Pediatric Medical Countermeasures: Antidotes and Cytokines for Radiological and Nuclear Incidents and Terrorism.

The war in Ukraine raises concerns for potential hazards of radiological and nuclear incidents. Children are particularly vulnerable in these incidents and may need pharmaceutical countermeasures, including antidotes and cytokines. Searches found no published study comparing pediatric indications and dosing among standard references detailing pediatric medications for these incidents. This study addresses this gap by collecting, tabulating, and disseminating this information to healthcare professionals caring for children. Expert consensus chose the following references to compare their pediatric indications and dosing of medical countermeasures for radiation exposure and internal contamination with radioactive materials: Advanced Hazmat Life Support (AHLS) for Radiological Incidents and Terrorism, DailyMed, Internal Contamination Clinical Reference, Medical Aspects of Radiation Incidents, and Medical Management of Radiological Casualties, as well as Micromedex, POISINDEX, and Radiation Emergency Medical Management (REMM). This is the first study comparing pediatric indications and dosing for medical countermeasures among commonly used references for radiological and nuclear incidents.

Addressing Health-Care Disparities in Pediatric Disaster Planning: A Qualitative Study.

OBJECTIVE: The Western Regional Alliance for Pediatric Emergency Medicine (WRAP-EM) is a multi-state, Administration for Strategic Preparedness and Response (ASPR) funded pediatric disaster center of excellence. WRAP-EM set out to determine the impact of health disparities on its 11 core areas. METHODS: We conducted 11 focus groups during April 2021. Discussions were led by an experienced facilitator, and participants could also include their thoughts on a Padlet throughout the discussion. Data were analyzed to determine overarching themes. RESULTS: Responses focused on health literacy, health disparities, resource opportunities, addressing obstacles, and resilience building. Health literacy data highlighted the need for development of readiness and preparedness plans, community engagement in cultural and language appropriate means, and increasing diversity in training. Obstacles faced included funding; inequitable distribution of research, resources, and supplies; lack of prioritization of pediatric needs; and fear of retribution from the system. Multiple already existing resources and programs were referenced highlighting the importance of best practice sharing and networking. A stronger commitment to mental health-care delivery, empowerment of individuals and communities, use of telemedicine, and ongoing cultural and diverse education were recurring themes. CONCLUSIONS: Results of the focus groups can be used to prioritize efforts to address and improve health disparities in pediatric disaster preparedness.

Pediatric Burn Care: How Burn Camps Survived and Thrived During the Coronavirus Pandemic.

Burn camps play a vital role in the recovery of burn survivors by allowing them to develop the confidence and skill sets needed to reintegrate back into society. During the COVID-19 pandemic, burn camps across the United States and Canada could not hold any in-person activities. They had to either pause burn camps or quickly adapt to a virtual online platform. A 37-item electronic survey was developed and emailed to burn camp directors in the United States and Canada to determine what adaptations were necessary during the pandemic. This survey allowed directors to provide details on many facets such as camp format, successes observed, and challenges encountered. Twenty-one of 34 (62%) burn camp organizations completed the survey. Thirteen of the 21 (62%) respondents held virtual burn camps in 2020 while everyone else canceled their camps in 2020. The mean number of camps offered per organization decreased from 6.3 in 2019 to 4.7 in 2020. The average number of burn survivors and family members participating also dropped in that same period (2019 aggregate mean = 229.2 vs 2020 aggregate mean = 151.4). Components of virtual camp included video conferencing platforms, "camp-in-a-box" activities, and some prerecorded sessions. Most camp directors believed that their campers were satisfied with the virtual format. Factors allowing for a successful virtual camp included an effective online platform, scheduling adequate duration of programs, and appropriate staffing levels. Most common barriers to an effective virtual camp were participant engagement, special needs/accessibility concerns, and staff effectiveness in this format. While challenging, burn camps can be held in a virtual format successfully with proper planning, staff training, and support of campers and their families.