Prioritization of Pediatric Chemical, Biological, Radiologic, Nuclear, and Explosive Disaster Preparedness Education and Training Needs

Abstract

Children are the members of our population who are most vulnerable to the effects of a chemical, biological, radiological, nuclear or explosive (CBRNE) attack. It has been over 12 years since 9/11 and the majority of clinicians who would be providing care to children in the event of another attack still lack the requisite disaster preparedness training. The purpose of this report is to provide an overview of the recent developments that will enable the affordable creation of key CBRNE educational and just in time material. In 2011, the National Center for Disaster Medicine and Public Health (NCDMPH) convened a pediatric disaster preparedness conference. Much of the initial groundwork for development of a pediatric disaster preparedness curriculum, including the identification of target audiences and requisite role specific CBRNE curriculum content, was the product of this conference. Much of the needed pediatric education and training content for the diagnosis and treatment of the injurious effects of CBRNE has recently been both developed and well vetted. Bringing together these efforts in an educational program will result in a workforce that is better trained and prepared to address the needs of children impacted by these types of disasters.

Extending the Reach of Pediatric Emergency Preparedness: A Virtual Tabletop Exercise Targeting Children’s Needs

“…6 More rigorous investigations using larger and more professionally diverse samples, and prospective linkages with performance measures after actual emergencies, would further our progress toward understanding and improving the VTTX's effectiveness. Additional evaluations of VTTXs and other emerging strategies (eg, virtual simulation models 17 ) are particularly needed as children's preparedness gains increasing attention 18,36 and could identify which approaches merit broad dissemination. 3 Finally, although exercise-planning conventions dictate that exercises be evaluated according to standardized core capabilities, 23,34 none specific to children's needs exist, limiting the comparability of existing studies.…”

“…A central concept reported by participants was the need for substantive inclusion of children's unique medical and developmental characteristics in the VTTX beyond simply placing them in the scenario. Knowledge about children's vulnerabilities is well-documented by academics, 6,36,37 government agencies, 1,38 and authoritative organizations safeguarding children. 2,5 In combination with suggestions proposed herein, this literature can inform future exercise content.…”

Disasters in Germany and France: An Analysis of the Emergency Events Database From a Pediatric Perspective

“…62 An update on the current state of this work in progress was published by Siegel et al in 2014. 63…”

Clinical Management of Patients Infected with Highly Pathogenic Microorganisms

“…Training and education are crucial for ensuring the ability of medical professionals to manage HCID mass casualty events [91]. The knowledge required of hospital personnel during an HCID epidemic encompasses both familiarity with the approach to a single/individual patient and his/her contacts and the overall organizational preparedness for mass casualties, increase of encounters of medical/nursing staff with patients, and the need to provide medical care in ambulatory and modified hospital conditions [92,93]. Medical as well as organizational aptitude is required [77,93].…”

“…The knowledge required of hospital personnel during an HCID epidemic encompasses both familiarity with the approach to a single/individual patient and his/her contacts and the overall organizational preparedness for mass casualties, increase of encounters of medical/nursing staff with patients, and the need to provide medical care in ambulatory and modified hospital conditions [92,93]. Medical as well as organizational aptitude is required [77,93]. Three main levels have been recognized as significant for inclusion in training programs for HCID events: (1) information concerning the varied biological agents, their consequences, the courses of the disease, and means to prevent and/or mitigate its infectivity; (2) ways to develop case definitions, criteria for hospitalization, medical protocols for in-house and ambulatory care, and provision of care for patients' contacts (including staff and family members); (3) policy and decisionmaking processes [91,94].…”