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Chapter 15 - Pediatrics in a Field Hospital

from Section 4 - Clinical Considerations

Published online by Cambridge University Press:  09 January 2020

Elhanan Bar-On
Affiliation:
The Israel Center for Disaster Medicine and Humanitarian Response, Sheba Medical Center, Tel Hashomer, Israel
Kobi Peleg
Affiliation:
National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Health Policy and Epidemiology and Tel-Aviv University, Disaster Medicine Department
Yitshak Kreiss
Affiliation:
Sheba Medical Center, Tel Hashomer, Israel
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Summary

It has been reported that 50% of the affected during natural or man-made disasters are children. They have unique vulnerabilities that require unique and specific management. It is therefore vital to understand the optimal management in pediatric emergencies, and to consider efforts regarding pediatric preparedness and response in humanitarian situations.

This chapter reviews the necessary means of pediatric care that must be included in medical relief delegations, and proposes a structure for a dedicated medical team, as well as necessary logistic and administrative considerations.

A triage algorithm is described, considering three key parameters: urgency, available resources, and the likelihood of saving a patient’s life. Ethical dilemmas posed by the above approach are discussed as well.

Lastly, the authors discuss the necessary collaboration between the pediatric team and the traumatology and obstetrics/gynecology departments, and describe the structure and function of a pediatric ward in a field hospital, based on experience from medical relief delegations deployed by the Israel Defense Forces (IDF) after natural disasters in Haiti and Nepal.

Type
Chapter
Information
Field Hospitals
A Comprehensive Guide to Preparation and Operation
, pp. 140 - 147
Publisher: Cambridge University Press
Print publication year: 2020

