Children at Risk: Kids are not Miniature Adults.

Starting School with H1N1?

Despite an initial optimistic announcement on H1N1 readiness (“H1N1 preparedness is going well”) from the White House, experts have identified meaningful gaps in preparedness in general and for special populations in particular.

There is a cruel irony in the fact that this nation’s Public Health Policy celebrates robust themes such as “no child left behind” and “every child must have access to quality health care” but fails to promote a reasonable level of protection for them during natural and man-made disasters. Law makers authorized multi-millions of dollars each year to save the smallest among us, neo-natal populations, but fail to adequately resource plans for millions of vulnerable children.

Responding to the 21^st century threat environment has become increasingly more complex. The decision-making matrix is built on critical bits of information on which viable alternatives are dependent. Those who are entrusted with the safety and welfare of vulnerable healthcare populations, in times of high risk, must be ready to make crucial decisions associated with “protect in place or evacuate”. Hospital stakeholder’s survival depends on timely responses made with alacrity and based on comprehensive, well designed pre-planned actions.

The “just in time” supply chain model, a widely accepted and highly valued practice has shifted warehousing and availability of age-and condition-appropriate equipment and supplies away from treatment sites. The intended or unintended consequence has cancelled out onsite inventories so vital to meeting “protect in place” all-hazards options. Most federal and state emergency medical stockpiles do not adequately stock emergency supplies in pediatric sizes.

Segregation of hospital populations into age-and condition-specific domains has resulted in higher levels of inpatient acuity requiring advanced life support systems and other technologies has profoundly influenced all-hazards survival choices for special populations.

These special populations, critically-ill neonates/children, immuno-compromised, severely injured, and mild to severe behavioral child patients pose a significant challenge to any evacuation protocol. As recently as September 3^rd, the CDC released information which would lead one to believe that there is evidence of a higher of mortality and morbidity among children, specifically those from ages 5 to 17.

In our next post, we will take a comprehensive look at specific barriers to meet the needs of children’s special populations in All Hazards evacuation.