Paediatric patients in mass casualty incidents: a comprehensive review and call to action

Abstract

The paediatric population is disproportionately affected during mass casualty incidents (MCIs). Several unique characteristics of children merit special attention during natural and man-made disasters because of their age, physiology, and vulnerability. Paediatric anaesthesiologists play a critical part of MCI care for this population, yet there is a deficit of publications within the anaesthesia literature addressing paediatric-specific MCI concerns. This narrative review article analyses paediatric MCI considerations and compares differing aspects between care provision in Australia, the UK, and the USA. We integrate some of the potential roles for anaesthesiologists with paediatric experience, which include preparation, command consultation, in-field care, pre-hospital transport duties, and emergency department, operating theatre, and ICU opportunities. Finally, we propose several methods by which anaesthesiologists can improve their contribution to paediatric MCI care through personal education, training, and institutional involvement.

Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage

“…Results of the PHP scoping review stressed the importance of a common terminology to be adopted across all agencies working in the same jurisdiction, along with the urgent need to include practices that support gender diversity and are contextual to vulnerable groups and special needs populations [ 30 , 111 , 140 , 147 , 159 , 160 ]. Included references addressed the role of technology in supporting the different PH MCI processes, from inter-agencies communication systems, to telemedicine and information management systems to coordinate the different resources deployed (including human resources, equipment, and vehicles) and to distribute MCI casualties in different health facilities [ 90 , 92 , 99 , 146 , 160 ].…”

Emergency medical services preparedness in mass casualty incidents: A qualitative study

“…These challenges are intensified in the case of lack of resources. Due to the vulnerability of these people and to reduce mortality, special guidelines should be developed for the management of high‐risk and vulnerable groups in MCIs 37–39 …”

“…Due to the vulnerability of these people and to reduce mortality, special guidelines should be developed for the management of high-risk and vulnerable groups in MCIs. [37][38][39] Ethical issues play a prominent role in all aspects of EMS response in MCIs. EMS systems seek to relieve suffering and preserve life, guided by the ethical principles of nonmaleficence (do no harm), beneficence (act for the benefit of others), respect for autonomy (self-determination), and justice (fairness and equitable allocation of resources).…”

A Call to Action: Why Anesthesiologists Must Train, Prepare, and Be at the Forefront of Disaster Response for Mass Casualty Incidents

“…Children constitute 25% to 30% of the victims in a disaster. 15,16 Other vulnerable populations may be affected as well, and may present equity challenges in MCI response. [17][18][19][20] Disasters may impact your community or your hospital infrastructure (Table 1).…”