Objectives:The differences between pediatric (≤17 years of age) and adult clinical field encounters were analyzed from four deployments of Disaster Medical Assistance Teams(DMATs).Methods:A retrospective cohort review of all patients who presented to DMAT field clinics during two hurricanes, one earthquake, and one flood was conducted. Descriptive statistics were used to analyze: (1) age; (2) gender; (3) severity category level; (4) chief complaint; (5) treatments provided; (6) discharge diagnosis; and (7) disposition. Five subsets of pediatric patients were analyzed further.Results:Of the 2,196 patient encounters reviewed, 643 (29.5%) encounters were pediatric patients. Pediatric patients had a greater number of blank severity category levels than adults. Pediatric patients also were: (1) more likely to present with chief complaints of upper respiratory infections or wounds; (2) less likely to present with musculoskeletal pain or abdominal pain; and (3) equally likely to present with rashes. Pediatric patients were more likely to receive antibiotics, pain medication, and antihistamines, but were equally likely to need treatment for wounds. Dispositions to the hospital were less frequent for pediatric patients than for adults.Conclusions:Pediatric patients represent a substantial proportion of disaster victims at DMAT field clinics. They often necessitate special care requirements different from their adult counterparts. Pediatric-specific severity category criteria, treatment guidelines, equipment/medication stocks, and provider training are warranted for future DMAT response preparations.
The needs of the patients differed in several areas between Hurricane Andrew and the Houston flood. This information should be tested in a future hurricane or flood and taken into account when planning for deployments.
Objectives:The New Mexico-1 Disaster Medical Assistance Team (NM-1 DMAT) has responded to more disasters due to hurricanes than disasters from any other type of event. To assess whether defined patient needs may be applied to future hurricanes, the patient needs after Hurricanes Andrew and Iniki were compared. The study question was, “Did patient medical needs differ after these hurricanes?”Methods:Design: Retrospective cohort review. Subjects: All patients evaluated by NM-1 DMAT following Hurricanes Andrew and Iniki. Observations: Age, past medical history, chief complaint, diagnosis, diagnostic tests, treatments, triage level, and disposition. Age was analyzed using Student's t-test, other data were analyzed using the chisquare test.Results:A total of 1,056 patients were evaluated. Age distributions did not differ between events. More patients had co-morbidities after Hurricane Andrew. The only difference in chief complaint was that more patients complained of “cold” symptoms following Hurricane Iniki. The only differences in diagnoses were for upper respiratory infections, which were diagnosed more often after Hurricane Iniki. There were no differences in the administration of tetanus toxoid, antibiotics, or analgesics. Patients evaluated after Hurricane Andrew had more diagnostic tests performed and a higher illness/injury acuity. The proportion of the total number of patients conveyed to a hospital did not differ.Conclusion:Patient needs were similar after Hurricane Andrew and Hurricane Iniki and may be applicable for predicting the needs of patients for future hurricanes.
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