Published online February 1, 2006
PEDIATRICS Vol. 117 No. 2 February 2006, pp. e340-e362 (doi:10.1542/peds.2005-2752)
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TECHNICAL REPORT

The Pediatrician and Disaster Preparedness

David Markenson, MD, Sally Reynolds, MD Committee on Pediatric Emergency Medicine and Task Force on Terrorism

ABSTRACT

For decades, emergency planning for natural disasters, public health emergencies, workplace accidents, and other calamities has been the responsibility of government agencies on all levels and certain nongovernment organizations such as the American Red Cross. In the case of terrorism, however, entirely new approaches to emergency planning are under development for a variety of reasons. Terrorism preparedness is a highly specific component of general emergency preparedness. In addition to the unique pediatric issues involved in general emergency preparedness, terrorism preparedness must consider several additional issues, including the unique vulnerabilities of children to various agents as well as the limited availability of age- and weight-appropriate antidotes and treatments. Although children may respond more rapidly to therapeutic intervention, they are at the same time more susceptible to various agents and conditions and more likely to deteriorate if they are not monitored carefully.

This article is designed to provide an overview of key issues for the pediatrician with respect to disaster, terrorism, and public health emergency preparedness. It is not intended to be a complete compendium of didactic content but rather offers an approach to what pediatricians need to know and how pediatricians must lend their expertise to enhance preparedness in every community. To become fully and optimally prepared, pediatricians need to become familiar with these key areas of emergency preparedness: unique aspects of children related to terrorism and other disasters; terrorism preparedness; mental health vulnerabilities and development of resiliency; managing family concerns about terrorism and disaster preparedness; office-based preparedness; hospital preparedness; community, government, and public health preparedness; and advocating for children and families in preparedness planning.

Key Words: emergency preparedness • disasters • terrorism • bioterrorism

Abbreviations: FEMA—Federal Emergency Management Agency • DMAT—disaster medical assistant team • CDC—Centers for Disease Control and Prevention • SNS—Strategic National Stockpile • FDA—Food and Drug Administration • AAP—American Academy of Pediatrics • DHS—Department of Homeland Security • NRP—national response plan • ESF—emergency support function • HSPD-5—Homeland Security Presidential Directive 5 • NIMS—national incident management system • VMI—vendor-managed inventory • HRSA—Health Resources and Services Administration • KI—potassium iodide