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Children in Disasters. Special Populations. Issues: Multi-casualty and complex. Dealing with primary injuries Rapid identification Protection of separated kids Reunification with legal guardians Minimize secondary injuries. Secondary injuries. Unintentional - Carbon monoxide inhalation
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Children in Disasters Special Populations
Issues: Multi-casualty and complex • Dealing with primary injuries • Rapid identification • Protection of separated kids • Reunification with legal guardians • Minimize secondary injuries
Secondary injuries • Unintentional - Carbon monoxide inhalation - Lacerations - Poisoning • Intentional - Abduction - Violence - Physical and sexual abuse - Neglect - Maltreatment
Background • 29th August, 2005, Hurricane Katrina a Cat.III storm hit New Orleans • 4th Sept., 2005 1600 evacuees (300 children) evacuated (31 hours bus ride) • Camp Gauber, Oklahoma National Guard Base • Oklahoma Army National Guard Maneuver Training Center (33,000 acre site), Cookson Hills, 60 miles from Tulsa
Shelter • Series of two storied military barrack buildings • 5-6 large room • 50 people in each room • Pediatric Injury Response Team (PIRT) provided care for child survivors • Child – safety crisis measures set up • Treated patients (dermatitis, asthma, upper respiratory infections, diarrhea, skin or wound infections)
Hypothesis tested: • A significant number of unregistered children at Camp Gruber were traveling without legal guardians and were on the National Center for Missing and Exploited Children (NCMEC)
Problems • No standard approach • No rapid plan to identify the immediate needs of children separated from parents • No registry set up • No information collected when they disembarked from the bus • Subjected to physical assaults, rape, gang attacks, murder etc.
Operation Child-ID: Case reports • Early identification of a high risk situation and reunification • Reunification of children and parents • Child abuse prevention
Discussions - ‘Principles’ not ‘Protocols’ • Displaced children - quickly reuniting with primary caregivers - Post Traumatic Stress Disorder (PTSD) minimized - Community panic reduced - Immediately register children and prioritize needs - Id’s with photographs and identifying bracelets - Set up a digital data entry system POSSIBLY A CENTRALIZED DATA TRACKING SYSTEM???