TABLE 1

Examples of Disaster Effects on NICU Populations

Disaster TypeGeneral ExamplesPotential Effects on NICU Patients
Natural disasterHurricane Katrina, Superstorm SandyLoss of electrical power and life-sustaining equipment
Particulate matter or droplets from debris that can affect skin or airwaysa,b
Increased risk of infection or injury during transfer or evacuation to another hospital
Exposure to temperature extremes; inability to minimize effects of conduction, convection, evaporation, and radiation
Constraints on adequate nutrition/caloric intake
Limited medication doses available
Increased risk of neonatal conditions related to maternal stress
Loss of clean water
Possible carbon monoxide poisoning from generators
Industrial disasterRadiologic disasters, chemical spillsDisruption of fetus’/infant’s growing organ systems
Radiation/carcinogen exposure that may lead to long-term effects
Contamination of water sources
Pandemic infectious diseasesH1N1 influenza, Ebola virus disease, Zika virusInfection control and medical countermeasure challenges
Need for patient isolation
Increased maternal illness, preterm birth, or birth defects
Risk to first responders, hospital staff, and caregivers
Bioterrorist event2001 anthrax attacks, aerosol release of smallpox, 1995 sarin attack in Tokyo subwayNonspecific syndromic symptoms
Limited access to postexposure vaccination
Selection criteria for administering vaccine
Jeopardized safety of first-response team