Your ED's disaster plan might overlook children
Your ED's disaster plan might overlook children
Imagine rapidly assessing 50 kids
Your ED might have a well-rehearsed, comprehensive disaster plan, but it might be missing one important element: How are you going to address the unique needs of children who will quickly flood your ED during a mass casualty?
"Depending on the situation, as many as half of the victims of a community disaster could be children," says Sally Phillips, PhD, RN, the program officer for the Agency for Healthcare Research and Quality's (AHRQ) Public Health Emergency Preparedness.
A new resource from AHRQ is designed to help pediatric EDs deal with a surge event. It also provides guidance that ED nurses in general hospitals who predominantly see adults can use to respond to an influx of pediatric patients. [To download the guidelines free of charge, go to the AHRQ web site (www.ahrq.gov). Click on "Public Health Preparedness." Under "Pediatrics," click on "Pediatric Hospital Surge Capacity in Public Health Emergencies."]
"Imagine yourself sitting in an ED that normally sees one or two children a month. Suddenly, you have 50 children sitting in your lobby, and you are having to do rapid assessments on their conditions," says Phillips. "Regardless of the type of ED you are working in, you need to think about what special considerations need to be made if you have large numbers of children coming into your facility."
To improve your preparedness:
• Get your skills up to speed.
According to the new publication, ED nurses have to take into account differences between children and adults. These include children's faster breathing rates, immature immune systems, limited self-preservation skills, greater risk of illness from exposure to extreme heat or cold, and greater risk of post-traumatic stress disorder.
"Develop a list of people in the community, either pediatricians or pediatric nurses, who might be able to come in and help with extra training or classes on pediatric care," recommends Phillips.
• Develop a way to tag and identify children who are coming in without adults.
"When treating a pediatric patient without a parent/guardian present, we would rely on our social workers or pastoral care to help facilitate the identification process," says Katy Stringfellow, EMT-P, RN, BSN, manager of the Emergency Department at St. Vincent Mercy Medical Center in Toledo, OH. "We aim to minimize confusion while the ED team continues treating the child.
• Be ready to perform a rapid assessment at triage.
The publication provides information on how to rapidly assess children using tools such as the Jump START Pediatric MCI Triage tool. [The Jump START Pediatric MCI Triage tool is included.]
These tools are very familiar to emergency medical services personnel, but ED nurses might not be familiar with them, says Phillips. "ED nurses might have to move to an eyeball rapid assessment of large numbers of kids, which is not a skill that is used every day," she says.
• Be sure you have the correct supplies.
"In order to properly treat pediatric patients in the ED during disasters, it is important to have supplies on hand to care for children of all sizes, says Stringfellow. "Depending on the age of the child, diapers, formula, pacifiers, bottles, and cribs may be needed."
Your ED might have a well-rehearsed, comprehensive disaster plan, but it might be missing one important element: How are you going to address the unique needs of children who will quickly flood your ED during a mass casualty?Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.