Disaster Preparedness in Families With Children With Special Health Care Needs.

Children with special health care needs (CSHCN) may present unique challenges for disaster preparedness. This study's objective was to determine the impact of a disaster supply starter kit intervention on preparedness for families of CSHCN. The study was a 1-group pre-post cohort design with consecutive enrollment at the Arkansas Children's Hospital Medical Home Clinic. Pre- and postintervention survey findings were compared using McNemar's test. Of the 249 enrolled, 223 completed the postsurvey. At presurvey, 43% had an Emergency Information Form, compared with 79% at postsurvey (P < .001). At presurvey, 18% had a disaster kit, compared with 99.6% at postsurvey, and 44% added items. Of the 183 respondents who did not have a disaster kit at presurvey, 99% (n = 182) had a disaster kit on postsurvey, and 38% (n = 70) added items. An inexpensive educational disaster supply starter kit may increase preparedness. Further investigation on sustainability and dissemination to other populations is needed.

Prehospital preparedness for pediatric mass-casualty events.

OBJECTIVES: Recent events have reiterated the need for well-coordinated planning for mass-casualty events, including those that involve children. The objective of this study was to document the preparedness of prehospital emergency medical services agencies in the United States for the care of children who are involved in mass-casualty events. METHODS: A national list of all licensed prehospital emergency medical services agencies was prepared through contact with each state's emergency medical services office. A survey was mailed to 3748 emergency medical services agencies that were selected randomly from the national list in November 2004; a second survey was mailed to nonresponders in March 2005. Descriptive statistics were used to describe study variables. RESULTS: Most (72.9%) agencies reported having a written plan for response to a mass-casualty event, but only 248 (13.3%) reported having pediatric-specific mass-casualty event plans. Most (69%) services reported that they did not have a specific plan for response to a mass-casualty event at a school. Most (62.1%) agencies reported that their mass-casualty event plan does not include provisions for people with special health care needs. Only 19.2% of the services reported using a pediatric-specific triage protocol for mass-casualty events, and 12.3% reported having a pediatrician involved in their medical control. Although most (69.3%) agencies reported participation in a local or regional disaster drill in the past year, fewer than half of those that participated in drills (49.0%) included pediatric victims. CONCLUSIONS: Although children are among the most vulnerable in the event of disaster, there are substantial deficiencies in the preparedness plans of prehospital emergency medical services agencies in the United States for the care of children in a mass-casualty event.

Mass-casualty events at schools: a national preparedness survey.

OBJECTIVE: Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event. METHODS: A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the chi2 test was used to compare urban versus rural preparedness. RESULTS: The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey. CONCLUSIONS: There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.