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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

Abstract


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.


Keywords


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

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References


Rosen-Reynoso M, Porche MV, Kwan N, et al.: Disparities in access to easy-to-use services for children with special health care needs. Matern Child Health J. 2016; 20(5): 1041-1053. doi:10.1007/s10995-015-1890-z.

Stough LM, Ducy EMA, Kang D: Addressing the needs of children with disabilities experiencing disaster or terrorism. Curr Psychiatry Rep. 2017; 19(4): 1-10. doi:10.1007/s11920-017-0776-8.

Kelen GD, Sauer L, Clattenburg E, et al.: Pediatric disposition classification (Reverse Triage) system to create surge capacity. Disaster Med Public Health Prep. 2015; 9(3): 283-290. doi:10.1017/dmp.2015.27.

Revere CJ: National Commission on children and disasters urges Obama Administration and Congress to address unique disaster needs of children. NASN Sch Nurse. 2010; 25(2): 78-80. doi:10.1177/1942602X09358432.

Murray JS: Disaster preparedness for children with special healthcare needs and disabilities. J Spec Pediatr Nurs. 2011; 16(3): 226-232. doi:10.1111/j.1744-6155.2011.00293.x.

Bothe DA, Olness KN, Reyes C: Overview of children and disasters. J Dev Behav Pediatr. 2018; 39(8): 652-662. doi:10.1097/DBP.0000000000000600.

United Nations Office for Disaster Risk Reduction: Global Assessment Report on Disaster Risk and Reduction. Geneva, Switzerland: United Nations Office for Disaster Risk Reduction; 2019.

Office of the Assistant Secretary for Preparedness: Healthcare Preparedness for Children in Disasters: A Report of the NACCD Healthcare Preparedness Working Group—November 13, 2015. Washington DC: ASPR; 2015.

Office of the Assistant Secretary for Preparedness: National Advisory Committee on Children and Disasters (NACCD) Metrics of Baseline Vulnerability in Pediatrics Health Care Services Report NACCD Brief Task: Identifying Metrics of Baseline Vulnerability in Pediatrics Health Care Services. Washington DC: ASPR; 2018.

Save the Children: Still at risk: U.S. Children 10 years after Hurricane Katrina 2015 national report card on protecting children in disasters. 2015. Available at https://www.savethechildren.org/content/dam/usa/reports/emergency-prep/disaster-report-2015.pdf. Accessed April 1, 2020.

Gibbs L, Nursey J, Cook J, et al.: Delayed disaster impacts on academic performance of primary school children. Child Dev. 2019; 90(4): 1402-1412. doi:10.1111/cdev.13200.

McFarland J, Hussar B, Zhang J, et al.: The Condition of Education 2019. US Department of Education; 2019. Available at https://nces.ed.gov/pubs2019/2019144.pdf. Accessed April 1, 2020.

Cooper H, Nye B, Charlton K, et al.: The effects of summer vacation on achievement test scores: A narrative and meta-analytic review. Rev Educ Res. 1996; 66(3): 227-268. doi:10.3102/00346543066003227.

Von Hippel PT: Is summer learning loss real? Educ Next. 2019; 19(4): 8-15.

Cooper H: Summer learning loss: The problem and some solutions. ERIC Digest. 2003. Available at https://www.ericdigests.org/2003-5/summer.htm. Accessed April 16, 2020.

García E, Weiss E: Student Absenteeism Who Misses School and How Missing School Matters for Performance. Washington DC: Economic Policy Institute; 2018. Available at https://www.epi.org/publication/student-absenteeism-who-misses-school-and-how-missing-school-matters-for-performance/. Accessed April 1, 2020.

Cutter SL, Boruff BJ, Shirley WL: Social vulnerability to environmental hazards. Soc Sci Q. 2003; 84(2): 242-261. doi:10.1111/1540-6237.8402002.

Durant TJ: The utility of vulnerability and social capital theories in studying the impact of Hurricane Katrina on the elderly. J Fam Issues. 2011; 32(10): 1285-1302. doi:10.1177/0192513X11412491.

Commission on Social Determinants of Health: Scoping Paper: Priority Public Health Conditions. Geneva, Switzerland: WHO; 2007.

Nomura S, Parsons AJQ, Hirabayashi M, et al.: Social determinants of mid- to long-term disaster impacts on health: A systematic review. Int J Disaster Risk Reduct. 2016; 16: 53-67. doi:10.1016/J.IJDRR.2016.01.013.

Sokol R, Austin A, Chandler C, et al.: Screening children for social determinants of health: A systematic review. Pediatrics. 2019; 144(4): e20191622. doi:10.1542/peds.2019-1622.

Simon T, Cawthon ML, Stanford S, et al.: Pediatric medical complexity algorithm: A new method to stratify children by medical complexity. Pediatrics. 2014; 133(6): e1647-e1654. doi:10.1542/peds.2013-3875.




DOI: https://doi.org/10.5055/ajdm.2020.0368

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