The Pediatric Patient in MCI

  • Adam Lee Goldstein
  • Dror Soffer
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


Despite the demographic minority of children in any given population, mass casualty incidents (MCI) often impact areas with a high concentration of children, such as schools and recreational events. Even those MCI primarily involving children are initially met by healthcare workers trained to provide care for adults (from the first-response team to the specialty physicians), as well as an infrastructure designed for triaging, transporting, and treating adult patients.



Thank you to Krystin Johnson, of Austin, Texas, for her editorial expertise.


  1. 1.
  2. 2.
    Seidel JS, Hornbein M, Yoshiyama K, Kuznets D, Finklestein JZ, St Geme JW. Emergency medical services and the pediatric patient: are the needs being met? Pediatrics. 1984;73(6):769–72.PubMedGoogle Scholar
  3. 3.
    Lyle K, Thompson T, Graham J. Pediatric mass casualty: triage and planning for the prehospital provider. Clin Pediatr Emerg Med. 2009;10(3):173–85.CrossRefGoogle Scholar
  4. 4.
    Gausche-Hill M, Schmitz C, Lewis RJ. Pediatric preparedness of US emergency departments: a 2003 survey. Pediatrics. 2007;120(6):1229–37.CrossRefGoogle Scholar
  5. 5.
    Chung S, Shannon M. Hospital planning for acts of terrorism and other public health emergencies involving children. Arch Dis Childhood. 2005;90(12):1300–7.CrossRefGoogle Scholar
  6. 6.
    Ferrer RR, Ramirez M, Sauser K, Iverson E, Upperman JS. Emergency drills and exercises in healthcare organizations: assessment of pediatric population involvement using after-action reports. Am J Disaster Med. 2008;4(1):23–32.CrossRefGoogle Scholar
  7. 7.
    Shirm S, Liggin R, Dick R, Graham J. Prehospital preparedness for pediatric mass-casualty events. Pediatrics. 2007;120(4):e756–61.CrossRefGoogle Scholar
  8. 8.
    Markenson D, Redlener I. Pediatric terrorism preparedness national guidelines and recommendations: findings of an evidenced-based consensus process. Biosecur Bioterror. 2004;2(4):301–19.CrossRefGoogle Scholar
  9. 9.
    Manoj BS, Baker AH. Communication challenges in emergency response. Commun ACM. 2007;50(3):51–3.CrossRefGoogle Scholar
  10. 10.
    Lerner EB, Schwartz RB, Coule PL, Weinstein ES, Cone DC, Hunt RC, Sasser SM, Liu JM, Nudell NG, Wedmore IS, Hammond J. Mass casualty triage: an evaluation of the data and development of a proposed national guideline. Disaster Med Public Health Prep. 2008;2(S1):S25–34.CrossRefGoogle Scholar
  11. 11.
    Jones N, White ML, Tofil N, Pickens M, Youngblood A, Zinkan L, Baker MD. Randomized trial comparing two mass casualty triage systems (JumpSTART versus SALT) in a pediatric simulated mass casualty event. Prehosp Emerg Care. 2014;18(3):417–23.CrossRefGoogle Scholar
  12. 12.
    Waisman Y, Amir L, Mor M, Feigenberg Z, Aharonson LD, Peleg K, Blumenfeld A. Prehospital response and field triage in pediatric mass casualty incidents: the Israeli experience. Clin Pediatr Emerg Med. 2006;7(1):52–8.CrossRefGoogle Scholar
  13. 13.
    Wallis LA, Carley S. Comparison of paediatric major incident primary triage tools. Emerg Med J. 2006;23(6):475–8.CrossRefGoogle Scholar
  14. 14.
    Nadeau NL, Cicero MX. Pediatric disaster triage system utilization across the United States. Pediatr Emerg Care. 2017;33(3):152–5.CrossRefGoogle Scholar
  15. 15.
    Ma OJ, Norvell JG, Subramanian S. Ultrasound applications in mass casualties and extreme environments. Crit Care Med. 2007;35(5):S275–9.CrossRefGoogle Scholar
  16. 16.
    Ong AW, McKenney MG, McKenney KA, Brown M, Namias N, MaCloud J, Cohn SM. Predicting the need for laparotomy in pediatric trauma patients on the basis of the ultrasound score. J Trauma Acute Care Surg. 2003;54(3):503–8.CrossRefGoogle Scholar
  17. 17.
    Barthel ER, Pierce JR, Goodhue CJ, Burke RV, Ford HR, Upperman JS. Can a pediatric trauma center improve the response to a mass casualty incident? J Trauma Acute Care Surg. 2012;73(4):885–9.CrossRefGoogle Scholar
  18. 18.
    Soffer D, Klausner JM. Trauma system configurations in other countries: the Israeli model. Surg Clin North Am. 2012;92(4):1025–40.CrossRefGoogle Scholar
