Many children are away from their families for a significant part of the day. If a disaster strikes when their kids are at school or child care, families often go to the nearest hospital to look for them.
After the mass shooting in Las Vegas last year, more than 500 family members arrived at one hospital. In 2016, nearly 800 people went to a local hospital looking for victims of a school bus crash that killed five children and one adult and injured 30 in Chattanooga, Tenn.
“Hospital spaces are tight. We need to think, how are we going to plan for hundreds of people arriving in our hospital and have them in a place where we can support them but at the same time not disrupt hospital operations?” said Sarita Chung, M.D., FAAP, a member of the AAP Disaster Preparedness Advisory Council.
The AAP collaborated with the Massachusetts General Hospital Center for Disaster Medicine to create a planning support tool to help all hospitals prepare for prompt reunification of children with their families after disasters. Family Reunification Following Disasters: A Planning Tool for Health Care Facilities is designed to complement and integrate with hospital emergency operations plans.
Children who are separated from families are at risk for significant physical and mental trauma, neglect, abuse and even exploitation. The AAP recognizes that shortening the separation period for children can help mitigate these risks.
The planning tool describes designated areas to best accommodate family reunification. Some options include offsite buildings away from the hospital, including a reunification center for families seeking children and a pediatric safe area that houses medically cleared children awaiting family reunification. Families who eventually learn their child has died or is still missing do not share space with families being reunited.
Victim identification can take days to weeks if hospitals do not have enough information, said Dr. Chung, co-editor of the tool. “Families expect immediate identification and education about all victims living or deceased.”
The plan outlines roles and processes for leadership and organization; registration, intake and tracking of unaccompanied children; identification; and information-sharing.
“You want to relieve the stress as much as possible on parents by giving a very unified message across the area,” said Rachel Charney, M.D., FAAP, co-editor of the tool.
Drills and other exercises can ensure the plan encompasses and fits with overall hospital plans, community plans and public agencies. The tool addresses reunification specifically, but hospitals can combine it with the AAP joint policy Pediatric Readiness in the Emergency Department on a day-to-day basis and in a disaster.
“Hospitals are going to have no choice to a certain extent of who’s going to show up at your door looking for lost family members,” Dr. Charney said. “You need to have somewhere to start.”