Pediatric Aspects of Hospital Preparedness

A meta‐analysis of hospital evacuations: Overcoming barriers to effective planning

“…This theme is reinforced from the general mass evacuation literature, which emphasizes the importance of having 1 person designated ahead of time who can order an evacuation . A centralized Incident Command center along with unit‐level designees to communicate with Incident Command are cited as reasons for success in multiple case reports and recommended in published guidelines . During the 1989 Loma Prieta earthquake, hospital officials cited confusion of roles as one of the major problems in how they handled their disaster response; often, it was unclear who the designated decision makers were …”

“…Communication is the one item cited more than any other as a major contributor to evacuation success or failure. As Paul Lambrecht, VP of clinical and support services at Underwood Memorial Hospital said, “you can never overcommunicate” in a disaster situation .…”

“…Making arrangements for child care can also help relieve staff anxiety, allowing them to focus on safely evacuating their patients without also having to worry about their own families . Regardless of what a hospital decides in regards to staff family, children, and pets, this must be considered as part of any disaster/evacuation plan . Designation of essential personnel is also important because excess staff in house can tax already limited resources…”

“…In addition to planning for basic needs such as food and sleep, it is important to plan for staff safety during an evacuation since conditions that force an evacuation are often hazardous to those involved. Therefore, hospitals are advised to stockpile protective equipment such as respirators and hazmat suits that can be used during an evacuation to ensure their staff's safety or provide ways of transporting staff to and from the hospital during severe weather or periods of civil unrest.…”

“…Examples of these patient populations include patients in any type of intensive care unit (eg, ICU, NICU, SICU, PICU), bariatric patients, pediatric patients, geriatric patients, and psychiatric patients. In regards to evacuation of these Special Patient Populations, there are scattered case reports, several simulated drills, and a few guidelines that are available, but there are still many unknowns in regards to the specifics of how to best evacuate these patients. For example, Gallagher et al described the successful evacuation of a burn center during Hurricane Katrina, but failed to discuss any of the specific considerations that went into evacuating these burn patients compared to a general medical/surgical patient .…”