Stories about: disaster relief efforts

Weathering the storm with children who have chronic illnesses

As Boston prepares for Hurricane Sandy, many people are buying last minute supplies: canned goods, water and extra batteries.  But for families with chronically ill children, disaster preparedness is more complicated. Many of these children require steady access to medication, clean water, electricity and often need significant help getting from place to place, so having a strategy in place to provide those items after a catastrophe can be crucial.

“The immediate loss of support resources for kids with medical needs is the biggest obstacle these children and their families face after a disaster,” says John Murray, PhD, RN, CPNP, CS, FAAN, director of Nursing Research in Surgical Programs and the Emergency Department at Boston Children’s Hospital. “Families should be prepared for the worst case scenarios. That way, if they do happen, they won’t be caught completely off guard.”

Disaster plans should cover the basics like safe meeting spots and access to stored supplies, but should also address the specific needs of chronically ill children, like having access to electricity that can run a respirator or having plenty of water to clean feeding tubes. To be best prepared, Murray suggests parents call local electricity and water providers, alert them to your family’s specific situation and ask about their emergency support services. This is especially important for electrical devices, as power outages can go on for some time after larger-scale disasters. “If your child needs steady access devices requiring electricity, you need to have a back up generator in case there’s a prolonged blackout,” he says. “Your local electric company or organization that supplies your medical equipment should be able to provide you with one based on your child’s needs.”

If your child needs steady access devices requiring electricity, you need to have a back up generator in case there’s a prolonged blackout.

Murray also suggests having an emergency information form that contains contact information for medical providers, friends and family, which could be incredibly important if parents and children are separated after a disaster. Depending on the child’s needs, detailed information about his condition and care should also be readily available. For instance, instructions on medicine dosage or techniques for managing a breathing tube may be particularly useful if the parent and child are separated after disaster strikes.

“Try to make the instructions succinct, because you don’t know under what situation they’ll be needed,” he says. “It’s possible the person reading them won’t be used to this type of situation or have access to everything you normally would. The notes in your disaster kit should take account of that.”

(Click for a copy of the American Academy of Pediatrics Emergency Information for Children with Special Needs Form, or create your own based on your child’s requirements.)

It’s also important to remember that major disasters can cause young children significant stress. To help alleviate some of their worry, you might consider involving your children in the creation of your family’s disaster preparedness. Engaging them in activates like trips to the grocery store to buy emergency supplies, or showing them how you contacted power companies to alert them to your family’s particular medical situation, can be empowering and help them feel safer. (Read our expert’s tips on lessening anxiety in children worried about natural disasters.)

“Knowing there is a disaster preparedness plan in place is going to help relive a lot of stress for kids,” Murray says. “Having them be involved with the preparation just drives home the point that your family is ready should something happen.”

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Children's and Project Medishare: reflections from the adult ward

Jill Merna, Nancy Joseph, Carla Odiago worked the night shift in the adult ward taking care of over 80 adult patients.
Jill Merna, Nancy Joseph, Carla Odiago worked nights taking care of over 80 adult patients.

From April 10 to 18, Children’s Hospital Boston sent a group of 26 clinicians to a field hospital in Haiti. Here, those who staffed the adult ward reflect on their experience.

Nancy Joseph, RN, BSN, MSN, FNP-C; staff nurse in CHPCC

This was my internal cry after arriving our first day. I thought I was going to lose my composure when those two women came in on the back of a truck requiring emergency C-sections.

Ayiti Cherie….
Bel mon, Bel moun, Bel lang
! a je!

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Children's and Project Medishare: reflections from the Emergency Department

The ER team: from left, Sarah Wingerter, MD, Stephen Monteiro, MS EMT-P, Sarita Chung, MD, Alexis Schmid, RN, Michelle Marini, RN.
The ER team: from left, Sarah Wingerter, MD, Stephen Monteiro, MS EMT-P, Sarita Chung, MD, Alexis Schmid, RN, Michelle Marini, RN.

From April 10 to 18, Children’s Hospital Boston sent a group of 26 clinicians to a field hospital in Haiti. Here, those who staffed the Emergency Department reflect on their experience.

Sarah Wingerter, MD, Division of Emergency Medicine

In retrospect it seems hard to believe we only spent 8 days in Haiti.  Each day was so intense and so replete with new experiences and powerful emotions.   I remain awestruck and humbled by the fortitude of the Haitians I met, both patients and Medishare staff members.  To know that they continue to work on putting their lives back together despite the unimaginable challenges they face has given me a new perspective on what used to seem like inconveniences in my own comfortable life.  I learned a great deal about patience, humility, and selflessness from patients and parents who waited hours in the sweltering heat—many after walking miles to reach the medical facility—for the opportunity to receive care for medical problems they had endured for months or even years.

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Lessons from a disaster relief simulation

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A group of clinicians worked together to stabilize the "patient."

Clinicians working in high-resource settings, like Children’s Hospital Boston, rely on the availability of certain equipment to do their jobs, like ventilators, specially sized needles and tubes and a fully stocked pharmacy. But when they’re forced to perform without their gear—like in Haiti in the immediate aftermath of the January earthquake—many find it bewildering and even paralyzing. “We fall into these patterns of providing care,” says David Mooney, MD, MPH, director of the Trauma Program, who was one of the first medical responders to respond after the disaster. “One of the things I noticed in Haiti was that many doctors really fixated on what they didn’t have.”

That mental block can waste time and be counterproductive, so Children’s is developing a training program to prepare the doctors, surgeons, nurses, pharmacists and other volunteers who are going to Haiti to continue relief efforts in the coming months for the conditions they’re likely to find. Mooney, along with Shannon Manzi, PharmD, and Debra Weiner, MD, PhD, worked with Children’s Simulator Program to create the special training, in which clinicians reenact challenging situations on robotic mannequins. Peter Weinstock, MD, PhD, director of the Simulator program, hopes that by practicing in an environment with limited supplies, clinicians will be encouraged to think outside of the box to find the resources they need, and will be better prepared for a disaster zone.

(Listen to a WBUR story about Children’s new simulation program and read The Boston Globe’s White Coat Notes report of it.)

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