title: Reunification: keeping families together in crisis.
abstract: BACKGROUND
  In reviewing the literature, there has not been a family reunification plan that has worked consistently during disasters. During Hurricane Katrina, there were children who were sent to a shelter in a different state than their patients. When children are involved, the issues become even more difficult, because some children who are preverbal cannot tell their names or their parents names. Tracking systems have been developed but are not interoperable. No central repository has been developed. There are also issues related to transporting patients, psychosocial issues as well as safety issues that are different when children will be unaccompanied by an adult.
  
  
  METHODS
  Two national meetings were held with experts from all over the country who have an expertise in the care of children. Six focused groups were identified: patient movement/transportation; technology/tracking; clinical issues, nonmedical issues; communication/regulatory issues; and pediatric psychosocial support. The second meeting was a consensus conference.
  
  
  RESULTS
  Recommendations from each subgroup were presented and voted on. All recommendations were accepted.
  
  
  CONCLUSIONS
  The issue of reunification of families in disaster is still a problem. Further work needs to be done on tracking systems that are interoperable before another large disaster strike, pediatric psychological issues after a disaster, transporting patients, and care of the pediatric patient who is not accompanied by an adult. Once a system has been developed, the system needs to be tested by large scale drills that practice moving children across state lines and from one area to another.
authors: PCS Critical Care Services and Education, Childrens Hospital Los Angeles, Los Angeles, California, USA.
authors: Nancy
authors: N
authors: Blake
authors: Kathleen
authors: K
authors: Stevenson
mesh_terms: D000328:Adult; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002669:Child Welfare; D002675:Child, Preschool; D004189:Disaster Planning; D005195:Family Relations; D006801:Humans; D014481:United States