Disaster medicine and public health preparedness
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Disaster Med Public Health Prep · Jun 2012
Comparative StudyComparison of severity of illness scores to physician clinical judgment for potential use in pediatric critical care triage.
A pediatric triage tool is needed during times of resource scarcity to optimize critical care utilization. This study compares the modified sequential organ failure assessment score (M-SOFA), the Pediatric Early Warning System (PEWS) score, the Pediatric Risk of Admission Score II (PRISA-II), and physician judgment to predict the need for pediatric intensive care unit (PICU) interventions. ⋯ No score had a clinically acceptable discriminate ability to predict patients who required a PICU intervention from those who did not. Physician judgment outperformed all three triage scores.
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Disaster Med Public Health Prep · Jun 2012
Increasing out-of-hospital regional surge capacity for H1N1 2009 influenza A through existing community pediatrician offices: a qualitative description of quality improvement strategies.
To describe initiatives undertaken by a network of community pediatricians to increase a city's surge capacity for patients presenting with influenza-like illnesses during the 2009 H1N1 influenza A pandemic. ⋯ Effective communication and improved access to health care enabled children within the network with influenza-like illnesses to continue to be cared for in their medical home. The measures used in response to novel influenza virus outbreaks can be adapted for other situations requiring increased community surge capacity.
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Disaster Med Public Health Prep · Jun 2012
Mapping US pediatric hospitals and subspecialty critical care for public health preparedness and disaster response, 2008.
The objective is to describe by geographic proximity the extent to which the US pediatric population (aged 0-17 years) has access to pediatric and other specialized critical care facilities, and to highlight regional differences in population and critical resource distribution for preparedness planning and utilization during a mass public health disaster. ⋯ This geospatial analysis describes the current state of pediatric critical care hospital resources and provides a visual and analytic overview of existing gaps in local pediatric hospital coverage. It also highlights the use of dasymetric mapping as a tool for public health preparedness planning.
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To assess the adequacy of the pediatric triage system in an acute care general hospital. ⋯ Our study revealed inadequacies in the pediatric triage system. A simple and objective triage system that is based on the measurement of crucial vital parameters and on prompt recognition of warning signs and symptoms to correctly identify high-risk groups has been introduced to ensure appropriate and effective triage of sick children.
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Disaster Med Public Health Prep · Jun 2012
Survey of emergency management professionals to assess ideal characteristics of a photographic-based family reunification tool.
A reunification tool that captures images of children at the time of the disaster would enable parents to locate their missing children, particularly if the children are unable to communicate their identity. This study assessed the ideal features and parameters of a photographic-based reunification tool. ⋯ Emergency management professionals identified desirable characteristics of a photographic-based reunification tool, including an algorithm displaying unedited photographs of missing children that loosely matches the parents' description, acknowledging the parents' emotional difficulty in viewing photographs with facial trauma. Participants were also willing to accept a lower percentage of successful reunifications as the scale of the disaster size increased.