Citation

Chiu M, Goodman L, Palacios CH, Dingeldein M. Semin. Pediatr. Surg. 2022; 31(5): e151219.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.sempedsurg.2022.151219

PMID

36343413

Abstract

Given recent disasters, hurricanes, mass shootings, floods and including the COVID-19 pandemic, there is a need for a national discussion about children in disasters. Approximately 25-30% of individuals injured in a disaster are children.1,2 Care for the pediatric population is unique given differing biological, social, and ethical factors, which requires additional consideration when approaching disaster response and preparedness.2 Since Hurricane Katrina in 2005, increased attention has been given to the pediatric population in disaster settings. Although we've seen significant improvement across the country in disaster preparedness, many of the recommendations in the 2010 National Commission on Children and Disasters have yet to be fully implemented.4,5 Recently, with the COVID19 pandemic, we have seen new challenges along with novel advancements for pediatric emergency response.5 This article serves to provide a brief overview regarding pediatric disaster response and its recent advancements, current issues, recommendations along with brief discussion on future areas of study.

The pediatric population is disproportionately affected during disasters and requires special consideration. The Federal Emergency Management Agency (FEMA) categories these into 3 groups: anatomy and physiology, psychological and education vulnerabilities. Anatomy & Physiology: Marianne Gausche-Hill outlined the significant differences seen in children in the August 2009 Journal of Trauma. The anatomic differences include the small circulating blood volume, thin skin and lack of body fat which make them more susceptible to fluid and heat loss than adults. For the same force delivered to a body the child's smaller mass receives more energy per square inch than adults. Skeletal immaturity and ligamentous laxity make the patterns of injury seen in children for a similar force applied different from adults. Shorter stature and higher body surface area to mass ratio put children at greater risk of toxin absorption and inhalation of heavy gasses such as sarin and chlorine...

Language: en