scholarly journals (P1-78) Utilizing New York City Pediatric Disaster Coalition Site Visits to Create Hospital Pediatric Critical Care Surge Plans

2011 ◽  
Vol 26 (S1) ◽  
pp. s124-s124
Author(s):  
A. Flamm ◽  
G. Foltin ◽  
K. Uraneck ◽  
A. Cooper ◽  
B.M. Greenwald ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critical Care ◽  
York City ◽  
Emergency Preparedness ◽  
Capacity Planning ◽  
Mass Casualty ◽  
Federal Grant ◽  
Surge Capacity ◽  
Pediatric Critical Care

PurposeThe New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has supported a federal grant establishing a Pediatric Disaster Coalition (PDC) comprised of pediatric critical care (PCC) and emergency preparedness consultants from major city hospitals and health agencies. One of the PDC's goals was to develop recommendation for hospital-based PCC surge plans.MethodsMembers of the PDC convened bi-weekly and among other projects, developed guidelines for creating PCC surge capacity plans. The PDC members, acting as consultants, conducted scheduled visits to hospitals in NYC and actively assisted in drafting PCC surge plans as annexes to existing hospital disaster plans. The support ranged from facilitating meetings to providing draft language and content, based on each institutions request.ResultsNew York City has 25 hospitals with PCC services with a total of 244 beds. Five major hospitals have completed plans, thereby adding 92 PCC beds to surge capacity. Thirteen additional hospitals are in the process of developing a plan. The PDC consultants participated in meetings at 11 of the planning hospitals, and drafted language for 10 institutions. The PDC continues to reach out to all hospitals with the goal of initiating plans at all 25 PCC hospitals.ConclusionsProviding surge guidelines and the utilization of on-site PDC consultants was a successful model for the development and implementation of citywide PCC surge capacity planning. Visiting hospitals and actively assisting them in creating their plans was an effective, efficient and well received, method to create increased PCC surge capacity. By first planning with major hospitals, a significant increase of surge beds (92 or 38%) was created, from a minimal number of hospitals. Once hospitals complete plans, it is anticipated that there will be the addition of at least 200 PCC surge beds that can be incorporated in to regional city-wide response to pediatric mass-casualty incident.

Utilizing a Pediatric Disaster Coalition Model to Increase Pediatric Critical Care Surge Capacity in New York City

2017 ◽  
Vol 11 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Michael Frogel ◽  
Avram Flamm ◽  
Mayer Sagy ◽  
Katharine Uraneck ◽  
Edward Conway ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critical Care ◽  
York City ◽  
Emergency Preparedness ◽  
Mass Casualty ◽  
Surge Capacity ◽  
Pediatric Critical Care ◽  
Mass Casualty Event ◽  
Care Surgery

AbstractA mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems. The PDC assisted 15 hospitals in creating PCC surge plans by utilizing template plans and site visits. These plans created an additional 153 potential PCC surge beds. Seven hospitals tested their plans through drills. The purpose of this article was to demonstrate the need for planning for disasters involving children and to provide a stepwise, replicable model for establishing a PDC, with one of its primary goals focused on facilitating PCC surge planning. The process we describe for developing a PDC can be replicated to communities of any size, setting, or location. We offer our model as an example for other cities. (Disaster Med Public Health Preparedness. 2017;11:473–478)

scholarly journals (P1-12) Had the Times Square Bomb Exploded: What about the Injured Children?

2011 ◽  
Vol 26 (S1) ◽  
pp. s102-s102
Author(s):  
E. Conway ◽  
A. Flamm ◽  
G. Foltin ◽  
A. Cooper ◽  
B.M. Greenwald ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critical Care ◽  
York City ◽  
Emergency Preparedness ◽  
Time Of Day ◽  
Federal Grant ◽  
Pediatric Critical Care ◽  
Times Square ◽  
Preparedness Planning

IntroductionChildren frequently are the victims of disasters due to natural hazards or terrorist attacks. However, there is a lack of specific pediatric emergency preparedness planning worldwide. To address these gaps, the federal grant-funded New York City Pediatric Disaster Coalition (PDC) established guidelines for creating Pediatric Critical care (PCC) surge plans and assisted hospitals in creating their plans. To date, five hospitals completed plans, thereby adding 92 beds to surge capacity. On 01 May 2010, 18:00h, there was an attempt to detonate a car bomb in Times Square, a large urban attraction in the heart of New York City. The perpetrator was later convicted of the attempted use of a weapon of mass destruction. Had the bomb exploded, given the location and time of day, it is possible that many critically injured victims would have been children.MethodsThe unit director or a senior attending of nine major hospitals in the NYC area (five in close proximity and four at secondary sites) were surveyed for the number of their vacant pediatric critical care beds at the time of the event before activation of surge plans.ResultsAt the time the car bomb was discovered, the nine hospitals, which have a total of 141 PCC beds, had only 29 vacant approved pediatric critical care beds.ConclusionsHad the event resulted in many pediatric casualties, the existing PCC vacant beds at these hospitals may not have satisfied the need. Activating surge plans at five of these hospitals would have added 92 to the 29 available PCC beds for a total of 121. In order to provide PCC to a large number of victims, it is crucial that hospitals prepare PCC surge plans.

scholarly journals Plan for Increasing Pediatric Critical Care Surge Capacity in New York City

2010 ◽  
Vol 25 (S1) ◽  
pp. S37-S37
Author(s):  
Sagy Mayer ◽  
Avram Flamm ◽  
George Foltin ◽  
Katherine Uraneck ◽  
Michael Tunik ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critical Care ◽  
York City ◽  
Surge Capacity ◽  
Pediatric Critical Care

scholarly journals (A47) Pediatric Mass-Casualty Triage: The New York City Approach

