Utilizing a Pediatric Disaster Coalition Model to Increase Pediatric Critical Care Surge Capacity in New York City

Abstract

A mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems. The PDC assisted 15 hospitals in creating PCC surge plans by utilizing template plans and site visits. These plans created an additional 153 potential PCC surge beds. Seven hospitals tested their plans through drills. The purpose of this article was to demonstrate the need for planning for disasters involving children and to provide a stepwise, replicable model for establishing a PDC, with one of its primary goals focused on facilitating PCC surge planning. The process we describe for developing a PDC can be replicated to communities of any size, setting, or location. We offer our model as an example for other cities. (Disaster Med Public Health Preparedness. 2017;11:473-478).

Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic

“…Increasing critical care beds is challenging because it carries specific infrastructure, human and technological resources, and supplies. There are protocols and recommendations that guide the reorganization of hospitals and other physical spaces for massive care of critically ill patients to face natural disasters, attacks, or different situations of a sudden increase in demand, capable of exceeding the local and regional response capacity [ [3] , [4] , [5] , [6] ]. However, the clinical/administrative framework for caring for adult patients in units previously intended for critically ill children, is limited [ 7 ].…”

Assessing Immediate Bed Availability and Barriers to Discharge in a United States Children’s Hospital

“…Common strategies to increase surge capacity include rapidly discharging patients, creating alternate care facilities, and altering standards of care. 8 Studies suggest early discharge could be used to make 1/3 of hospital beds available in 24 h. 7 We identified 3 strategies to increase IBA beyond currently empty beds and planned discharges: developing safe discharge plans, providing some care not requiring nursing expertise, and providing advanced care by a nurse or other licensed medical professional. The largest gain in IBA in our hospital would be accomplished by providing a safe area for children to continue to receive some basic care requiring minimal medical personnel while caregiver training and discharge planning was completed.…”

Performance comparison in Pediatric Fundamental Critical Care Support among staff from the USA versus those from resource-limited countries

“…The New York Pediatric Disaster Coalition to which our hospital belongs also recommends the PFCCS as a training tool for non-critical care medical staff. 8 , 9 The courses were taught by strict adherence to the protocol and standard specified by the SCCM.…”