Medical Aspects of Chemical Warfare (2008) - The Black Vault

Medical Aspects of Chemical WarfareExhibit 21-6Developing a Family Emergency Plan• Discuss, prepare, and practice for various types of disasters with those who share your residence.• Formulate a plan to stay in contact if separated (eg, specify at least two meeting places as alternatives to yourhome and your neighborhood).• Select an out-of-state contact that all the family members can call to provide location and personal situationinformation.• Post emergency numbers at home and also have all the family members carry them when away fromhome.• Practice turning off water, power, and gas at home.• Install and check smoke detectors.• Obtain battery-operated radios.• Ready battery-operated flashlights to avoid using matches to see when electricity fails.• Prepare supply kits with water, food, first aid supplies, tools, clothing, bedding, batteries for radios andflashlights, and other special items, such as medication, baby formula, or diapers. (It may be appropriate tohave a kit at home and in automobiles.)Data source: Bradley BJ, Gresham LS, Sidelinger DE, et al. Pediatric health professionals and public health response. Pediatric Ann.2003;32(2):87–94.nightmares, insomnia, fear of the dark, or separationanxiety. Under stress, they may regress developmentallyand adopt the behaviors of a younger child or sibling.Parents and teachers should be taught that thesebehaviors may signify children are having difficultycoping. Older children may manifest with depression,pessimism, and substance abuse. Some children maybe diagnosed with PTSD. PTSD is diagnosed when apatient demonstrates symptoms of increased arousal,relives the event, and avoids reminders of the eventfor at least 1 month. Those children directly involvedin an attack are at higher risk of developing PTSD.In responding to an event, it is important to talk tochildren to help them understand what has occurredand to allow them to express their feelings. Evenyoung children should be kept informed because theycan sense that a serious event has occurred and canbecome concerned when the issue is not explained. Itmay be helpful to limit children’s television viewingand assure them of their safety after a disaster (Exhibit21-7). Pediatricians and parents play a critical role inidentifying coping mechanisms among children andproviding the support they need to adjust to the aftermathof a terrorist attack.Exhibit 21-7Strategies to Help Children Cope with Terrorist Events• Inform children about a terrorist even as soon as possible.• Help children understand the event by stating the basic facts in simple, direct, and clear terms.• Limit television viewing to avoid exposing children to detailed information and graphic images.• Reassure children they should feel safe in their schools, homes, and communities.• Reassure children of their complete lack of responsibility.• Watch for signs of guilt and anger.• Act as a role model by sharing feelings of fear, sadness, and empathy.• Offer to discuss terrorist events with older children and adolescents, but do not force conversations.• Anticipate delayed and anniversary reactions (sadness or fear on the anniversary of a tragic event).• Provide concrete advice on how to make participation in commemorative events meaningful.Data source: Schonfeld DJ. Supporting children after terrorist events: potential roles for pediatricians. Pediatr Ann. 2003;32(3):182–187.680