Pediatric Surge: Strategies and Tools for Capacity Building

Summary: Children around the world are vulnerable to disasters irrespective of the local abundance or scarcity of health resources. Often, children are overlooked in healthcare systems primarily focused on adults. Creating pediatric specific strategies that are adaptable to different geographies is essential to support children, especially during surge incidents. The United States government has recently supported the initiatives, the Administration for Strategic Preparedness and Response (ASPR) Pediatric Disaster Center for Excellence (PDCOE), and the Health Resources and Services Administration (HRSA) Pediatric Pandemic Network (PPN), to improve pediatric care throughout the disaster cycle in the US healthcare system. These initiatives have created partnerships with state, regional, and local entities to promote pediatric disaster response by all healthcare systems and their communities, regardless of local pediatric resources. The PDCOE, Region 5 for Kids, created a pediatric hazard vulnerability analysis (HVA) toolkit that focuses on pediatric vulnerabilities in all disasters, a regional metrics scorecard to assist regions in understanding their pediatric strengths and gaps, and uses weekly regional hospital metrics to assist with surge mitigation. The PDCOE, Western Regional Alliance for Pediatric Emergency Management (WRAP-EM) created a Surge Toolkit as a just-in-time aid for a respiratory surge. The PPN created the Pediatric Surge All Hospital Handbook (PedSAHH), addressing community-wide needs to integrate pediatric surge planning in all hospitals. WRAPM-EM also created the “15 ‘til 50 Pediatric Mass Casualty Incident Plan Template”. These tools give critical recommendations for planning and just-in-time management of a surge of pediatric patients after a disaster or during a pandemic. While these pediatric surge support tools have been evaluated in a well-resourced country, the strategies described are applicable and adaptable to all communities, regions, and countries. The recommendations can be implemented with local surge practices to ensure that children receive optimal care within the entire disaster cycle.