Hospitals' Preparedness to Treat Pediatric Patients During Mass Casualty Incidents
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Published on: July 30, 2009
Chiaki Toida1, Takashi Muguruma1, Keiji Hashimoto1
1Disaster Response Working Group,National Center for Child Health and Development,Tokyo,Japan.
Insights
Hospital disaster preparedness for pediatric patients in Japan requires improved staff training and validated triage methods. A drill revealed challenges with the Simple Triage and Rapid Treatment (START) method for young children and significant evacuation needs.
Area of Science:
- Disaster Medicine
- Pediatric Emergency Care
- Hospital Preparedness
Background:
- Limited understanding of pediatric hospital disaster preparedness in Japan.
- Assessing a children's hospital's readiness for mass casualty incidents is crucial.
Purpose of the Study:
- Evaluate disaster preparedness in a Japanese children's hospital.
- Assess the efficacy of triage education and the Simple Triage and Rapid Treatment (START) method for pediatric patients.
- Determine the need for evacuation resources during a major incident.
Main Methods:
- Conducted a retrospective review of triage tags and medical records from a hospital-wide disaster drill.
- Included all hospitalized pediatric patients in the triage drill.
- Analyzed the validity of the START method and staff education effectiveness.
Main Results:
- Disaster education is challenging for inadequately trained staff.
- The START method shows high over-triage rates in children under 5 years old.
- Approximately 40% of "immediate" triage patients may require evacuation transport.
Conclusions:
- Enhanced disaster preparedness, including staff education and robust evacuation systems, is vital for pediatric mass casualty incident response.
- Refining triage protocols for young children is necessary.
- Proactive planning for patient evacuation is essential.
Objectives:
Little is known about the preparedness of hospitals to care for pediatric patients during a major incident in Japan. This study assessed the disaster preparedness of a children's hospital in Japan by using a disaster drill.Materials and MethodsWe performed a triage drill with all hospitalized patients. The triage tags and medical records were reviewed retrospectively. We determined the efficacy of triage education, the validity of the Simple Triage and Rapid Treatment (START) method for children, and the potential need for evacuation through the disaster drill.
Results:
This study highlights 3 important issues about the hospital's preparedness. First, it is difficult to promote disaster education for staff who are not well trained on handling disasters. Second, the START method is suitable for children older than 5 years, but it has a high rate of over-triaging among younger children. Third, approximately 40% of patients who are coded as immediate may require transportation resources in a hospital evacuation.
Conclusions:
Our findings suggest that disaster preparedness, such as educating hospital staff regarding disasters and establishing evacuation systems for a number of pediatric patients when a disaster happens, is essential for caring for hospitalized children during a mass casualty incident. (Disaster Med Public Health Preparedness. 2019;13:429-432).
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