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A proposed pediatric risk stratification method (PRiSM) for disaster preparedness

Paul E. Patterson, MD, PhD, Matthew T. Scott, MD, Jonathan W. Chooey, DO, Meagan R. Butsch, DO, Rebecca A. Christi, MD, Bonnie J. Jordan, MD, Daniel S. Roy, MD, Eric M. Flake, MD


Objective: Children are a uniquely vulnerable population in times of disaster. Understanding the risk associated with the pediatric population is complex and involves aspects beyond just the medical needs of children.

Design: We reviewed current literature in two databases regarding risk and disaster preparedness in children to assess current risk stratification methodologies across multiple domains including medical, social, and educational.

Results: No comprehensive risk stratification tool exists that considers multiple domains. Three key domains are inter-related to a child’s vulnerability in times of disaster; medical, educational, and social. We propose a pediatric risk stratification method (PRiSM) for disaster preparedness as one way to consider the three critical domains. Using existing medical, educational, and social data, our proposed framework considers all three domains to stratify children by their degree of risk in terms of disaster preparedness. PRiSM consists of a three-digit alphanumeric guide to stratify patients based on complex medical, educational, and social needs.

Conclusion: This framework provides a possible method to risk stratify children prior to a disaster to better inform planning and responses in the future.


pediatric risk stratification, disaster planning, comprehensive risk stratification, children with special health care needs

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