Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, California, USA.
J Trauma Acute Care Surg. 2012 Oct;73(4):885-9. doi: 10.1097/TA.0b013e318251efdb.
Recent events including the 2001 terrorist attacks on New York; Hurricane Katrina; the 2010 Haitian and Chilean earthquakes; and the 2011 earthquake, tsunami, and nuclear disaster in Japan have reminded disaster planners and responders of the tremendous scale of mass casualty disasters and their resulting human devastation. Although adult disaster medicine is a well-developed field with roots in wartime medicine, we are increasingly recognizing that children may comprise up to 50% of disaster victims, and response mechanisms are often designed without adequate preparation for the number of pediatric victims that can result. In this short educational review, we explore the differences between the pediatric and adult disaster and trauma populations, the requirements for designation of a site as a pediatric trauma center (PTC), and the magnitude of the problem of pediatric disaster patients as described in the literature, specifically as it pertains to the availability and use of designated PTCs as opposed to trauma centers in general. We also review our own experience in planning and simulating pediatric mass casualty events and suggest strategies for preparedness when there is no PTC available. We aim to demonstrate from this brief survey that the availability of a designated PTC in the setting of a mass casualty disaster event is likely to significantly improve the outcome for the pediatric demographic of the affected population. We conclude that the relative scarcity of disaster data specific to children limits epidemiologic study of the pediatric disaster population and offer suggestions for strategies for future study of our hypothesis.
Systematic review, level III.
最近发生的事件包括 2001 年对纽约的恐怖袭击；卡特里娜飓风；2010 年海地和智利地震；以及 2011 年日本地震、海啸和核灾难，这些事件提醒灾难规划者和应对者注意大规模伤亡灾难的巨大规模及其造成的人类破坏。尽管成人灾难医学是一个发达的领域，其根源在于战时医学，但我们越来越认识到，儿童可能占灾难受害者的 50%，而应对机制通常是在没有充分准备应对可能导致的大量儿科受害者的情况下设计的。在这个简短的教育性综述中，我们探讨了儿科和成人灾难和创伤人群之间的差异、指定儿科创伤中心 (PTC) 的要求，以及文献中描述的儿科灾难患者问题的严重程度，特别是涉及指定 PTC 的可用性和使用相对于一般创伤中心。我们还回顾了我们在规划和模拟儿科大规模伤亡事件方面的经验，并提出了在没有 PTC 可用时的准备策略。我们旨在通过这项简短的调查表明，在大规模伤亡灾难事件中，指定 PTC 的可用性很可能显著改善受灾人群中儿科人群的结果。我们得出结论，特定于儿童的灾难数据相对稀缺限制了对儿科灾难人群的流行病学研究，并为我们假设的未来研究策略提供了建议。
系统评价，三级。
