Center for Disaster Medicine

New York Medical College School of Public Health

Considerations in Considerations in Emergency Emergency

Preparedness: Preparedness: A Two-track Conference A Two-track Conference

David Markenson, M.D.David Markenson, M.D.Director, Center for Disaster Director, Center for Disaster MedicineMedicineNew York Medical College New York Medical College School of Public HealthSchool of Public HealthChief, Pediatric Emergency Chief, Pediatric Emergency MedicineMedicineMaria Fareri Children’s Maria Fareri Children’s HospitalHospital

Objectives of ConferenceObjectives of Conference

Review new pediatric literatureReview new pediatric literature Update pediatric guidelinesUpdate pediatric guidelines Expand guidelines in selected areasExpand guidelines in selected areas Review literature of persons with Review literature of persons with

disabilitiesdisabilities Draft guidelines on emergency Draft guidelines on emergency

preparedness for persons with preparedness for persons with disabilitiesdisabilities

Changes in Terrorism Changes in Terrorism GuidelinesGuidelines

Role of fluoroquinolonesRole of fluoroquinolones RoleRole Inclusion of ones other than Inclusion of ones other than

ciprofloxacinciprofloxacin Nerve agent auto-injectorNerve agent auto-injector

Pediatric equivalentPediatric equivalent AnticonvulsantAnticonvulsant

CidofavirCidofavir

Added and Expanded Added and Expanded TopicsTopics

School PreparednessSchool Preparedness Child Congregate Facility PreparednessChild Congregate Facility Preparedness Sheltering Needs of ChildrenSheltering Needs of Children Pediatric Needs for Public Health Pediatric Needs for Public Health

Emergency PreparednessEmergency Preparedness Children with Special Health Care Needs Children with Special Health Care Needs

and Technologically Assisted Childrenand Technologically Assisted Children Decontamination of ChildrenDecontamination of Children Biological Terrorism Prophylaxis and Biological Terrorism Prophylaxis and

Treatment of Emerging AgentsTreatment of Emerging Agents Family Centered PreparednessFamily Centered Preparedness

Recommendations for Schools and Recommendations for Schools and Child Child

Congregate FacilitiesCongregate Facilities Develop safety plans that identify unique Develop safety plans that identify unique

threats or hazards that schools may face threats or hazards that schools may face Share safety plans with community to Share safety plans with community to

ensure that all community resources will be ensure that all community resources will be utilized in emergenciesutilized in emergencies

Have schools practice fire and evacuation Have schools practice fire and evacuation drills regularly, at least twice per academic drills regularly, at least twice per academic yearyear

Have local plans reflect major role of schools Have local plans reflect major role of schools in community planning and as emergency in community planning and as emergency resourcesresources

Recommendations for Recommendations for DecontaminationDecontamination

Decontamination of young children must be Decontamination of young children must be done with high-volume, low-pressure, heated done with high-volume, low-pressure, heated water systemswater systems

Systems must be designed for Systems must be designed for decontamination of all ages and types of decontamination of all ages and types of children children

All protocols and guidance must address:All protocols and guidance must address: Water temperature and pressureWater temperature and pressure Nonambulatory childNonambulatory child Child with special health care needsChild with special health care needs Clothing for after decontaminationClothing for after decontamination

Recommendations for Recommendations for HospitalsHospitals

72 hours of pediatric supplies and 72 hours of pediatric supplies and pharmaceuticals on hand for average pharmaceuticals on hand for average daily census plus minimum surge of daily census plus minimum surge of 5% adjusted for risk assessment5% adjusted for risk assessment

Engage in specific pediatric disaster Engage in specific pediatric disaster risk assessment with community to risk assessment with community to include school districts, emergency include school districts, emergency services, police dept., fire dept., child services, police dept., fire dept., child welfare, private practitioners, child welfare, private practitioners, child care, public health, and mental healthcare, public health, and mental health