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 Children are particularly vulnerable to illness and injuries during
these emergency situations and their distinct needs – such as
special drug formulations or dosing and pint-size medical devices –
mean supplies set aside for adults may not work for them.
To start fixing the problem, the U.S. needs more investment in
treatments that are appropriate for children, including research to
develop age-appropriate therapies as well as investments to increase
the nation’s stockpile of remedies already made for kids, according
to the report from AAP’s Disaster Preparedness Advisory Council.
“Without research and development the pipeline of new and innovative
medical countermeasures will not be achieved or sustained,” said
lead report author Dr. Daniel Fagbuyi of George Washington
University in Washington, D.C.
“Life or death is what’s at stake,” Fagbuyi, a retired infantry
veteran with expertise in disaster and terror response, added by
email.
While significant strides have been made in recent decades to
improve the U.S. stockpile of supplies needed for children in
emergencies, there’s still a lot to be done, Fagbuyi and colleagues
write in the journal Pediatrics.
To meet the needs of children, the nation’s disaster stockpile
should include life-saving equipment, devices, supplies and
medications that are appropriate for children.
With medicines and vaccines in particular, the stockpile should have
pediatric formulations such as liquid alternatives to pills adults
might swallow, as well as age-based or weight-based dosing
instructions, the report authors say.
One considerable challenge to adding more pediatric treatments to
the stockpile is the paucity of research done in kids, which is due
in part to difficulties getting consent from parents to include
children in clinical trials and meeting clinical trial requirements
that are more stringent for kids than adults, Dr. Laura Faherty of
the University of Pennsylvania and the Children’s Hospital of
Philadelphia noted in an accompanying editorial.
Doing more research as public health disasters unfold may help
scientists better understand how to help children in these emergency
situations, Faherty said by email.
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The goal is to rapidly learn what works and what doesn’t, and to get
this information quickly, Faherty said, adding, “The systems to do
good research must be set up in advance to more quickly figure out
what’s going on during an outbreak or similar public health
emergency, and respond accordingly.”
Cost can also be an obstacle, particularly because many pediatric
versions of drugs are liquids that may have a shorter shelf life
than pills for adults and be harder to transport and store, noted
report co-author Dr. David Schonfeld of the University of Southern
California.
“Yes, there are limited resources available for preventive and
treatment services, and we always need to balance the likely benefit
against the cost,” Schonfeld said by email. “But if as a country we
decide to create a national stockpile of medical countermeasures, I
feel we have an obligation to ensure that children are protected at
least to the same extent as adults – which is not the current
situation.”
The need for better pediatric emergency supplies has also become
more pressing as the perceived domestic risk for exposure to
chemical, biologic and radiologic agents has increased, noted Dr.
Steven Krug, a researcher at Northwestern University Feinberg School
of Medicine in Chicago and chair of the AAP Disaster Preparedness
Advisory Council.
“Disasters will continue to occur,” Krug said by email. “We
therefore need to be prepared and we need to be able to better
weather the storm.”
SOURCE: http://bit.ly/1OKAnPW Pediatrics, online January 4, 2016.
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