Published online May 1, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. S416-S420 (doi:10.1542/peds.2006-0099O)

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SUPPLEMENT ARTICLE

Moving Hospitalized Children All Over the Southeast: Interstate Transfer of Pediatric Patients During Hurricane Katrina

Steve Baldwin, MD^a, Andria Robinson, MBA^b, Pam Barlow, BS^b and Crayton A. Fargason, Jr, MD, MM, FAAP^a

^a Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
^b Department of Pediatrics, Children's Hospital of Alabama, Birmingham, Alabama

Key Words: Hurricane Katrina • interstate transfer • pediatrics • disaster planning • surge capacity • regionalization

Abbreviations: FEMA, Federal Emergency Management Agency • VAD, ventricular assist device • NDMS, National Disaster Medical System

The first 300 words of the full text of this article appear below.

RACTICAL QUESTIONS: The question was, and is, "Can hospitalized children, in a geographic area, have their continuing medical needs met when capacity in that geographic area to provide care is exceeded?"

Events after the landfall of Hurricane Katrina on the city of New Orleans, Louisiana, generated significant information about pediatric care delivery during a disaster. In particular, Katrina helped answer 3 key questions regarding the care of children under disaster conditions:

1. In a disaster, will regional capabilities be used to augment local capabilities to care for children? In particular, will there be a preference for bypassing nearby providers of adult care to send pediatric patients to more specialized pediatric care facilities that are more geographically distant?
   
2. Can the communication and logistic challenges associated with regional pediatric patient movement be overcome during a disaster?
   
3. Do government disaster plans at the local, state, and federal levels facilitate pediatric patient movement across jurisdictions during a disaster?
   

We will provide a chronological timeline of pediatric activities related to the care of patients in 3 New Orleans hospitals (Tulane University Hospital, Children's Hospital of New Orleans, and Alton Ochsner Foundation Hospital) at the time of Katrina's landfall. After outlining the relevant sequence of activities, we will relate these activities to the 3 questions posed above.

Our discussion focuses on New Orleans, because it is an urban center with the highest concentration of pediatric inpatients that were impacted by Katrina. Our timeline is based on selected interviews and publicly available information. Despite the biased, qualitative, and focused nature of the analysis, the New Orleans experience demonstrates the need for significant adjustments in our disaster plans for pediatric care during disasters.

	2004–2005: 1 YEAR BEFORE LANDFALL

 
Ironically, pediatric health care providers from 5 states had been participating in the Southeastern Regional Pediatric Disaster Response Network for 1 year before Hurricane Katrina in . . . [Full Text of this Article]

Address correspondence to Crayton A. Fargason, MD, Children's Hospital of Alabama, ACC Suite 512, 1600 7th Ave S, Birmingham, AL 35233. E-mail: crayton.fargason@peds.uab.edu

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