title: Disaster response in a pediatric field hospital: lessons learned in Haiti.
abstract: OBJECTIVE
  This study outlines the evolution of a pediatric field hospital after the January 2010 Haiti earthquake.
  
  
  METHODS
  Project Medishare set up a field hospital in Port-au-Prince 48 hours after the event. Our institution staffed the pediatric component for 45 days, with sequential deployment of 9 volunteer medical teams. Evolving facility and manpower requirements and changing patient demographics over time were evaluated.
  
  
  RESULTS
  Delegations consisted of surgeons, pediatricians, nurses, operating room (OR) personnel, physical therapists, pharmacists, and support staff. Primary goals involved creation of a child-specific ward, pediatric OR, and a wound care center. Major inpatient demographic changes occurred as time from the disaster elapsed. Initial census showed that 93% of the patients were surgical admissions with 40% undergoing operations, mostly fracture and wound care, over the first week. Eight weeks later, medical illnesses accounted for 70% of inpatients, whereas OR volume dropped by more than 50%. A second trend involved increasing acuity of care. Initially, children were admitted for serious or limb-threatening, but usually not life-threatening, injuries. Within 2 months, one third of the patients were housed in the developing NICU/PICU; and only 12% were admitted for injuries related to the earthquake. This change in patient needs led to alterations in facility requirements and in staffing and leadership needs.
  
  
  CONCLUSIONS
  A disaster involving significant casualties in a populated area demands the rapid development of a field facility with pediatric personnel. Requirements for equipment, manpower, medical records, and systems addressing volunteer stress and ethical dilemmas can be anticipated.
authors.affiliation: Department of Pediatric Surgery, Miami Children's Hospital and FIU College of Medicine, Miami, FL 33155, USA. cburnweit@aol.com
authors.forename: Cathy
authors.initials: C
authors.lastname: Burnweit
authors.forename: Steven
authors.initials: S
authors.lastname: Stylianos
mesh_terms: D002648:Child; D054597:Disaster Medicine / Q000458:organization & administration; D004189:Disaster Planning / Q000458:organization & administration*; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006205:Haiti; D006776:Hospitals, Pediatric / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007391:International Cooperation; D008297:Male; D008952:Mobile Health Units; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D009873:Operating Rooms / Q000458:organization & administration; D015397:Program Evaluation; D012066:Relief Work / Q000458:organization & administration; D018570:Risk Assessment; D015996:Survival Rate; D013997:Time Factors; D014838:Volunteers / Q000458:organization & administration