On August 29, 2005, Hurricane Katrina struck the Gulf Coast of the United States, displacing hundreds of thousands of people from their homes. Experts estimated that this hurricane caused more than $100 billion in damage.
This tragedy highlighted many challenges or gaps in regards to children's preparedness, including:
- Low awareness of how children are different and why they need customized planning and response in a disaster. See The Youngest Victims: Disaster Preparedness to Meet Children's Needs.
- Disaster planning did not strategically address health issues, and health professionals were not consistently included in planning efforts.
- Limited to no capacity within hospitals to diagnose and treat children in emergencies (for individual children as well as large numbers of children in a mass casualty situation).
- Physicians were not supported to maintain office practices. See Pediatric Private Practice After Hurricane Katrina: Proposal for Recovery.
- No "home" or repository for policies, clinical guidance, and resources on children's preparedness.
These challenges and more were documented in the May 2006 supplement to Pediatrics titled, Hurricane Katrina, Children, and Pediatric Heroes. Initial progress was captured about 5 years later in the August 2011 follow-up supplement to Pediatrics titled, Hurricane Katrina's Children and an AAP News article, Katrina's Legacy.
Significant Progress has been Achieved
- National emphasis on personal preparedness.
- Families, schools, and communities recognize the need to be self-sustainable for several days after a disaster.
- Community resilience has emerged as a focal point in disaster planning.
- Enriched AAP infrastructure (see information about the AAP Disaster Preparedness Advisory Council (DPAC), Chapter Contacts, Contact Network, policies, and resources within the Children and Disasters Web site).
- Improved governmental response. Several federal agencies and other support organizations are now focusing on children's preparedness and working with pediatricians to advise best practices. One example is that the Federal Emergency Management Agency (FEMA) established a Children’s Working Group and developed guidance on Post-Disaster Reunification of Children.
- Congress passed the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) reauthorizing programs to sustain and strengthen national preparedness for public health emergencies. PAHPRA contained several first-ever provisions focusing the federal government's efforts on children including the creation of the HHS National Advisory Committee on Children and Disasters.
- Select federal grants to states encourage specific activities to improve children's preparedness (Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program, Centers for Disease Control and Prevention (CDC) Public Health Emergency Preparedness, Emergency Medical Services for Children).
- Formation of federal advisory committees with AAP member participation on each:
- There are strong collaborative partnerships between the AAP and federal agencies involved in disaster preparedness and response, and AAP leaders are included routinely in national preparedness decision-making discussions. Progress is captured in Children and Disasters newsletters and DPAC annual reports.
- Several AAP members have testified before Congress on the importance of recognizing the unique needs of children and incorporating those needs into disaster preparedness and response efforts as well as for medical countermeasure development.
- Increased attention towards day-to-day pediatric emergency preparedness. The AAP offers a policy statement titled Guidelines for Care of Children in the Emergency Department and a Checklist for hospitals. The National Pediatric Readiness Project aims to ensure all hospital emergency departments have the essential guidelines and resources in place to provide effective emergency care to children. The recent article in JAMA Pediatrics titled A National Assessment of Pediatric Readiness of Emergency Departments reports on an assessment of all emergency departments in the US for compliance with national guidelines for pediatric readiness, 82.7% of emergency departments responded. 99.5% of emergency department respondents reported that staff are trained on the location of pediatric equipment in the emergency department and have a pre-calculated chart or a length-based tool or use medical software to ensure proper sizing of resuscitation equipment and dosing of medications.
- Improved planning for safe care (shelter-in-place) or evacuation/transport of critically ill children.
- Pediatric-focused initiatives were implemented:
Reports and Resources
2012-2013 Report of the Children's HHS Interagency Leadership on Disasters (CHILD) Working Group: Update on Departmental Activities and Areas for Future Consideration
The HHS has made significant progress in addressing the needs of children in disasters. This report summarizes HHS interagency activities and references select accomplishments of the AAP and its members.
AAP National Survey 2010
The AAP conducted an opinion poll to stimulate discussion on the use of resources related to disaster planning and response specific to children's issues.
AAP Pediatric Preparedness Resource Kit
This resource allows pediatricians, public health leaders and others to assess what is already happening in their community or state, and help determine what needs to be done to improve outcomes for children before an emergency or disaster. The kit promotes collaborative discussions and decision making about pediatric preparedness planning. The kit also includes information and strategies to accomplish the following:
AAP Preparedness Checklist for Pediatric Practices
Based on the concepts and information in the AAP Pediatric Preparedness Resource Kit, this Checklist offers steps that pediatricians or their practice staff can take to improve office preparedness.
AAP Preparedness for Pediatric Practices: Newborn Screening in Emergencies
This resource was designed to assist pediatricians to enhance contingency planning for interruptions in the newborn screening process. The handout details the newborn screening process and why contingency planning for newborn screening is important during emergencies.
National Biodefense Science Board Community Health Resilience Report
The appointment of the National Commission facilitated significant progress in identifying and addressing issues specific to children. This report defines "community health resilience", shares five recommendations of the National Preparedness and Response Science Board (NPRSB) working group, and identifies steps that can be taken to improve resilience.
National Commission on Children and Disasters: 2010 Report to the President and Congress
This report cites persistent gaps in disaster preparedness for children since Hurricane Katrina and calls for the development of a national strategy for children in disasters to ensure children are protected before, during, and after an emergency.
AAP Policy Statements/Clinical Reports