Real-Time Pediatric Disaster Response System Taking Shape

     In California, a computer scientist and a pediatric surgeon are collaborating on a project to create a powerful tool that they believe will help save young lives in large-scale emergencies.

     The surgeon, Jeffrey S. Upperman, MD, of Childrens Hospital Los Angeles, and Robert Neches, a division director of the USC Viterbi School of Engineering Information Sciences Institute, believe that in the confusion following a large earthquake or other major disaster, the lives of children will depend on ways to get the latest, best information about resources and needs into the hands of decision-makers quickly, accurately and flexibly in a form that enables them to make the right moves. Neches, who has designed successful systems now being used by the military to do the same thing, has been working with Upperman to adapt to emergency pediatrics the lessons learned from software he built that allows Marine Corps air units to quickly and effectively plan missions based on the latest information. The model the partners are working on is called an "adaptive planning paradigm," which essentially breaks down the barriers between preparation and execution and eliminates the problems of creating plans that are not followed and following plans that don't fit.

     "Right now, we're in the fact-finding stage," says Upperman. "As you can imagine, we have to do a needs assessment first. We know there are divergent pieces of information that are not typically collected in one environment, so our ultimate goal is to put together decision-making software that not only deals with these divergent data sources, but helps the user with real-time decision-making."

     Childrens Hospital, says Upperman, is one of 12 disaster resource centers in Los Angeles County that make up the backbone for having a coordinated disaster response. The network is supported in part by federal funds that are used to purchase and distribute items like ventilators and vaccines that might be needed in the event of something like a pandemic flu. At present, the first-receivers are being trained in best practices, which is where Upperman and Neches come in by developing smart systems for implementation of best practices in a disaster response. Their interest, obviously, is in pediatric victims and how to care for them, says Upperman.

     "If you look at traumatically injured children, studies have showed that, in particular injury categories, the outcomes from care at adult centers are not the same as at pediatric centers," he says. "It suggests to us that since adult centers don't routinely take care of children, there may be some knowledge issues, as well as system issues. We know that a disaster results in chaos, so you try to minimize the chaotic response and hope that healthcare providers have some algorithms to fall back on so they don't create errors or problems based on the fact that they don't routinely see pediatric patients. I think all of us in emergency preparedness realize we need a plan today so we aren't looking back on a bad situation tomorrow and saying 'we should've, would've, could've.' We need to address issues like, if hundreds of kids had to be seen by a pocket of adult centers, how would an adequate supply of pediatric-size equipment get to them sooner rather than later? That's just one of the things we're looking at to see if we can figure out some just-in-time strategies to deal with those acute needs."

     For more information, visit www.childrenshospitalla.org.