TY - CHAP M1 - Book, Section TI - Disaster Preparedness A1 - Chung, Sarita A1 - Hewett, Elizabeth K. A1 - Adirim, Terry A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. A2 - Schafermeyer, Robert PY - 2019 T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 5e AB - Anatomic, physiological, developmental, and behavioral differences between children and adults influence the management of children during a mass casualty event (MCE).During an MCE, emergency department (ED) staff should expect casualties to come in two waves (dual wave phenomenon): The first wave typically appears after about 15 to 30 minutes and largely consists of “the walking wounded”; the second wave typically arrives 30 to 60 minutes after the onset of the event and is comprised of the more critically ill or injured patients.ED leadership and staff should understand their roles within the hospital incident command system to optimize patient care before, during, and after a mass casualty event.Because of physiological and anatomical differences between adults and children, adult MCE triage protocols are inappropriate for use in triaging infants and children.EDs should have guides with predetermined medication dosing based on weight, and equipment sizes based on age, ready for mass casualties, so that staff members do not have to perform calculations during events.Decontamination of children generally takes longer than that of adults. It should be done as a family unit to facilitate a child’s cooperation and minimize psychological impact.Blast incidents can cause unique patterns of injury, including both penetrating and blunt trauma. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/13 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1155750625 ER -