Pediatric Mass Casualty Care in Resource-Limited Emergency Departments: A Narrative Review

Gilbert R, Abel MR, Vernberg EM, Jacobs AK. The use of psychological first aid in children exposed to mass trauma. Curr Psychiatry Rep. 2021;23(9):53.

Article  PubMed  Google Scholar 

Ker GL, Gangadharan S. Management of fluid overload in the pediatric ICU. In: Mastropietro CW, Valentine KM, editors. Pediatric critical care: current controversies. Cham: Springer International Publishing; 2019. pp. 193–209.

Chapter  Google Scholar 

Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018;6(11):e1196–252.

Article  PubMed  PubMed Central  Google Scholar 

Nakao H, Ukai I, Kotani J. A review of the history of the origin of triage from a disaster medicine perspective. Acute Med Surg. 2017;4(4):379–84.

Article  PubMed  PubMed Central  Google Scholar 

Robertson-Steel I. Evolution of triage systems. Emerg Med J. 2006;23(2):154–5.

Article  PubMed  PubMed Central  Google Scholar 

Benson M, Koenig KL, Schultz CH. Disaster triage: START, then SAVE–a new method of dynamic triage for victims of a catastrophic earthquake. Prehosp Disaster Med. 1996;11(2):117–24.

Article  PubMed  Google Scholar 

https://iris.who.int/bitstream/handle/10665/43386/9241546875_eng.pdf [Internet]. [cited 2025 Aug 3]. Available from: https://iris.who.int/bitstream/handle/10665/43386/9241546875_eng.pdf

Hands C, Hands S, Verriotis M, Bunn J, Bailey E, Samuels RJ, et al. Emergency Triage Assessment and Treatment Plus (ETAT+): adapting training to strengthen quality improvement and task-sharing in emergency paediatric care in Sierra Leone. J Glob Health. 2021;11:04069.

Article  PubMed  PubMed Central  Google Scholar 

Hategeka C, Mwai L, Tuyisenge L. Implementing the Emergency Triage, Assessment and Treatment plus admission care (ETAT+) clinical practice guidelines to improve quality of hospital care in Rwandan district hospitals: healthcare workers’ perspectives on relevance and challenges. BMC Health Serv Res. 2017;17(1):256.

Article  PubMed  PubMed Central  Google Scholar 

Institute of Medicine (US) Committee on Guidance for Establishing Standards of Care for Use in Disaster Situations. In: Stroud C, Hanson SL, Hanfling D, Gostin LO, editors. Guidance for establishing crisis standards of care for use in disaster situations: A letter report. Altevogt BM. Washington (DC): National Academies Press (US); 2009.

Google Scholar 

Matics TJ, Sanchez-Pinto LN. Adaptation and Validation of a Pediatric Sequential Organ Failure Assessment Score and Evaluation of the Sepsis-3 Definitions in Critically Ill Children. JAMA Pediatr. 2017;171(10):e172352.

Article  PubMed  PubMed Central  Google Scholar 

Gillard S, Anderson K, Clarke G, Crowe C, Goldsmith L, Jarman H, et al. Evaluating mental health decision units in acute care pathways (DECISION): a quasi-experimental, qualitative and health economic evaluation. Health Soc Care Deliv Res. 2023;11(25):1–221.

Article  PubMed  Google Scholar 

Desmond M, Schwengel D, Chilson K, Rusy D, Ingram K, Ambardekar A. Paediatric patients in mass casualty incidents: a comprehensive review and call to action. Br J Anaesth [Internet. 2022;1(2):e109–19.

Article  Google Scholar 

Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Global Health [Internet] 2018;6(11).

Olatunji G, Kokori E, Aderinto N, Alsabri M. Emergency airway management in resource limited setting. Int J Emerg Med 2024 Mar 14.

Blakeman TC, Scott JB, Yoder MA, Capellari E, Strickland SL. AARC Clinical Practice Guidelines: Artificial Airway Suctioning. Respiratory Care [Internet] 2022 Jan;24.

Daniel JW, Pinosky ML. A Simple Suction Device to Aid in Transportation of the Critically III Pediatric Patient. Anesthesiology. 1996.

Estillore KM, Quevedo GL, Bonifacio LR. Improvised Suction Apparatus for Closure of Large Soft Tissue Deficit. Malaysian Orthop J. 2013.

