Saving Children In a Crisis

The needs of children during large-scale public health emergencies from terrorists or from natural origins have received limited attention, and schools, in particular, are ill-prepared for their position at the front lines of children's health, says Michael Shannon, M.D., MPH, chief of Emergency medicine at Children's Hospital Boston and director of its Center for Biopreparedness.

Children especially are at high risk after exposure to chemical or biological agents, says Shannon, as they breathe faster, increasing their exposure to agents; are less resistant to fluid loss and hypothermia; often lack self-preservation skills; and are more likely to develop post-traumatic stress.

"Children don't carry wallets, and they may not be able to tell you who they are," Shannon adds.

Unique demands of treating children in a terrorism situation include the difficulty for clinicians wearing cumbersome protective equipment to treat tiny babies. "It's terrifying when you've lost your dexterity and have to care for someone so small," Shannon says.

Other considerations include the need for sophisticated, real-time surveillance techniques to detect and track infectious outbreaks among children; special logistical concerns for hospitals; and possible approaches to a regionally coordinated pediatric bioterrorism response.

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