Researchers at Children’s Hospital Los Angeles (CHLA) recently published a study that found that the United States is unprepared for the surge in pediatric patients that an infectious disease pandemic could cause.
The paper, which was published in the American Journal of Disaster Medicine, proposes a structured and coordinated response plan for such a crisis with national guidelines reflected in regional response systems.
The study concluded that national and regional do not adequately account for the needs of children. Children require special care and resources as their physical and psychological needs differ from those of adults, the paper said. Most preparedness plans, according to the report, are too heavily skewed toward the needs of adult patients.
“Children represent 23 percent of the population, yet most of our disaster plans are aimed at the ‘average,’ patient, assuming that patient is an adult and neglect the specific needs of children,” said Jeffrey Upperman, director of the trauma program at CHLA, associate professor of Surgery at the Keck School of Medicine of USC, and one of the study’s authors. “That’s a mistake we need to correct.”
Preparedness plans should include specific protocols regarding the needs of children, the study said. The report identifies four categories of need that should be addressed: structure, staff, stuff (shorthand for resources) and space.
The structure category addresses the need for a reliable delivery system in case of medical surge events and coordination of care among hospitals.
The staff category addresses the need to educate those responsible for the care of pediatric patients in a pandemic and strategies for dealing with potential shortages of healthcare workers in the event of a surge in pediatric patients.
The stuff category addresses the need for more emergency departments that admit children, more pediatric intensive care units and adequate stocks levels of materials that would be needed to address the potential needs of pediatric patients in the event of a pandemic.
The space category addresses the need for hospitals to prepare to accommodate surges that could triple their typical patient capacity through measures such as converting private rooms to shared rooms and using hallways, lobbies and other spaces for patients.
“The theme underlying all of these categories is relationships,” Rita V. Burke, assistant professor of Research Surgery and Preventive Medicine at CHLA and Keck School of Medicine of USC and one of the study’s authors, said. “Establishing connections and lines of communication among hospitals in a region or a local area is essential to being prepared for this type of challenge to our healthcare system.”