Brandenburg Mark A, Arneson Wendy L
Department of Emergency Medicine, University of Oklahoma College of Medicine, USA.
Am J Disaster Med. 2007 May-Jun;2(3):151-62.
Mass casualty incidents and large-scale disasters involving children are likely to overwhelm a regional disaster response system. Children have unique vulnerabilities that require special considerations when developing pediatric response systems. Although medical and trauma strategies exist for the evaluation and treatment of children on a daily basis, the application of these strategies under conditions of resource-constrained triage and treatment have rarely been evaluated. A recent report, however, by the Institute of Medicine did conclude that on a day-to-day basis the U.S. healthcare system does not adequately provide emergency medical services for children. The variability, scale, and uncertainty of disasters call for a set of guiding principles rather than rigid protocols when developing pediatric response plans. The authors propose the following guiding principles in addressing the well-recognized, unique vulnerabilities of children: (1) terrorism prevention and preparedness, (2) all-hazards preparedness, (3) postdisaster disease and injury prevention, (4) nutrition and hydration, (5) equipment and supplies, (6) pharmacology, (7) mental health, (8) identification and reunification of displaced children, (9) day care and school, and (10) perinatology. It is hoped that the 10 guiding principles discussed in this article will serve as a basic framework for developing pediatric response plans and teams in developed countries.
涉及儿童的大规模伤亡事件和大型灾难可能会压垮地区灾难应对系统。儿童有其独特的脆弱性，在制定儿科应对系统时需要特别考虑。虽然日常有针对儿童评估和治疗的医疗及创伤策略，但在资源受限的分诊和治疗条件下这些策略的应用很少得到评估。然而，医学研究所最近的一份报告确实得出结论，美国医疗系统在日常情况下并未充分为儿童提供紧急医疗服务。灾难的多变性、规模和不确定性要求在制定儿科应对计划时要有一套指导原则而非严格的规程。作者针对儿童公认的独特脆弱性提出以下指导原则：（1）恐怖主义预防与准备，（2）全灾种准备，（3）灾后疾病与伤害预防，（4）营养与水合作用，（5）设备与物资，（6）药理学，（7）心理健康，（8）流离失所儿童的身份识别与团聚，（9）日托与学校，以及（10）围产医学。希望本文讨论的这10项指导原则能成为发达国家制定儿科应对计划和团队的基本框架。
