1. Disasters: What you could have known… What you wished you would have known… What you can do now! Lou E. Romig MD, FAAP, FACEP Pediatric Emergency Medicine Miami Children’s Hospital Medical Director, FL5 DMAT

2. Did we know about the possibilities of a “Katrina scenario” before it happened? FEMA Photo Library

3. KnowingDoing BelievingCommitting

4. Medical Model Disaster Preparedness and Mitigation Preventive Medicine =

5. Do pediatricians have a role in preventive medicine?  Believe it’s worth the investment  Practice it ourselves  Teach our patients and their families  Participate in preventive medicine efforts  Advocate for institutionalization of preventive health measures

6. Do pediatricians have a role in disaster preparedness?  Believe it’s worth the investment  Practice it ourselves  Teach our patients and their families  Participate in disaster preparedness and response efforts  Advocate for institutionalization of disaster preparedness and mitigation

7. Culture of Preparedness: Believe! Excrement occurs! Disasters don’t happen to places.

8. Lou Romig

9. Earthquake in Memphis? Hurricane in New York? Tsunami in Alaska? Terrorist bombing in Oklahoma City? Atlanta?

10. Culture of Preparedness Disasters don’t happen to places. Disasters happen to people.

11. Lou Romig FEMA Photo Library

12. Culture of Preparedness Disasters don’t happen to places. Disasters happen to people. Disasters can happen to us.

13. Lou Romig

14. Disaster preparedness is a personal responsibility: My family and friends My home My livelihood My patients My community

15. Personal Preparedness  Risk assessment  Natural hazards  Nonintentional man-made hazards  Intentional man-made hazards  Plan for all reasonable hazards

16. Risk Assessment: Natural  Weather  Geography  Home  Schools  Office/Hospital  Epidemiology  Port of entry  Travel destination

17. Risk Assessment: Man-made  Industry  Chemicals  Explosives/Fires  Transportation  Hubs  Through traffic

18. Risk Assessment: Man-made  Seats of government/politics  Symbolic institutions and icons  Commerce and industrial centers  Transportation centers  Military bases  Religious and cultural institutions  Schools  Medical facilities  Mass gathering sites

19. All Hazards Planning Environment Resources

20. ADAPT to Environments Lou Romig FL OEM Library Lou Romig FEMA Photo Library

21. STOCK your own resources All photos Lou Romig

22. Personal Planning  Share your plans with family, friends and co-workers  Know the plans at family members’ schools and workplaces  Review and exercise your plans. Involve the kids!  Learn from your own experiences and those of others

23. Personal and Family Disaster Planning Resources  www.aap.org/healthtopics/terrorism.cfm  AAP Family Readiness Kit  www.redcross.org  www.ready.gov  www.fema.gov  www.fifionline.org/disaster_planning.htm  www.nod.org (Emergency Preparedness)  www.jumpstarttriage.com

24. Plan to protect your livelihood  Have disaster plans for your office and staff  Have appropriate hazard and business interruption insurance  Protect patient and business records. Make them transportable.  Plan how to continue your practice if your office is not functional  Make sure your patients know your plans

25. A Disaster Preparedness Plan for Pediatricians Scott Needle MD, FAAP Mississippi Chapter AAP www.aap.org/healthtopics/terrorism.cfm

26. Teaching patients and families  Disaster preparedness should be a part of anticipatory guidance.  Physicians should assist families in disaster planning for children with special healthcare needs and other chronic illnesses.

27. Teaching patients and families Remember that any acute medical need can be a “disaster” for a family. Use tools like the AAP’s Emergency Information Form. www.aap.org/advocacy/emergprep.htm

28. Start young! www.ready.gov/kids www.fema.gov/kids

29. Participate: Planning  Local planning/training  Schools/childcare facilities  Shelters  Hospitals  Community Emergency Response Teams (CERTs)  Local NGO programs  Faith-based programs

30. Participate: Planning  Regional/state planning  Professional associations AAP, AMA  Healthcare networks  Public Health Departments  State EMS for Children Programs

31. Participate: Response Become a part of the system before the disaster happens!

32. Great volunteers…  Know the system in which they are enlisted to work  Have their credentials established and verified before the disaster  Understand liability issues  Know how to live and work in austere conditions  Bring their own supplies and support  Have the support of their families and co-workers

33. Nightmare on Sesame Street! FEMA USAR ESF SNS NRP NIMS DHS EMAC JFO

34. Federal Alphabet Soup  US Citizen Corps  Community Emergency Response Teams (CERTs)  Medical Reserve Corps (MRCs)  www.citizencorps.gov  Volunteer Protection Act of 1997  National Disaster Medical System (NDMS)  Disaster Medical Assistance Teams (DMATs)  International Medical-Surgical Response Teams (IMSuRTs)  Covered by USERRA regulations and Federal Tort Claims Act

35. Institutionalizing Preparedness

36.  Teach children about disaster preparedness  Incorporate disaster preparedness into workplace policies and procedures  Teach professions about pertinent aspects of disaster preparedness and response

37. Institutionalizing Preparedness  Disaster preparedness incentives  Overcome financial obstacles to personal preparedness  Study the tangible value of preparedness and mitigation  Tackle liability issues

38. Institutionalizing Preparedness  Recognize the strengths and limits of generosity and use it responsibly  Take the best advantage of volunteerism  Build strong teams

39. Review  Turn knowledge into action  Take disasters personally  It’s OK to be selfish  Like injury and illness prevention and workplace safety measures, disaster preparedness should be a matter-of-fact part of our lives

40. Review  Recognize the tangible values of preaction instead of reaction  Get on a team  Play well together

41. Lou Romig

43. Thank you! Presentation available at www.jumpstarttriage.com louromig@bellsouth.net Lou Romig