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Evaluation of a County-Wide Pediatric Surge Plan

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Evaluation of a County-Wide Pediatric Surge Plan
Natalie E. Demeter, MPH1, Bridget M. Berg, MPH FACHE1, Mark Saatzer, BS1, Millicent Wilson, MD2, Terry Crammer, RN BSN2 and Jeffery S. Upperman, MD1, 1Children's Hospital Los Angeles, Los Angeles CA, 2Los Angeles County Emergency Medical Services Agency, Los Angeles CA

Objective: PURPOSE: Pediatric victims require specific care, supplies, and security during mass casualty incidents. A pediatric surge plan was created to address these concerns for the Los Angeles County trauma system in the event of an incident that disproportionately affects children. The tiered plan distributes pediatric patients based on acuity and age and categorizes hospitals by level of pediatric capabilities. After the development of the pediatric surge plan, we aimed to test effectiveness of the plan.
Methods: A county-wide tabletop exercise was held to evaluate the current pediatric surge plan. The tabletop scenario was a hypothetical strong wind mass casualty event that disproportionately affected children. Exercise attendees participated in both small-group and room-wide discussions of the plan and completed an anonymous survey. Both small group and room-wide discussions were documented by evaluators. RESULTS Fifty-seven of 82 (69.5%) Hospital Preparedness Program participant hospitals in the county were represented at the tabletop exercise. On average, participants believed that their facilities were moderately prepared to respond to a pediatric surge event with an average score of 4.5/6, (1=not prepared and 6=very prepared). Common themes that emerged from the room-wide discussion include concerns about reunification of children, pediatric-specific dosing and supplies, and secondary transfer policy. The exercise also highlighted the need to differentiate between pediatric trauma and medical capabilities in the plan. CONCLUSION Through the tabletop exercise, we identified several opportunities for improvement to the county-wide pediatric surge plan. Additionally, hospital participants identified several areas where they can improve their hospital's response.
Objective: Discuss the concerns of county-wide management of a pediatric surge event.Objective Content: Through the presentation of this evaluation, audience members will be able to identify the trauma system wide and specific hospital concerns of managing a large mass casualty incident that disproportionately affects children. The presentation will briefly describe the pediatric surge plan, the evaluation of the plan, and the next steps in further development of the plan that emerged post-evaluation.


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