Pediatric PreparednessPediatric Preparedness

Susan Pollack MD, FAAPSusan Pollack MD, FAAPUniversity of KentuckyUniversity of Kentucky

Department of Pediatrics, College of MedicineDepartment of Pediatrics, College of MedicineDept. of Preventive Medicine and Environmental Health, College of Public Health Dept. of Preventive Medicine and Environmental Health, College of Public Health

and Kentucky Injury Prevention and Research Centerand Kentucky Injury Prevention and Research Centershpoll@uky.edu 859-257-4954 859-257-4954

IMPORTANT!!IMPORTANT!!• Injuries are the leading cause of death for children and

adolescents, yet most injuries are preventable. Injury prevention in preparedness and for survivors is not a luxury to be ignored, it is an essential part of disaster planning, otherwise children who survived the initial event will die because we did not think ahead enough to protect them.

• Children’s developmental job is to play and explore! Safe fun and adventure (both inside and outdoors) are important to kids’ normal development, well-being, processing of disaster events and resilient recovery.

General PreparationGeneral Preparation• Planning and development of collaborative Planning and development of collaborative

efforts across local, regional, state and efforts across local, regional, state and federal agencies/ levels, with inclusion of federal agencies/ levels, with inclusion of needs of infants, children being raised by needs of infants, children being raised by grandparents and in foster care, children grandparents and in foster care, children with special medical/developmental with special medical/developmental needs, and their caregivers.needs, and their caregivers.

• Encouragement of public preparedness by Encouragement of public preparedness by those agencies, including child- specific those agencies, including child- specific plans, notification of local EMS… plans, notification of local EMS…

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Preparing for a Disaster ComingPreparing for a Disaster Coming

Consider evacuation (where to, Consider evacuation (where to, how get there, what essentials go)how get there, what essentials go)

Post-Disaster Survival NeedsPost-Disaster Survival Needs

Gathering Family Gathering Family

Shelter (warmth)Shelter (warmth)

ComfortComfort

FoodFood

Place to SleepPlace to Sleep

Post disaster shelterPost disaster shelter

• More families will go to someone they know than a public shelter (friends may be better prepared to help with children/pets)

• Families may try to shelter in car near home- risk of both hypo and hyperthermia to those in car, plus of carbon monoxide poisoning from running heater in car.

Pediatric Needs in a ShelterPediatric Needs in a Shelter

• Formula, water, diapers• SAFE SLEEP for infants, cribs not cots, not

inflatable mattresses! Suffocation risks• Replacement car seats/boosters for travel• Safe play area for toddlers• Respite helpful, help with needs of caregivers

(parents/grandparents/foster parents) to keep them able to support kids

What are the major infant injury issues?What are the major infant injury issues?

• Safe sleep- 60% of infant injury deaths from suffocation. Most in unsafe bedding. Beds and the “killer couch”.

(Have you seen the bus?)• Age appropriate feeding- Tooth appropriate instead of

age appropriate? Don’t walk and eat! Choking hazards include grapes, gum, popcorn, hot dogs, hard candy, gummy bears, meat..

• Never shake a baby/child abuse- No cruise, no bruise. We are all mandated to report abuse.

• Child passenger safety (CPS): car seats. Buckle up on every ride, parents too- we need you!

Pediatric Issues in ShelterPediatric Issues in Shelter

• Food safety (both choking prevention for toddlers and food borne illness for all)

• Immunization needs- pertussis protection, tetanus, flu potential…problems with vaccine storage and temperature.

• Provision of safe play area for caregiver respite, protection of shelter elders and those who may be immunosuppressed.

Communication with childrenCommunication with children

• Talk with them- they know something is wrong. Cannot hide things- they know.

• Answer their questions (ask what they know, or have heard), no need to give them information beyond what they ask, but do give them opportunity to express fears/concerns

• Turn off TV after using any warnings- no need to see disaster repeated 100 times

Resilience and recoveryResilience and recovery

• Return to play/school can be good for children, signals return of normal structure. Don’t be offended that they “don’t care”

• Look for signs of distress, build in time to address needs and not just school for exams and scores.

• Listen to children, be truly present and not just on phone/text. Get mental health help for adult caregivers after trauma.

Resources for Pediatric Resources for Pediatric PreparednessPreparedness

• American Academy of Pediatrics (www.aap.org)• http://pediatricemergencypreparedness.org/Planning_To

ols.html• http://www.inclusivepreparedness.org/