Published online October 1, 2007
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e756-e761 (doi:10.1542/peds.2006-2856)
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ARTICLE

Prehospital Preparedness for Pediatric Mass-Casualty Events

Steve Shirm, MD, Rebecca Liggin, MD, Rhonda Dick, MD and James Graham, MD

Department of Pediatrics, University of Arkansas for Medical Sciences, College of Medicine, and Arkansas Children's Hospital, Little Rock, Arkansas

OBJECTIVES. Recent events have reiterated the need for well-coordinated planning for mass-casualty events, including those that involve children. The objective of this study was to document the preparedness of prehospital emergency medical services agencies in the United States for the care of children who are involved in mass-casualty events.

METHODS. A national list of all licensed prehospital emergency medical services agencies was prepared through contact with each state's emergency medical services office. A survey was mailed to 3748 emergency medical services agencies that were selected randomly from the national list in November 2004; a second survey was mailed to nonresponders in March 2005. Descriptive statistics were used to describe study variables.

RESULTS. Most (72.9%) agencies reported having a written plan for response to a mass-casualty event, but only 248 (13.3%) reported having pediatric-specific mass-casualty event plans. Most (69%) services reported that they did not have a specific plan for response to a mass-casualty event at a school. Most (62.1%) agencies reported that their mass-casualty event plan does not include provisions for people with special health care needs. Only 19.2% of the services reported using a pediatric-specific triage protocol for mass-casualty events, and 12.3% reported having a pediatrician involved in their medical control. Although most (69.3%) agencies reported participation in a local or regional disaster drill in the past year, fewer than half of those that participated in drills (49.0%) included pediatric victims.

CONCLUSIONS. Although children are among the most vulnerable in the event of disaster, there are substantial deficiencies in the preparedness plans of prehospital emergency medical services agencies in the United States for the care of children in a mass-casualty event.

Key Words: disasters • emergency aid • terrorism

Abbreviations: MCE—mass-casualty event • EMS—emergency medical services • START—simple triage and rapid treatment

Accepted Feb 19, 2007.