Public Health Emergency Preparedness
This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.
This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.
Please go to www.ahrq.gov for current information.
Table 5.1. Pediatric Vulnerabilities To Chemical Terrorism
| Realm |
Potential Vulnerability |
Potential Response |
| Physiologic |
Increased respiratory exposure (higher minute ventilation, live closer to the ground) |
Early warning, shelteringa (gas masks not advised because of risk of poor fit, suffocation) |
| Increased dermal exposure (thinner, more permeable skin; larger body surface area/mass ratio) |
Protective clothing, early decontamination1 |
| Increased risk of dehydration, shock with illness-induced vomiting, diarrhea (decreased fluid reserves, larger body surface area/mass ratio) |
Recognition, aggressive fluid therapy |
| Increased risk of hypothermia during decontamination (larger body surface area/mass ratio) |
Warm water decontamination |
| More fulminant disease; (possible) physiologic detoxification immaturity; more permeable blood-brain barrier |
Pediatric-specific research for early diagnosis and treatment of chemical weapons victims1 |
| Developmental |
Less ability to escape attack site, take appropriate evasive actions (developmental immaturity, normal dependence on adult caregivers who might be injured or dead) |
? |
| Psychological |
Less coping skill of children who suffer injury or witness parental, sibling death (psychological immaturity) |
Child psychiatry involvement, research for preventing pediatric post-traumatic stress disorder1 |
| Greater anxiety over reported incidents, hoaxes, media coverage, etc |
Pediatric counseling of parents and childrenb |
| EMS |
Less capacity to cope with influx of critical pediatric patients |
Community and regional planning with significant pediatric input |
| Loss of routine hospital transfer protocols |
|
| Limited ability to expand pediatric hospital bed capacity through NDMS |
|
a Plausible, but unproved or unstudied, and/or not intuitively obvious.
b For American Academy of Pediatrics (AAP) and American Academy of Child and Adolescent Psychiatrists (AACAP) resources for parents and pediatricians, go to http://www.aap.org/advocacy/releases/disastercomm.htm and http://www.aacap.org/publications/factsfam/disaster.htm. 
1 Adapted from Rotenberg JS, Newmark J. Nerve agent attacks on children: diagnosis and management. Pediatrics 2003; 112:648-58.
Note: EMS = emergency medical services; NDMS = National Disaster Medical System.
Source: Adapted from Henretig FM, Cieslak TJ, Eitzen EM Jr. Biological and chemical terrorism. J Pediatr 141:311-326, ©2002, with permission from Elsevier.
Return to Document
5600 Fishers Lane Rockville, MD 20857