Evaluating the MCI Preparedness of U.S. Pediatric Emergency Departments

Background: Mass Casualty Incidents involving pediatric patients present unique and significant challenges the readiness of hospitals caring for children There has been limited research applied to attempting to quantify the readiness of pediatric and children's facilities to effectively respond to mass casualty incidents (MCI). A large national assessment of pediatric readiness of emergency departments (EDs) showed that only 47% have disaster plans that include care of children.

Methods: As part of an initial query into MCI readiness by the Western Regional Alliance for Pediatric Emergency Management (WRAP-EM) in early 2020, a survey was sent to the Pediatric Emergency Medicine North American Chiefs database (PEMNAC)of all U.S. facilities that have EDs specifically for the pediatric population. Questions were asked pertaining to the patient volumes, existing capabilities in MCI readiness and frequency of disaster drills performed.

Results: Forty- two of 141 facilities responded (29.7%) to the survey, including 17 free-standing children's hospitals seeing over 80,000 visits a year. Hospitals in 24 states representing 67% of the U.S. population responded to the survey. Nearly 36% reported that their facility had not had a full scale MCI disaster exercise in the prior 24 months. Thirty-one percent of respondents reported that they did not have 10 intubation or chest tube kits immediately available in their EDs. Sixty percent of facilities did not report having advanced bleeding control devices immediately available in their pediatric EDs.

Conclusion: A representative survey of U.S. pediatric EDs suggests hospitals are underprepared for mass casualty events at the present time. Improving the availability and quantity of supplies for these scenarios, and increasing the frequency of drills, should be considered to build capacity and enhance preparedness and response capabilities. In addition, increased hospital participation in the National Pediatric Readiness Project (NPRP) survey, and subsequent expansion of pediatric disaster preparedness initiatives and programs, are recommended.