Of 3,700 EMS agencies surveyed in 2005, 86% lacked a pediatrics-specific mass-casualty plan, and 80% did not use a pediatric triage plan. EMS agencies need to do more to provide supplemental training and ensure competency in pediatric care and disaster response. Furthermore, jurisdictions should conduct regular disaster drills with at least 25% of the patients being pediatric (that’s the percentage of children in the population), with varying levels of acuity.

Any disaster will include an early chaotic period where efforts at performing triage, treatment and transport to appropriate facilities will be marginalized. Within this context, pediatric care is often reduced to “scoop and run,” especially when more critical patients may emerge shortly. EMS agencies are advised to adopt the MUCC/SALT methodology into their disaster triage protocols and procedures, and to institute proper triage, treatment and transport (and electronic tracking) early in the incident.

Agencies and jurisdictions also need to develop disaster caches of medical supplies and equipment specifically geared toward pediatrics, and explore alternative methods of transportation. EMS systems and professionals must see themselves in the larger context of disaster health and partner with their local healthcare, emergency management and disaster mental health experts to plan and respond to pediatric disasters.

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