  19. 19.
    Burke RV, Iverson E, Goodhue CJ, Neches R, Upperman JS. Disaster and mass casualty events in the pediatric population. Semin Pediatr Surg. 2010;19(4):265–70. WB Saunders.CrossRefGoogle Scholar
  20. 20.
    Kissoon N, Dreyer J, Walia M. Pediatric trauma: differences in pathophysiology, injury patterns and treatment compared with adult trauma. CMAJ. 1990;142(1):27.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Quintana DA, Jordan FB, Tuggle DW, Mantor PC, Tunell WP. The spectrum of pediatric injuries after a bomb blast. J Pediatr Surg. 1997;32(2):307–11.CrossRefGoogle Scholar
  22. 22.
    Goldstein AL, Klausner JM, Soffer D. Not a blunt issue, but penetrating-an Israeli experience with abdominal injury in civilian multiple casualty blast incidents. Am Surg. 2014;80(1):98.Google Scholar
  23. 23.
    Markenson D, Reynolds S. The pediatrician and disaster preparedness. Pediatrics. 2006;117(2):e340–62.CrossRefGoogle Scholar
  24. 24.
    Committee on Environmental Health, Committee on Infectious Diseases. Chemical-biological terrorism and its impact on children: a subject review. Pediatrics. 2000;105(3):662–70.CrossRefGoogle Scholar
  25. 25.
    Bearer CF. How are children different from adults? Environ Health Perspect. 1995;103(Suppl 6):7.CrossRefGoogle Scholar
  26. 26.
    Stephenson T. How children’s responses to drugs differ from adults. Br J Clin Pharmacol. 2005;59(6):670–3.CrossRefGoogle Scholar
  27. 27.
    Chilton LA. Prevention and management of hypernatremic dehydration in breast-fed infants. West J Med. 1995;163(1):74.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Jones RT. Teaching children to make emergency telephone calls. J Black Psychol. 1980;6(2):81–93.CrossRefGoogle Scholar
  29. 29.
    Garrett AL, Grant R, Madrid P, Brito A, Abramson D, Redlener I. Children and megadisasters: lessons learned in the new millennium. Adv Pediatr. 2007;54(1):189–214.CrossRefGoogle Scholar
  30. 30.
    Johnson TD, Lindholm D, Dowd MD. Child and provider restraints in ambulances: knowledge, opinions, and behaviors of emergency medical services providers. Acad Emerg Med. 2006;13(8):886–92.CrossRefGoogle Scholar
  31. 31.
    Waisman Y, Aharonson-Daniel L, Mor M, Amir L, Peleg K. The impact of terrorism on children: a two-year experience. Prehosp Disaster Med. 2003;18(3):242–8.CrossRefGoogle Scholar
  32. 32.
    Redlener I, Markenson D. Disaster and terrorism preparedness: what pediatricians need to know. Dis Mon. 2004;50(1):6–40.CrossRefGoogle Scholar
  33. 33.
    Bala M, Kaufman T, Keidar A, Zelig O, Zamir G, Mudhi-Orenshat S, Bdolah-Abram T, Rivkind AI, Almogy G. Defining the need for blood and blood products transfusion following suicide bombing attacks on a civilian population: a level I single-centre experience. Injury. 2014;45(1):50–5.CrossRefGoogle Scholar
  34. 34.
    Blake N, Stevenson K. Reunification: keeping families together in crisis. J Trauma Acute Care Surg. 2009;67(2):S147–51.CrossRefGoogle Scholar
  35. 35.
    King S, Dancause K, Turcotte-Tremblay AM, Veru F, Laplante DP. Using natural disasters to study the effects of prenatal maternal stress on child health and development. Birth Defects Res C Embryo Today. 2012;96(4):273–88.CrossRefGoogle Scholar
  36. 36.
    Almond D, Currie J. Killing me softly: the fetal origins hypothesis. J Econ Perspect. 2011;25(3):153–72.CrossRefGoogle Scholar
  37. 37.
    Pynoos RS, Goenjian A, Tashjian M, Karakashian M, Manjikian R, Manoukian G, Steinberg AM, Fairbanks LA. Post-traumatic stress reactions in children after the 1988 Armenian earthquake. Br J Psychiatry. 1993;163(2):239–47.CrossRefGoogle Scholar
  38. 38.
    Curtis JW, Curtis A, Upperman JS. Using a geographic information system (GIS) to assess pediatric surge potential after an earthquake. Disaster Med Public Health Prep. 2012;6(2):163–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Adam Lee Goldstein
    • 1
  • Dror Soffer
    • 2
  1. 1.The Department of General SurgeryTel Aviv Sourasky Medical CenterTel AvivIsrael
  2. 2.Yitzhak Rabin Trauma DivisionTel Aviv Sourasky Medical CenterTel AvivIsrael

Personalised recommendations