Disasters

The CCITT may be asked to take a critical or even a leadership role in internal or external hospital disasters or events requiring patient movement within, to, or from the hospital.

The Federal Emergency Management Agency became part of the new US Department of Homeland Security in March 2003 and has championed a new disaster management structure. The National Incident Management System (NIMS), developed by the Secretary of Homeland Security, integrates effective practices in emergency preparedness and response into a comprehensive national framework for incident management (http://www.fema.gov/nims/). Understanding and participating in NIMS training should enable CCITT and EMS personnel to work together more effectively to manage domestic incidents no matter what the cause, size, or complexity.

The Hospital Emergency Incident Command System (HEICS) is a ver­sion of IC that is specific to hospital emergency planning and operations. CCITT members should be trained in how to operate within the HEICS system to function optimally and maintain accountability and safety when operating within the hospital system. If an incident involves special medical considerations, such as one with a biological or chemical agent, the CCITT may be involved as an important participant in providing organized and optimal care for large numbers of potentially exposed children. In such cases, it is important for the CCITT to rely on current training and have clear access to specific medical and logistical information and personnel for the appropriate and safe care of children in this environment.

In an evolving disaster plan, current systems need to focus on the vol­ume of patients with specialized needs. Although fewer, critical pediatric and neonatal patients may pose added challenges and need to be considered in any well-rounded disaster plan. Integrated CCITTs must be utilized for the specialized or high-tech pediatric patients. In any response plan, these CCITTs could be used for back transport for the less severe pediatric patients to non disaster hospitals that can appropriately manage pediatric patients. The integration of various CCITTs into the state or regional plans must have active participation by the medical physician and nursing director of the transporting services in the regional and state disaster response systems.

As in the previous section, the needs of the “high tech or special­ized” pediatric and neonatal warrants particular integration by the CCITT service for their needs during disaster planning or implementation. Also, these particular pediatric/neonatal patient transports should be developed and integrated into any CCITT service as part of their disaster response for local, regional, or state response plan.