Two new reports call for more attention when attending to the needs of children in disaster preparedness.
An estimated 66.5 million children worldwide are affected by disasters each year, a number that is expected to grow due to climate change and societal shifts, according to a new report by the Federal Emergency Management Agency’s Citizen Corps. “However,” the report says, “scant attention has been paid to this particular population regarding emergency preparedness and planning.” To remedy this, there should be more school and community programs that address children’s needs in disasters; efforts to get children themselves more involved in disaster preparedness; and a review of the effectiveness of programs once implemented.
In the report, researchers reviewed research on youth disaster preparedness and education published in the past 20 years. The research, though limited, showed that children were at greater risk of injuries, including head trauma and fractures; were more at risk from airborne toxins; and lack “self-preservation skills” to allow them to escape a disaster. But other research showed children can be the impetus for families to prepare a disaster plan or kit and serve as translators of important information in families that speak more than one language. The report also offers 12 tips for designing disaster preparedness programs for youth. For more information, go to citizencorps.gov/news/webcasts/youthpreparedness.shtm and scroll down to “Bringing Youth Preparedness Education to the Forefront: A Literature Review and Recommendations.”
In other news, the National Commission on Children and Disasters has approved its “2010 Report to the President and Congress,” which calls for the development of programs to address the physical and mental health of children, as well as educational, housing and human services needs for children in disasters. The full report was expected to be released in October; the executive summary is available at childrenanddisasters.acf.hhs.gov/.
To learn more about the needs of children, FEMA has recently started offering a web-based independent study course through the Emergency Management Institute on Planning for the Needs of Children in Disasters. Go to training.fema.gov/IS/ and scroll down to course ID IS-366.
New AHA Guidelines to Be Unveiled at ECCU
ECCU2010 will be held Dec. 7–11 at the San Diego Manchester Grand Hyatt. The conference brings together CPR instructors, EMS personnel, researchers and community organizers to learn about the latest in resuscitation technology, research and techniques, including the new American Heart Association guidelines. To mark the 50th anniversary of CPR, a Survivor’s Summit will bring together 50 cardiac arrest survivors along with many of their rescuers. Go to eccu2010.com for more information. The conference is sponsored by the Citizen CPR Foundation.
Delays Raise Risk of Death From STEMI
As we reported in the October issue, deaths from ST-segment elevation myocardial infarction (STEMI), a severe type of heart attack, rose by about 10 percent for every hour of delay between the time the patient called for an ambulance and was treated in the hospital, Danish researchers reported in the Aug. 18 issue of the Journal of the American Medical Association.
Most research on delays in care for heart attacks has focused on what happens after a patient arrives at the hospital, says lead study author Christian Juhl Terkelsen, M.D., a cardiologist at Aarhus University Hospital. But the time between when the person recognizes the symptoms of heart attack and the ambulance gets him or her to the hospital also matters.
During a follow-up that averaged about 3.5 years, approximately 15.4 percent of patients who waited less than an hour from the time they called for an ambulance to the time they were being treated at the hospital died; 23.3 percent treated in less than two hours died; 28.1 percent of those treated in two to three hours died; and 30.8 percent treated in three to four hours died. “Our message is we should focus on all health care system delays, which often starts with the call for the ambulance,” Terkelsen says.
The three hospitals included in the study all offered primary percutaneous coronary intervention (PCI), or balloon angioplasty, in which a catheter is threaded into the artery and a balloon at the end inflates. In the U.S., not every hospital offers PCI, and even those that do may not always have the medical staff available to get it done quickly enough, Terkelsen says.
That makes getting to the right hospital—one that has a catheterization lab in which staff can be activated quickly—critical, Terkelsen says. In ambulances equipped with 12-lead electrocardiograms, EMS personnel can diagnosis the STEMI en route. While all ambulances in Denmark have 12-lead electrocardiograms, not all U.S. ambulances do.
EMS in Georgia Sees a Spike in Younger Patients
Benny Atkins, president of National EMS in Rockdale County, Ga., says his agency saw a surge in 911 calls this past summer from people aged 35 to 50. Atkins told the Rockdale Citizen the uptick may be due to a loss of health insurance due to the recession and unemployment. “We’re paying attention to this and trying to figure out why our 35- to 50-year-olds are being transported as much as our 50- to 65-year-olds,” he says.
Private Ambulances in Philly Promise to Pitch in During MCIs
In case of a major disaster, the Philadelphia Fire Department will be able to count on help from the fleet of 300 private ambulances operating in the city, according to the mayor. Amid the ongoing controversy over fire departments conducting brownouts in an effort to save money, union leaders questioned whether the move was a step toward privatization, according to the Philadelphia Inquirer. But city officials described it as a new milestone in public-private EMS cooperation. A state-funded rebate will cover half the cost of new radios that will enable private ambulances to communicate with the city’s 911 system. So far, 80 private ambulances have the radios.
Rural/Metro Acquires Colorado Ambulance Service
Rural/Metro is acquiring Pridemark Paramedic Services, which provides advanced and basic life support in the Denver and Boulder, Colo., areas, as well as interfacility ambulance transport throughout Denver and Boulder County. “We are very excited to execute on this component of our growth model and look forward to exploring similar opportunities in the future,” says Rural/Metro President and CEO Michael DiMino.
The acquisition, which was expected to close for an undisclosed price in late October, will add $12 million in net ambulance revenue and approximately 38,000 transports per year, according to a Pridemark news release.
Memphis Fire Department Using Cooling Therapy in Cardiac Arrest
This summer, Memphis Fire Department’s ambulances joined the growing ranks of EMS agencies that offer therapeutic hypothermia to cardiac arrest patients while en route to the hospital. Memphis’ 33 ambulances are now equipped with coolers used to chill a saline solution that can flow into the veins of people who have suffered cardiac arrest but have regained a heartbeat.
Studies show cooling therapy, in which body temperature is cooled to between 89.6° and 93.2° F, can preserve neurological function in those who survive. Yet when cooling therapy needs to begin is still open to debate; a recent study in the journal Circulation found patients whose hypothermia began in the ambulance fared no better than those who had to wait for hypothermia to begin in the emergency department. (See Research Monitor for more on cooling therapy.)
Program Makes It Easier for EMTS, Paramedics to Volunteer in Major Disasters
To make it easier for health care professionals to volunteer in major disasters such as hurricanes and earthquakes, the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response has launched a new website that streamlines the process by verifying credentials in advance, according to Medical News Today. The Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) is a national network of state-based programs that verifies the identity, licenses and credentials of health care professionals before an emergency happens. “ESAR-VHP saves time so we can make the most of volunteers’ specialized medical skills when hours, even minutes, really matter,” Nicole Lurie, M.D., HHS’ assistant secretary for preparedness and response, told Medical News Today.
“Volunteering to help those in need during a disaster is an incredible act of compassion, and ESAR-VHP helps us get volunteers in place when they can make the biggest impact. It puts those who want to volunteer in the best position to be able to do so.” All health care professionals are encouraged to register with their state system. Once registered, participants can opt in or out when contacted for volunteer service.
“Everybody volunteers for different reasons,” says Matthew McCoy, an EMT from Oklahoma City whose ESAR-VHP registration enabled him to volunteer for three hurricane responses, including Hurricane Katrina. “There’s a part of everybody that really wants to help, and when you volunteer with ESAR-VHP, that happens.” For more info, visit phe.gov/esarvhp/Pages/default.aspx.
