Bioterrorism

Terrorism preparedness is a highly specific component of general emergency preparedness. In addition to the unique pediatric issues involved in general emergency preparedness, terrorism preparedness must consider several additional issues, including the unique vulnerabilities of children to various agents as well as the limited availability of age- and weight-appropriate antidotes and treatments. Although children may respond more rapidly to therapeutic intervention, they are at the same time more susceptible to various agents and conditions and more likely to deteriorate if not carefully monitored. It is well known that children may exhibit different effects of biologic agents. Here are some examples: • Smallpox: Lack of immunity in children, whereas some adults who were vaccinated as children may still possess some degree of immunity. • Trichothecenes: The data show that children maybe more susceptible. • Melioidosis : Children manifest unique parotitis. • Anthrax: Recent and older data support the concept that children are less susceptible to the effects of anthrax

Pediatric Preparedness for Disasters and Terrorism: A National Consensus Conference: Executive Summary

In a time of crisis, it is essential to ensure the needs of children are being met in planning and preparing for disasters and terrorist events. The current adult models and guidelines cannot be applied to the care of children. We convened experts from the multiple areas of expertise and disciplines involved in the planning for and care of children during times of disaster and terrorist events. The goals of this unprecedented meeting were to: 1) Build collaboration among individuals with expertise in pediatrics, pediatric emergency medicine, pediatric critical care, pediatric surgery, and emergency management, including disaster planning, management, and response; 2) Review and summarize the existing data on the needs of children in disasters, including planning, preparation, and response; 3) Develop consensus on the needs of children in disasters; 4) Create a research agenda to address knowledge gaps based on the limited data that exist on the needs of children in disasters

Pediatric Terrorism Preparedness National Guidelines and Recommendations: Findings of an Evidenced-based Consensus Process

A cadre of experts and stakeholders from government agencies, professional organizations, emergency medicine and response, pediatrics, mental health, and disaster preparedness were gathered to review and summarize the existing data on the needs of children in the planning, preparation, and response to disasters or terrorism. This review was followed by development of evidence-based consensus guidelines and recommendations on the needs of children in disasters, including chemical, biological, and radiological terrorism. An evidence-based consensus process was used in conjunction with a modified Delphi approach for selection of topic areas and discussion points. These recommendations and guidelines represent the first national evidence-based standards for pediatric disaster and terrorism preparedness

Disaster and Terrorism Preparedness: What Pediatricians Need To Know

This chapter is designed to provide an overview of key issues for the pediatrician with respect to terrorism and disaster preparedness. It is not intended to be a complete compendium of didactic content, but it does represent an approach to understanding what needs to be learned by the pediatrician on this difficult topic and how pediatricians must lend their expertise and perspective to the urgent national need to enhance preparedness in every community

National Preparedness Planning: The Historical Context and Current State of the U.S. Public's Readiness, 1940-2005

In the United States, national public preparedness efforts meant to ready individuals and families for disasters have been driven primarily by international threats, actual or anticipated. These include terrorism, war and the potential for global instability such as the millennium Y2K computer error. The national dialogue on public preparedness following Hurricanes Katrina and Rita in the fall of 2005 is a notable departure from the more typical focus of public preparedness, which is oriented toward terrorism and international threats. However, the response to the hurricanes was largely viewed as an unanticipated test of the public’s readiness for a disaster and the penetration of the public preparedness messages that have been actively promulgated since 11 September 2001. As such, we argue that the poor state of public readiness that was found in the U.S. Gulf Coast region after the hurricanes actually reflects a national state of unpreparedness for emergency events despite the post-September 11th calls from all levels of government for the U.S. public to be prepared

Recovery Research, Katrina's Fifth Anniversary, and Lessons Relearned

What may be called “disaster science” is a broad field that begins with understanding hazards, risks, and population vulnerabilities and moves on to establishing best-practice models of response, mitigation, and recovery. Gaps abound in our collective knowledge in all of these areas, and it is fair to suggest that we have only begun to scratch the surface in terms of what we need to know. The goal continues to be to learn how to prevent disasters whenever possible and, when prevention is not possible, to at least optimize survival, preserve vital infrastructure, and return rapidly to a state of normalcy

Hurricane Sandy: Lessons Learned, Again

Hurricane Sandy was a sobering reminder to those of us who call New York home that it is a port city and subject to the whims of wind and water. The storm itself was massive: climatologically, a thousand miles wide at its peak; economically, an estimated excess of $50 billion in damages. In the New York metropolitan area, 97 people died in the storm, thousands were displaced from their homes, and 2 major hospitals required perilous evacuations even as the hurricane force winds engulfed the metropolitan region. For those of us in the fields of disaster medicine and public health preparedness, the question is, were we ready? During the past decade considerable public investment has been made in standardizing command and communication, assuring appropriate and rapid supply chains, and training the medical and public health workforces to respond appropriately. And yet, in the week after the storm, persistent reports of widespread gaps in the provision of coordinated relief were received from the Rockaways to Coney Island to Staten Island and New Jersey. The question was not one of capacity and capability as much as it was of communication and coordination. Resources did not always make it the last mile to reach those most in need