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References

Radinsky, K, Davidovich, S, Markovitch, S, eds. WWW 2012. Learning causality for news events prediction 2012: Lyon, France.Google Scholar
Guha-Sapir, D, Hoyois, P. Estimating populations affected by disasters: a review of methodological issues and research gaps, in Centre for Research on the Epidemiology of Disasters (CRED). Brussels, Belgium: Université catholique de Louvain; ed. 2015.Google Scholar
Nicholls, S, Healy, C. Communication with disaster survivors: towards best practice. Australian Journal of Emergency Management 2008: 23(3).Google Scholar
Emergency field handbook: a guide for UNICEF staff. Geneva, Switzerland: UNICEF; 2005.Google Scholar
Rothstein, DH. Pediatric care in disasters. Pediatrics 2013: 132(4): 602–5.Google Scholar
Peek, L, Stough, LM. Children with disabilities in the context of disaster: a social vulnerability perspective. Child Development 2010: 81(4): 1260–70.Google Scholar
Bennett, CM, Friel, S. Impacts of climate change on inequities in child health. Children (Basel) 2014: 1(3): 461–73.Google Scholar
IV Geneva Convention relative to the protection of civilian persons in time of war. 1949: Geneva, Switzerland.Google Scholar
Young, H, Harvey, P. The sphere project: the humanitarian charter and minimum standards in disaster response: introduction. Disasters 2004: 28(2): 99.Google Scholar
Wong, EG, Trelles, M, Dominguez, L, Gupta, S, Burnham, G, Kushner, AL. Surgical skills needed for humanitarian missions in resource-limited settings: common operative procedures performed at Médecins Sans Frontières facilities. Surgery 2014: 156(3): 642–9.Google Scholar
Edwards, MJ, Lustik, M, Burnett, MW, Eichelberger, M. Pediatric inpatient humanitarian care in combat: Iraq and Afghanistan 2002 to 2012. Journal of the American College of Surgeons 2014: 218(5):1018–23.Google Scholar
Idenburg, FJ, van Dongen, TT, Tan, EC, et al. Pediatric surgical care in a Dutch military hospital in Afghanistan. World Journal of Surgery 2015: 39(10): 2413–21.Google Scholar
Kreiss, Y, Merin, O, Peleg, K, et al. Early disaster response in Haiti: the Israeli field hospital experience. Annals of Internal Medicine 2010: 153(1): 45–8.Google Scholar
Farfel, A, Assa, A, Amir, I, et al. Haiti earthquake 2010: a field hospital pediatric perspective. European Journal of Pediatrics 2011: 170(4): 519–25.Google Scholar
Ytzhak, A, Sagi, R, Bader, T, et al. Pediatric ventilation in a disaster: clinical and ethical decision making. Critical Care Medicine 2012: 40(2): 603–7.Google Scholar
O’Laughlin, DT, Hick, JL. Ethical issues in resource triage. Respiratory Care 2008: 53(2): 190–7; discussion 7200.Google Scholar
Schultz, CH, Koenig, KL, Noji, EK. A medical disaster response to reduce immediate mortality after an earthquake. The New England Journal of Medicine 1996: 334(7): 438–44.Google Scholar
Hick, JL, Rubinson, L, O’Laughlin, DT, Farmer, JC. Clinical review: allocating ventilators during large-scale disasters – problems, planning, and process. Critical Care 2007: 11(3).Google Scholar
Bar-On, E, Lebel, E, Blumberg, N, Sagi, R, Kreiss, Y, Israel Defense Forces Medical Corps. Pediatric orthopedic injuries following an earthquake: experience in an acute-phase field hospital. The Journal of Trauma and Acute Care Surgery 2013: 74(2): 617–21.Google Scholar
Bulut, M, Fedakar, R, Akkose, S, Akgoz, S, Ozguc, H, Tokyay, R. Medical experience of a university hospital in Turkey after the 1999 Marmara earthquake. Emergency Medicine Journal 2005: 22(7): 494–8.Google Scholar
Xiang, B, Cheng, W, Liu, J. Triage of pediatric injuries after the 2008 Wen-Chuan earthquake in China. Journal of Pediatric Surgery 2009: 44(12): 2273–7.Google Scholar
Jafari-Rouhi, AH, Sardashti, S, Taghizadieh, A, Soleimanpour, H, Barzegar, M. The Emergency Severity Index, version 4, for pediatric triage: a reliability study in Tabriz Children’s Hospital, Tabriz, Iran. International Journal of Emergency Medicine 2013: 6(1): 36.Google Scholar
Wuerz, RC, Travers, D, Gilboy, N. Implementation and refinement of the emergency severity index. Academic Emergency Medicine 2001: 8(2):170–6.Google Scholar
Hohenhaus, SM, Travers, D, Mecham, N. Pediatric triage: a review of emergency education literature. Journal of Emergency Nursing 2008: 34(4): 308–13.Google Scholar
Gilboy, N, Tanabe, P, Travers, D, Rosenau, A. Emergency severity index (ESI): a triage tool for emergency department care. Rockville, Maryland, USA: AHRQ – US Department of Health and Human Services; 2011.Google Scholar
Travers, DA, Waller, AE, Katznelson, J, Agans, R. Reliability and validity of the emergency severity index for pediatric triage. Academic Emergency Medicine 2009: 16(9): 843–9.Google Scholar
Trudeau, MO, Baron, E, Herard, P, Labar, AS, Lassalle, X, Teicher, CL, et al. Surgical care of pediatric patients in the humanitarian setting: the Médecins Sans Frontières experience, 2012–2013. JAMA Surgery 2015: 150(11): 1080–5.Google Scholar
Petrosyan, M, Guner, YS, Emami, CN, Ford, HR. Disparities in the delivery of pediatric trauma care. The Journal of Trauma and Acute Care Surgery 2009: 67(2 Suppl): S114–9.Google Scholar
Barthel, ER, Pierce, JR, Goodhue, CJ. Availability of a pediatric trauma center in a disaster surge decreases triage time of the pediatric surge population: a population kinetics model. Theoretical Biology and Medical Modelling 2011: 8: 38.Google Scholar
Weiser, G, Ilan, U, Mendlovic, J, Bader, T, Shavit, I. Procedural sedation and analgesia in the emergency room of a field hospital after the Nepal earthquake. Emergency Medicine Journal 2016: 33(10): 745–7.Google Scholar
Goldenberg, RL, Culhane, JF, Iams, JD, Romero, R. Epidemiology and causes of preterm birth. The Lancet 2008: 371(9606): 7584.Google Scholar
Tucker, J, McGuire, W. Epidemiology of preterm birth. The BMJ 2004: 329(7467): 675–8.Google Scholar
Bar-Dayan, Y, Beard, P, Mankuta, D, et al. An earthquake disaster in Turkey: an overview of the experience of the Israeli Defence Forces Field Hospital in Adapazari. Disasters 2000: 24(3): 262–70.Google Scholar
Pinkert, M, Dar, S, Goldberg, D, et al. Lessons learned from an obstetrics and gynecology field hospital response to natural disasters. Obstetrics & Gynecology 2013: 122(3): 532–6.Google Scholar
Dvoyris, V, Kreiss, Y, Bader, T. Treatment capabilities of field hospitals at war and mass-casualty disasters, in Wolfson, N (ed.), Orthopedics in disasters: orthopedic injuries in natural disasters and mass casualty events. Berlin, Heidelberg: Springer-Verlag; 2016: 3746.Google Scholar
Efrati, I. [Medical clowns want to be treated seriously]. Haaretz. 2016.Google Scholar

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