Paediatric patients in mass casualty incidents: a comprehensive review and call to action

Area of Science:

• Disaster Medicine
• Paediatric Emergency Care
• Anaesthesiology

Background:

• Children are disproportionately affected by mass casualty incidents (MCIs) due to their unique physiological and vulnerability characteristics.
• Existing anaesthesia literature lacks comprehensive focus on paediatric-specific concerns during MCIs.
• Paediatric anaesthesiologists are vital in managing children during disasters but require more defined roles and training.

Purpose of the Study:

• To analyze paediatric considerations during mass casualty incidents (MCIs).
• To compare paediatric MCI care provision across Australia, the UK, and the USA.
• To define and propose enhanced roles for anaesthesiologists in paediatric MCI response.

Main Methods:

• This study is a narrative review of paediatric mass casualty incident (MCI) considerations.
• It analyzes and compares paediatric MCI care strategies in Australia, the UK, and the USA.
• The review integrates potential roles for anaesthesiologists with paediatric expertise in MCI scenarios.

Main Results:

• Paediatric anaesthesiologists have multifaceted potential roles in mass casualty incidents (MCIs), including preparation, command consultation, in-field care, transport, and hospital-based services (ED, OR, ICU).
• Differences exist in paediatric MCI care provision across Australia, the UK, and the USA.
• There is a recognized deficit in anaesthesia literature addressing paediatric-specific MCI challenges.

Conclusions:

• Anaesthesiologists with paediatric experience are essential for effective mass casualty incident (MCI) response.
• Improving anaesthesiologists' contribution to paediatric MCI care requires enhanced personal education, specialized training, and institutional support.
• Proactive engagement and defined roles can significantly improve outcomes for children during mass casualty events.