2011 ◽  
Vol 26 (S1) ◽  
pp. s16-s16
Author(s):  
A. Cooper ◽  
D. Gonzalez ◽  
M. Frogel ◽  
A. Flamm ◽  
D. Prezant ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critically Ill ◽  
York City ◽  
Emergency Preparedness ◽  
Early Recognition ◽  
Trauma Surgery ◽  
Mass Casualty ◽  
Infants And Children ◽  
Mass Casualty Event

IntroductionA Mass-Casualty Event (MCE) involving pediatric victims could overwhelm existing pediatric resources. Therefore, early recognition of critically ill infants and children is essential for proper distribution among pediatric capable hospitals. However, emergency medical services (EMS) personnel have limited experience with pediatric assessments, and less with pediatric mass-casualty triage (MCT). To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) in collaboration with the Fire Department (FDNY) and Office of Emergency Management, made simple alterations to the START-based NYC-MCT Algorithm that can be rapidly and accurately applied by EMS personnel in the field with minimal additional education and preparation, obviating the requirement for extensive and expensive retraining.MethodsThe PDC includes experts in pediatric emergency preparedness, emergency medicine, critical care, and trauma surgery in NYC, as well as DOHMH, FDNY-OMA, and OEM. Its Triage Subcommittee determined the minimum essential pediatric alterations to the Algorithm, which then was tested by FDNY-EMS.ResultsAfter focused literature review and multiple draft revisions aimed to maximize pediatric benefit yet minimize unnecessary complexity, the Algorithm was modified to ensure that: (1) five rescue breaths will be provided to infants or children prior to being categorized as Dead or Expectant; (2) infants under 12 months old will be categorized as Critical and receive priority transport, and (3) children initially categorized as Delayed or Minor will be uptriaged to a new Urgent (Orange) category to receive such care in a rapid manner. To date, > 3,000 FDNY personnel have been trained in its use, and tested its accuracy using tabletop scenarios. Mean accuracy is 80–90%.ConclusionsThe model is an effective, multidisciplinary approach to planning. Minimum alterations to the Algorithm were adopted by the regional EMS system. The Modified Algorithm improves identification of critically ill infants and children. This approach could be adopted by other large urban centers.

scholarly journals Emergency Preparedness Training for Hospital Nursing Staff, New York City, 2012–2016

2018 ◽  
Vol 51 (1) ◽  
pp. 81-87 ◽  
Author(s):  
Jasmine L. Jacobs‐Wingo ◽  
Jeffrey Schlegelmilch ◽  
Maegan Berliner ◽  
Gloria Airall‐Simon ◽  
William Lang
Keyword(s):  
New York ◽  
New York City ◽  
Nursing Staff ◽  
York City ◽  
Emergency Preparedness ◽  
Hospital Nursing

scholarly journals Using a joint triage model for multi-hospital response to a mass casualty incident in New York city

2009 ◽  
Vol 2 (2) ◽  
pp. 114 ◽  
Author(s):  
Bonnie Arquilla ◽  
Lorenzo Paladino ◽  
Charlotte Reich ◽  
Ethan Brandler ◽  
Michael Lucchesi ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Hospital Response

scholarly journals Regional Variation in Critical Care Evacuation Needs for Children After a Mass Casualty Incident

2012 ◽  
Vol 6 (2) ◽  
pp. 146-149 ◽  
Author(s):  
Robert K. Kanter
Keyword(s):  
Public Health ◽  
New York ◽  
Critical Care ◽  
Metropolitan Area ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Evacuation Time ◽  
Pediatric Critical Care ◽  
Ground Ambulance ◽  
Ground Ambulances

ABSTRACTObjectives: To determine the ability of five New York statewide regions to accommodate 30 children needing critical care after a hypothetical mass casualty incident (MCI) and the duration to complete an evacuation to facilities in other regions if the surge exceeded local capacity.Methods: A quantitative model evaluated pediatric intensive care unit (PICU) vacancies for MCI patients, based on data on existing resources, historical average occupancy, and evidence on early discharges and transfers in a public health emergency. Evacuation of patients exceeding local capacity to the nearest PICU center with vacancies was modeled in discrete event chronological simulations for three scenarios in each region: pediatric critical care transport teams were considered to originate from other PICU hospitals statewide, using (1) ground ambulances or (2) helicopters, and (3) noncritical care teams were considered to originate from the local MCI region using ground ambulances. Chronology of key events was modeled.Results: Across five regions, the number of children needing evacuation would vary from 0 to 23. The New York City (NYC) metropolitan area could accommodate all patients. The region closest to NYC could evacuate all excess patients to PICU hospitals in NYC within 12 hours using statewide critical care teams traveling by ground ambulance. Helicopters and local noncritical care teams would not shorten the evacuation. For other statewide regions, evacuation of excess patients by statewide critical care teams traveling by ground ambulance would require up to nearly 26 hours. Helicopter transport would reduce evacuation time by 40%-44%, while local noncritical care teams traveling by ground would reduce evacuation time by 16%-34%.Conclusions: The present study provides a quantitative, evidence-based approach to estimate regional pediatric critical care evacuation needs after an MCI. Large metropolitan areas with many PICU beds would be better able to accommodate patients in a local MCI, and would serve as a crucial resource if an MCI occurred in a smaller community. Regions near a metropolitan area could be rapidly served by critical care transport teams traveling by ground ambulance. Regions distant from a metropolitan area might benefit from helicopter transport. Using local noncritical care transport teams would involve shorter delays and less expert care during evacuation.(Disaster Med Public Health Preparedness. 2012;6:146–149)

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