Sagar P, Kumar R, Chandran A. Efficiency and usability of an elementary hand-held suction assembly in paediatric tracheostomised patients. J Laryngol Otol. 2022;136(11):1077–80.

Article  CAS  PubMed  Google Scholar 

Haseler LJ, Sibbitt RR, Sibbitt WL, Michael AA, Gasparovic CM, Syringe BAD et al. Vacuum Generation, and Needle Control in Aspiration Procedures. Cardiovascular and Interventional Radiology. 2010.

Creamer E, Smyth EG. Suction apparatus and the suctioning procedure: reducing the infection risks. J Hosp Infect [Internet] 1996.

Dramowski A, Bekker A, Anugulruengkitt S, Bayani O, Martins Gonçalves F, Naizgi M. Keeping It Real: Infection Prevention and Control Problems and Solutions in Low- and Middle-income Countries. The Pediatric Infectious Disease Journal [Internet] 2022;1;41(3S):S36.

Anjay M, Anoop P. Improvised Meconium Suction Device: A Practical Alternative for Developing Countries. Nigerian J Paediatrics. 2004.

Ezike OC, Nwaneri AC, Odikpo LC, Onyia EN, Makata NE, Irodi CC, et al. Infection control practices among nurses working in neonatal intensive care units (NICU) of two selected tertiary hospitals in Enugu, Nigeria. Int J Afr Nurs Sci. 2021;15:100344.

Google Scholar 

White AM, Mutai D, Cheruiyot D, Rule A, Mortensen JE, Schaffzin JK. Disinfection of Neonatal Resuscitation Equipment in Low-Resource Settings: The Importance, the Reality, and Considerations for the Future. International Journal of Environmental Research and Public Health [Internet] 2021.

Tomobi O, Avoian S, Ekwere I, Waghmare S, Diaban F, Davis G, et al. A comparative analysis of intravenous infusion methods for low-resource environments. Front Med (Lausanne). 2024;11:1326144.

Article  PubMed  PubMed Central  Google Scholar 

Pierce ET, Kumar V, Zheng H, Peterfreund RA. Medication and Volume Delivery by Gravity-Driven Micro-Drip Intravenous Infusion. Anesthesia & Analgesia. 2013.

Kim UR, Peterfreund RA, Lovich MA. Drug Infusion Systems. Anesthesia & Analgesia. 2017.

Bowes DE, Gamble JJ, Bajwa JS. Using automated pump-delivery devices to reduce the incidence of excessive fluid administration during pediatric dental surgery: a randomized-controlled trial. Can J Anesthesia/Journal canadien d’anesthésie. 2020.

Feld LG, Neuspiel DR, Foster BA, Leu MG, Garber MD, Austin K. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatr [Internet] 2018.

Couperus K, Kmiecik K, Kang C. IV dripassist: an innovative way to monitor intravenous infusions away from an outlet? Mil Med. 2019;184(Suppl 1):322–5.

Article  PubMed  Google Scholar 

Shah K, Skerrett E, Nojoomi M, Walker T, Maynard K, Pan M. Maji: A New Tool to Prevent Overhydration of Children Receiving Intravenous Fluid Therapy in Low-Resource Settings. American Journal of Tropical Medicine and Hygiene [Internet 2015].

Little CM, Merritt M, Wentworth A. An improvised oxygen supply system for pandemic and disaster use. Acad Emerg Med. 2009;16(6):558–63.

Article  PubMed  Google Scholar 

Einav S, Hick JL, Hanfling D, Erstad BL, Toner ES, Branson RD. Surge Capacity Logistics Chest. 2014.

Ritz RH, Previtera JE. Oxygen supplies during a mass casualty situation. Respir Care. 2008.

Conradi N, Opoka RO, Mian Q, Conroy AL, Hermann LL, Charles O, et al. Solar-powered O2 delivery for the treatment of children with hypoxaemia in Uganda: a stepped-wedge, cluster randomised controlled trial. Lancet. 2024;403(10428):756–65.

Article  CAS  PubMed  Google Scholar 

Huang Y, Mian Q, Conradi N, Opoka RO, Conroy AL, Namasopo S, et al. Estimated Cost-effectiveness of Solar-Powered Oxygen Delivery for Pneumonia in Young Children in Low-Resource Settings. JAMA Netw Open. 2021;4(6):e2114686.

