P3A227: The New York City Pediatric Intensivist Response Team

Background: Children are frequently victims of disasters; however, important gaps remain in pediatric disaster preparedness. The New York City Pediatric Disaster Coalition’s goal is to prepare for catastrophic events impacting children and their families. The NYCPDC has developed a network of pediatric intensivists to create the Pediatric Intensivist Response Team (PIRT). PIRT consists of volunteer pediatric intensivists that currently practice at Pediatric Critical Care units. PIRT has an essential role in the NYC Pediatric Disaster Plan and act as subject matter experts during disasters. PIRT maintains a 24/7 on-call schedule in preparation for the onset of a disaster involving pediatric patients. Once activated, the PIRT physician on call works closely with FDNY/EMS to triage/prioritize pediatric patients for secondary transport based on acuity and need for specialized services. This allows for matching pediatric patients to the appropriate level of care at designated tiered Pediatric Disaster Ambulance/Facility destinations.

Project Description: To maintain readiness the NYCPDC and PIRT have participated in tabletop exercises for pediatric mass casualty incidents and conducted call down drills to test communication capability. During the tabletop exercise 11 PIRT members were given 15 patient profiles and asked to sort patients for secondary transport based on their injuries and medical needs. The participants correctly prioritized 15 patients within 30 minutes. PIRT participants were also tested on their communication response ability through a no notice activation drill. 11 of the 13 team members responded within 38 minutes, all within a goal of one hour. The primary on-call physician responded in 1 minute and the backup physician responded in 20 minutes.

Discussion: In addition, PIRT responded to a NYC real time event. A five-alarm fire resulted in multiple pediatric casualties including patients with cardiac arrest, smoke inhalation and other injuries. The PIRT physician on call responded immediately to a notification from the local borough coalition and offered SME, patient prioritization and referral for transport to the pediatric burn center.

Conclusion: The utilization of a PIRT enhanced pediatric response capabilities. These capabilities were successfully tested through a tabletop exercise, call down drill and real time event. This model can be used by others in developing pediatric disaster preparedness programs.

Objectives:

Introduces the unique needs of children during disasters.

Explain current gaps in pediatric disaster planning related to the provision of transport prioritization and pediatric subject matter expertise during disasters.

Describe how utilization of a Pediatric Intensive Care Response Team (PIRT) can address gaps and match resources to needs.