Critical Care 3
George Foltin, MD (he/him/his)
State University of New York Downstate Medical Center College of Medicine
Irvington, New York, United States
Children represent 25% of the population, have special needs and are often over-represented in disasters. The New York City Pediatric Disaster Coalition (NYC PDC) is funded by the NYC Department of Health and Mental Hygiene (DOHMH) to improve pediatric disaster preparedness and response. PDC worked with a network of pediatric intensivists to create the Pediatric Intensive-Care Response Team (PIRT). PIRT consists of volunteer pediatric intensivists that currently practice in New York City.
The purpose of the PIRT is to provide overall SME during disasters, and prioritization triage services to the agency responsible for inter-facility secondary transport of pediatric patients during large-scale disasters. The PIRT system was assessed in call down drills and case scenario exercises.
Secondary transport may be requested by hospitals due to a mismatch of resources to needs for patients requiring critical and or subspecialty care. The team is activated when a disaster involves a significant number of pediatric patients. In the proposed plan, the PIRT physician on-call will triage/prioritize the patients based on acuity and need for services and relay the necessary information to the transport agency. PIRT is designated to provide subject matter expertise and resources during real-world events. PIRT maintains a 24/7 on-call schedule with backup. The PIRT system was tested in four call-down communications drills and a tabletop exercise for prioritization of pediatric mass casualty victims.
The call down drills demonstrated the ability to contact the on call and backup physicians by e-mail or text within 20 minutes and others within one hour. Text was the preferred method of communications.
In the tabletop PIRT team members were given 15 patient profiles based on a scenario and asked to prioritize patients based on their injuries/medical needs. This was accomplished in less than 30 minutes, followed by a review and discussion of the rank order. A number of lessons learned were identified and will be presented.
The NYCPDC has developed and tested a PIRT that is available 24/7 to prioritize patients for secondary transport and offer subject matter expertise during Pediatric Mass Casualty Events. This model can be utilized to enhance pediatric disaster preparedness.