title: Emergency department staff preparedness for mass casualty events involving children.
abstract: BACKGROUND
  In recent years, the World Health Organization in general, and Israel in particular, have dealt with mass casualty events (MCEs) resulting from terrorism. Children are the casualties in many of these events-a reality that forces hospitals to prepare to deal with such a scenario. A literature review designed to identify unique recommendations regarding pediatric MCEs highlights both a lack of existing training programs and uncertainty on the part of health care staff when dealing with these events.
  
  
  OBJECTIVE
  The purpose of the study was to examine the preparedness level of emergency department staff to deal with MCEs involving pediatric casualties. The study included 104 physicians and nurses working in, or responding to, the emergency department at a hospital in Israel.
  
  
  METHODS
  The study included a 41-item questionnaire examining perception, approaches, and staff knowledge regarding dealing with pediatric MCEs versus those involving adults. The reliability of all sections of the questionnaire ranged between Chronbach's alpha coefficient 0.6 alpha-0.94.
  
  
  RESULTS
  The preparedness levels for MCEs involving children were found to be low. Study participants ranked the likelihood of a pediatric MCE lower than one involving adults, while ranking significantly higher (P = .000) their ability to cope mentally and the knowledge and skills required when treating adults involved in MCEs. While nurses ranked higher than physicians regarding their knowledge and skills in dealing with pediatric MCE casualties, the level of knowledge for MCEs involving children was low in all subjects. Staff agreement for the parent of an MCE victim to be present during treatment was medium-low.
  
  
  CONCLUSIONS
  On the basis of these findings, additional research involving a larger number of individuals and hospitals is indicated to determine if these results are consistent throughout the region.
authors.affiliation: Nursing Research Unit, Assaf Harofeh Medical Center, Zrifine, Bear Yaakov 70300, Israel. rasinm@asaf.health.gov.il
authors.forename: Michal
authors.initials: M
authors.lastname: Rassin
authors.forename: Miri
authors.initials: M
authors.lastname: Avraham
authors.forename: Anat
authors.initials: A
authors.lastname: Nasi-Bashari
authors.forename: Sigalit
authors.initials: S
authors.lastname: Idelman
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Peretz
authors.forename: Shani
authors.initials: S
authors.lastname: Morag
authors.forename: Dina
authors.initials: D
authors.lastname: Silner
authors.forename: Gali
authors.initials: G
authors.lastname: Weiss
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence / Q000592:standards*; D004189:Disaster Planning / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D007557:Israel; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D008875:Middle Aged; D020380:Needs Assessment; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D010372:Pediatrics / Q000193:education / Q000458:organization & administration*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D023481:Terrorism; D014193:Trauma Centers