting hostages and set off explosions in gymnasium
Rescuers storm school Hundreds injured or killed Resources limited due to remote location
and prolonged event
The Rescue Attempt BeginsThe Rescue Attempt Begins
A Sudden Influx of PatientsA Sudden Influx of Patients
A Sudden Influx of PatientsA Sudden Influx of Patients
A Sudden Influx of PatientsA Sudden Influx of Patients
A Sudden Influx of PatientsA Sudden Influx of Patients
Beslan, Russia 9/1/04Beslan, Russia 9/1/04
Who should receive the efforts of a limited number of providers and medical facilities?
Does this meet our definition of disaster? An exceptional event that disrupts community functioning,
causes human suffering or fatalities, and/or creates needs that the victims can not alleviate without assistance
Who should receive the efforts of a limited number of providers and medical facilities?
Does this meet our definition of disaster? An exceptional event that disrupts community functioning,
causes human suffering or fatalities, and/or creates needs that the victims can not alleviate without assistance
Mass Casualty IncidentsMass Casualty Incidents
MCI’s may or may not represent disasters to a community, based on the level of preparedness in the community Why is that?
Many of the same priorities, knowledge and tools in PDLS still apply when responding to an MCI
MCI’s may or may not represent disasters to a community, based on the level of preparedness in the community Why is that?
Many of the same priorities, knowledge and tools in PDLS still apply when responding to an MCI
Natural DisastersNatural Disasters
As if terrorism was not enough… Some experts think that the numbers of
natural disasters are increasing Increased numbers at risk due to
globalization and development of at-risk areas
As if terrorism was not enough… Some experts think that the numbers of
natural disasters are increasing Increased numbers at risk due to
globalization and development of at-risk areas
Earthquakes and TsunamiEarthquakes and Tsunami
Earthquakes and TsunamiEarthquakes and Tsunami
Nias, Indonesia 4/05
HurricanesHurricanes
TornadoesTornadoes
FloodsFloods
Volcanoes, Mudslides, LaharsVolcanoes, Mudslides, Lahars
The Risk ExistsThe Risk Exists
No community is exempt from the risk of a disaster
As healthcare providers we have a responsibility to prepare for the care of children and adults- the whole community
PDLS is a starting point
No community is exempt from the risk of a disaster
As healthcare providers we have a responsibility to prepare for the care of children and adults- the whole community
PDLS is a starting point
OutlineOutline
PDLS has two core lectures: Fundamental Concepts in Pediatric Disaster
Medicine Practical Issues in Pediatric Disaster
Medicine
Followed by a field training exercise that will give you an opportunity to practice some of the skills presented in PDLS
PDLS has two core lectures: Fundamental Concepts in Pediatric Disaster
Medicine Practical Issues in Pediatric Disaster
Medicine
Followed by a field training exercise that will give you an opportunity to practice some of the skills presented in PDLS