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Pediatric Mass Casualty

Michael Frogel, Avram Flamm, Mayer Sagy, Katharine Uraneck, Edward Conway, Michael Ushay, Bruce M Greenwald, Louisdon Pierre, Vikas Shah, Mohamed Gaffoor, Arthur Cooper, George Foltin
A mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems...
June 13, 2017: Disaster Medicine and Public Health Preparedness
Ilana Bank, Elene Khalil
OBJECTIVES: Pediatric hospital disaster responders must be well-trained and prepared to manage children in a mass-casualty incident. Simulations of various types have been the traditional way of testing hospital disaster plans and training hospital staff in skills that are used in rare circumstances. The objective of this longitudinal, survey-based, observational study was to assess the effect of disaster response and management-based experiential learning on the knowledge and confidence of advanced learners...
October 2016: Prehospital and Disaster Medicine
Stefan Katharios-Lanwermeyer, Jon-Erik Holty, Marissa Person, James Sejvar, Dana Haberling, Heather Tubbs, Dana Meaney-Delman, Satish K Pillai, Nathaniel Hupert, William A Bower, Katherine Hendricks
BACKGROUND: Bacillus anthracis, the causative agent of anthrax, is a potential bioterrorism agent. Anthrax meningitis is a common manifestation of B. anthracis infection, has high mortality, and requires more aggressive treatment than anthrax without meningitis. Its rapid identification and treatment are essential for successful management of an anthrax mass casualty incident. METHODS: Three hundred six published reports from 1880 through 2013 met predefined inclusion criteria...
June 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
J Joelle Donofrio, Amy H Kaji, Ilene A Claudius, Todd P Chang, Genevieve Santillanes, Mark X Cicero, Saranya Srinivasan, Alexis Perez-Rogers, Marianne Gausche-Hill
BACKGROUND: Rapid, accurate evaluation and sorting of victims in a mass casualty incident (MCI) is crucial, as over-triage of victims may overwhelm a trauma system and under-triage may lead to an increase in morbidity and mortality. At this time, there is no validation tool specifically developed for the pediatric population to test an MCI algorithm's inherent capabilities to correctly triage children. OBJECTIVE: To develop a set of criteria for outcomes and interventions to be used as a validation tool for testing an MCI algorithm's ability to correctly triage patients from a cohort of pediatric trauma patients...
May 2016: Prehospital Emergency Care
Ilene Claudius, Amy H Kaji, Genevieve Santillanes, Mark X Cicero, J Joelle Donofrio, Marianne Gausche-Hill, Saranya Srinivasan, Todd P Chang
INTRODUCTION: Using the pediatric version of the Simple Triage and Rapid Treatment (JumpSTART) algorithm for the triage of pediatric patients in a mass-casualty incident (MCI) requires assessing the results of each step and determining whether to move to the next appropriate action. Inappropriate application can lead to performance of unnecessary actions or failure to perform necessary actions. Hypothesis/Problem To report overall accuracy and time required for triage, and to assess if the performance of unnecessary steps, or failure to perform required steps, in the triage algorithm was associated with inaccuracy of triage designation or increased time to reach a triage decision...
October 2015: Prehospital and Disaster Medicine
Kristin C Lyle, Jerrod Milton, Daniel Fagbuyi, Roxanna LeFort, Paul Sirbaugh, Jacqueline Gonzalez, Jeffrey S Upperman, Tim Carmack, Michael Anderson
OBJECTIVE: Children account for 30 percent of the US population; as a result, many victims of disaster events are children. The most critically injured pediatric victims would be best cared for in a tertiary care pediatric hospital. The Children's Hospital Association (CHA) undertook a survey of its members to determine their level of readiness to respond to a mass casualty disaster. DESIGN: The Disaster Response Task Force constructed survey questions in October 2011...
2015: American Journal of Disaster Medicine
Ilene Claudius, Amy Kaji, Genevieve Santillanes, Mark Cicero, J Joelle Donofrio, Marianne Gausche-Hill, Saranya Srinivasan, Todd P Chang
INTRODUCTION: Multiple modalities for simulating mass-casualty scenarios exist; however, the ideal modality for education and drilling of mass-casualty incident (MCI) triage is not established. Hypothesis/Problem Medical student triage accuracy and time to triage for computer-based simulated victims and live moulaged actors using the pediatric version of the Simple Triage and Rapid Treatment (JumpSTART) mass-casualty triage tool were compared, anticipating that student performance and experience would be equivalent...
October 2015: Prehospital and Disaster Medicine
Philip Toltzis, Gerardo Soto-Campos, Christian R Shelton, Evelyn M Kuhn, Ryan Hahn, Robert K Kanter, Randall C Wetzel
OBJECTIVE: ICU resources may be overwhelmed by a mass casualty event, triggering a conversion to Crisis Standards of Care in which critical care support is diverted away from patients least likely to benefit, with the goal of improving population survival. We aimed to devise a Crisis Standards of Care triage allocation scheme specifically for children. DESIGN: A triage scheme is proposed in which patients would be divided into those requiring mechanical ventilation at PICU presentation and those not, and then each group would be evaluated for probability of death and for predicted duration of resource consumption, specifically, duration of PICU length of stay and mechanical ventilation...
September 2015: Pediatric Critical Care Medicine
Stephen D Waterford, Mallory Williams, Charles J Siegert, P Marco Fisichella, Abraham Lebenthal
BACKGROUND: Trauma is the leading cause of death from ages 1-44-y in the United States and the fifth leading cause of death overall, but there are few studies quantifying trauma education in medical school. This study reviews curriculum hours devoted to trauma education at a northeastern medical school. MATERIALS AND METHODS: We reviewed the preclinical curriculum at a northeastern medical school affiliated with three adult and two pediatric level I trauma centers verified by the American College of Surgeons...
