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Emergency department staff preparedness for mass casualty events involving children
Michal Rassin1, Miri Avraham, Anat Nasi-Bashari
1Nursing Research Unit, Assaf Harofeh Medical Center, Zrifine, Bear Yaakov 70300, Israel. rasinm@asaf.health.gov.il
Insights
Emergency department staff show low preparedness for pediatric mass casualty events (MCEs). Enhanced training is crucial for improving care for children during MCEs, particularly in regions facing terrorism threats.
Area of Science:
- Emergency Medicine
- Disaster Preparedness
- Pediatric Critical Care
Background:
- Mass casualty events (MCEs) from terrorism impact children, necessitating hospital preparedness.
- A literature review revealed a lack of pediatric MCE training and staff uncertainty.
- Hospitals must be equipped to handle pediatric casualties during mass casualty events.
Purpose of the Study:
- To assess emergency department staff preparedness for MCEs involving pediatric casualties.
- The study focused on 104 physicians and nurses in an Israeli hospital's emergency department.
- Investigated staff perceptions, approaches, and knowledge regarding pediatric MCEs.
Main Methods:
- A 41-item questionnaire assessed staff knowledge and perceptions of pediatric vs. adult MCEs.
- Questionnaire reliability ranged from Chronbach's alpha 0.6 to 0.94.
- Data collected from emergency department staff, including physicians and nurses.
Main Results:
- Preparedness for pediatric MCEs was significantly lower than for adult MCEs.
- Staff reported lower confidence in mental coping and skills for pediatric MCEs.
- Nurses showed slightly better knowledge than physicians, but overall knowledge for pediatric MCEs was low.
Conclusions:
- Findings indicate a need for improved preparedness and training for pediatric mass casualty events.
- Further research with larger samples across multiple hospitals is recommended.
- Results suggest a regional need to address gaps in pediatric MCE response.
Background:
In recent years, the World Health Organization in general, and Israel in particular, have dealt with mass casualty events (MCEs) resulting from terrorism. Children are the casualties in many of these events-a reality that forces hospitals to prepare to deal with such a scenario. A literature review designed to identify unique recommendations regarding pediatric MCEs highlights both a lack of existing training programs and uncertainty on the part of health care staff when dealing with these events.
Objectives:
The purpose of the study was to examine the preparedness level of emergency department staff to deal with MCEs involving pediatric casualties. The study included 104 physicians and nurses working in, or responding to, the emergency department at a hospital in Israel.
Method:
The study included a 41-item questionnaire examining perception, approaches, and staff knowledge regarding dealing with pediatric MCEs versus those involving adults. The reliability of all sections of the questionnaire ranged between Chronbach's alpha coefficient 0.6 alpha-0.94.
Results:
The preparedness levels for MCEs involving children were found to be low. Study participants ranked the likelihood of a pediatric MCE lower than one involving adults, while ranking significantly higher (P = .000) their ability to cope mentally and the knowledge and skills required when treating adults involved in MCEs. While nurses ranked higher than physicians regarding their knowledge and skills in dealing with pediatric MCE casualties, the level of knowledge for MCEs involving children was low in all subjects. Staff agreement for the parent of an MCE victim to be present during treatment was medium-low.
Implications:
On the basis of these findings, additional research involving a larger number of individuals and hospitals is indicated to determine if these results are consistent throughout the region.
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