1. Pediatric Healthcare Providers and Disasters: Have you learned the lessons? Lou E. Romig MD, FAAP, FACEP Pediatric Emergency Medicine Miami Children’s Hospital Team Medical Director, FL5 DMAT

2. Objectives  Taking preparedness personally  Family and business disaster planning  Preparing our patients and their families for disasters  Institutionalizing preparedness

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

4. KnowingDoingBelievingCommitting

5. Medical Model Disaster Preparedness and Mitigation Preventive Medicine =

6. Do healthcare providers 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

7. Do healthcare providers 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

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

9. Lou Romig

10. Earthquake in Memphis? Hurricane in New York? Tsunami in Alaska? Terrorist bombing in Oklahoma City? Terrorist bombing in Bath, Michigan?

11. Michigan Disasters  Bath school disaster, 1927, 45 dead, mostly children  Tornado outbreak (MI/OH), 1953, 139 dead  Great Blizzard of 1978, 20 dead  Detroit theater roof collapse, 1898, 15 dead  Italian Hall disaster, 1913, Calumet, 73 dead  South-central MI earthquake, 1947

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

13. Lou Romig FEMA Photo Library ALL kinds of people!

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

15. Lou Romig

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

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

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

19. Risk Assessment: Man-made  Industry  Chemicals  Explosives/Fires

20. Rogers Dam

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

22. 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

23. All Hazards Planning Environment Resources

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

25. STOCK your own resources All photos Lou Romig

26. 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

27. Personal and Family Disaster Planning Resources  www.aap.org/healthtopics/terrorism.cfm www.aap.org/healthtopics/terrorism.cfm  AAP Family Readiness Kit  http://www.aap.org/family/frk/frkit.htm http://www.aap.org/family/frk/frkit.htm  www.redcross.org www.redcross.org  www.ready.govwww.ready.gov  www.fema.gov www.fema.gov  http://www.nod.org/research_publications /emergency_preparedness_materials/ http://www.nod.org/research_publications /emergency_preparedness_materials/  www.jumpstarttriage.com www.jumpstarttriage.com

28. 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

29. A Disaster Preparedness Plan for Pediatricians Scott Needle MD, FAAP Mississippi Chapter AAP http://www.aap.org/disasters/pdf/DisasterPrepPlanforPeds.pdf

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

31. 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. http://www.aap.org/advocacy/blankform.pdf

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

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

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

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

36. 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

37. Institutionalizing Preparedness

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

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

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

41. 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

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

45. Lou Romig

48. Thank you! www.jumpstarttriage.com louromig@bellsouth.net Lou Romig