August 2015: Journal of Surgical Research
Joshua P Bobko, David W Callaway, E Reed Smith
No abstract text is available yet for this article.
October 2014: JEMS: a Journal of Emergency Medical Services
Bridget M Berg, Valerie M Muller, Millicent Wilson, Roel Amara, Kay Fruhwirth, Kathleen Stevenson, Rita V Burke, Jeffrey S Upperman
INTRODUCTION: Children are one of the most vulnerable populations during mass casualty incidents because of their unique physiological, developmental, and psychological attributes. The objective of this project was to enhance Los Angeles County's (LAC) pediatric surge capabilities. The purpose of this study was threefold: (1) determine gaps in pediatric surge capacity and capabilities; (2) double pediatric inpatient capacity; and (3) document a plan to address gaps and meet pediatric inpatient surge...
2014: American Journal of Disaster Medicine
Rita V Burke, Tae Y Kim, Shellby L Bachman, Ellen I Iverson, Bridget M Berg
INTRODUCTION: Children are particularly vulnerable during disasters and mass-casualty incidents. Coordinated multi-hospital training exercises may help health care facilities prepare for pediatric disaster victims. PROBLEM: The purpose of this study was to use mixed methods to assess the disaster response of three hospitals, focusing on pediatric disaster victims. METHODS: A full-functional disaster exercise involving a simulated 7.8-magnitude earthquake was conducted at three Los Angeles (California USA) hospitals, one of which is a freestanding designated Level I Pediatric Trauma Center...
December 2014: Prehospital and Disaster Medicine
Elizabeth N Austin, Serap E Bastepe-Gray, H Wayne Nelson, Judith Breitenbach, Kathleen T Ogle, Angela Durry, Sheila D Green, Lisa A Crabtree, Mindy Haluska
No abstract text is available yet for this article.
September 2014: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Donell Harvin, Nora Caplan, Sean M Kivlehan
No abstract text is available yet for this article.
July 2014: EMS World
A L Genovesi, B Hastings, E A Edgerton, L M Olson
INTRODUCTION: In the USA, the emergency medical services (EMS) system is vital for American Indians and Alaska Natives, who are disproportionately burdened by injuries and diseases and often live in rural areas geographically far from hospitals. In rural areas, where significant health disparities exist, EMS is often a primary source of healthcare providing a safety net for uninsured individuals or families who otherwise lack access to health-related services. EMS is frequently the first entry point for children and their families into the healthcare system...
2014: Rural and Remote Health
Mitchell Hamele, William Bradley Poss, Jill Sweney
Both domestic and foreign terror incidents are an unfortunate outgrowth of our modern times from the Oklahoma City bombings, Sarin gas attacks in Japan, the Madrid train bombing, anthrax spores in the mail, to the World Trade Center on September 11(th), 2001. The modalities used to perpetrate these terrorist acts range from conventional weapons to high explosives, chemical weapons, and biological weapons all of which have been used in the recent past. While these weapons platforms can cause significant injury requiring critical care the mechanism of injury, pathophysiology and treatment of these injuries are unfamiliar to many critical care providers...
February 4, 2014: World Journal of Critical Care Medicine
Katherine Kenningham, Kathryn Koelemay, Mary A King
OBJECTIVE: This study aims to 1) demonstrate one method of pediatric disaster preparedness education using a regional disaster coalition organized workshop and 2) evaluate factors reflecting the greatest shortfall in pediatric mass casualty incident (MCI) triage skills in a varied population of medical providers in King County, WA. DESIGN: Educational intervention and cross-sectional survey. SETTING: Pediatric disaster preparedness conference created de novo and offered by the King County Healthcare Coalition, with didactic sessions and workshops including a scored mock pediatric MCI triage...
March 2014: Journal of Emergency Management: JEM
Gabrielle A Jacquet, Bhakti Hansoti, Alexander Vu, Jamil D Bayram
BACKGROUND: Children are a special population, particularly susceptible to injury. Registries for various injury types in the pediatric population are important, not only for epidemiological purposes but also for their implications on intervention programs. Although injury registries already exist, there is no uniform injury classification system for traumatic mass casualty events such as earthquakes. OBJECTIVE: To systematically review peer-reviewed literature on the patterns of earthquake-related injuries in the pediatric population...
2013: PLoS Currents
Carmen I Rios, David R Cassatt, Andrea L Dicarlo, Francesca Macchiarini, Narayani Ramakrishnan, Mai-Kim Norman, Bert W Maidment
The possibility of a public health radiological or nuclear emergency in the United States remains a concern. Media attention focused on lost radioactive sources and international nuclear threats, as well as the potential for accidents in nuclear power facilities (e.g., Windscale, Three Mile Island, Chernobyl, and Fukushima) highlight the need to address this critical national security issue. To date, no drugs have been licensed to mitigate/treat the acute and long-term radiation injuries that would result in the event of large-scale, radiation, or nuclear public health emergency...
February 2014: Drug Development Research
Nicole Jones, Marjorie Lee White, Nancy Tofil, MeKeisha Pickens, Amber Youngblood, Lynn Zinkan, Mark D Baker
PURPOSE: Several field triage systems have been developed to rapidly sort patients following a mass casualty incident (MCI). JumpSTART (Simple Triage and Rapid Transport) is a pediatric-specific MCI triage system. SALT (Sort, Assess, Lifesaving interventions, Treat/Transport) has been proposed as a new national standard for MCI triage for both adult and pediatric patients, but it has not been tested in a pediatric population. This pilot study hypothesizes that SALT is at least as good as JumpSTART in triage accuracy, speed, and ease of use in a simulated pediatric MCI...
July 2014: Prehospital Emergency Care
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