Article  PubMed  PubMed Central  Google Scholar 

Calderon R, Morgan MC, Kuiper M, Nambuya H, Wangwe N, Somoskovi A, et al. Assessment of a storage system to deliver uninterrupted therapeutic oxygen during power outages in resource-limited settings. PLoS ONE. 2019;14(2):e0211027.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Tolla HS, Woyessa DB, Balkew RB, Asemere YA, Fekadu ZF, Belete AB. Decentralizing oxygen availability and use at primary care level for children under-five with severe pneumonia, at 12 Health Centers in Ethiopia: a pre-post non-experimental study. BMC Health Serv Res. 2022.

Graham H, Tosif S, Gray A, Qazi S, Campbell H, Peel D, et al. Providing oxygen to children in hospitals: a realist review. Bull World Health Organ. 2017;95(4):288–302.

Article  PubMed  PubMed Central  Google Scholar 

Gilbertson J, Quintanar-Solares M, Liland F, Niermeyer S. High-level disinfection of re-usable neonatal resuscitation equipment through boiling and steaming. J Hosp Infect. 2020.

Tegtmeyer K, Conway EE, Upperman JS, Kissoon N, Task Force for Pediatric Emergency Mass Critical Care. Education in a pediatric emergency mass critical care setting. Pediatr Crit Care Med. 2011;12(6 Suppl):S135–40.

Article  PubMed  Google Scholar 

Brown KM, Ackerman AD, Ruttan TK, Snow SK, COMMITTEE ON PEDIATRIC EMERGENCY MEDICINE; AMERICAN COLLEGE OF EMERGENCY PHYSICIANS, PEDIATRIC EMERGENCY MEDICINE COMMITTEE; EMERGENCY NURSES ASSOCIATION, PEDIATRIC COMMITTEE. Access to optimal emergency care for children. Pediatrics. 2021;147(5):2018–9.

Article  Google Scholar 

Gearing RE, Schwalbe CS, MacKenzie MJ, Brewer KB, Ibrahim RW, Olimat HS, et al. Adaptation and translation of mental health interventions in Middle Eastern Arab countries: a systematic review of barriers to and strategies for effective treatment implementation. Int J Soc Psychiatry. 2013;59(7):671–81.

Article  PubMed  Google Scholar 

Tol WA, Barbui C, Galappatti A, Silove D, Betancourt TS, Souza R, et al. Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet. 2011;378(9802):1581–91.

Article  PubMed  PubMed Central  Google Scholar 

Grindlay J, Breeze KM. Planning for disasters involving children in Australia: A practical guide. J Paediatr Child Health. 2016;52(2):204–12.

Article  PubMed  Google Scholar 

Yonekura T, Ueno S, Iwanaka T. Care of children in a natural disaster: lessons learned from the Great East Japan earthquake and tsunami. Pediatr Surg Int. 2013;29(10):1047–51.

Article  PubMed  Google Scholar 

[cited 2025 Aug 30]. Available from: https://image.savethechildren.org/disaster-report-2015.pdf-ch11044433.pdf/62p0425o0855f8kt6k562a686npgcf43.pdf?utm_source=chatgpt.com

Desmond M, Schwengel D, Chilson K, Rusy D, Ingram K, Ambardekar A, et al. Paediatric patients in mass casualty incidents: a comprehensive review and call to action. Br J Anaesth. 2022;128(2):e109–19.

Article  PubMed  Google Scholar 

American Academy of Pediatrics. Family Separation and Reunification in Disasters [Internet]. 2024 [cited 2025 Jun 27]. Available from: https://www.aap.org/en/patient-care/disasters-and-children/disaster-management-resources-by-topic/family-separation-and-reunification-in-disasters/?srsltid=AfmBOop8rgOBHZ8qBbXQgAIul2OB7Qk9v5RYgaEYK07R52LHn9hmHRs

Barnert ES, Lee J, Huston S, Using. DNA to Reunify Families Separated by Disasters. NAM. 2024.

Shah S, Kharel A, Pangeni PM, Mehta R, Sah S, Sah R, et al. Earthquakes and associated infectious diseases in Nepal. Egypt J Intern Med. 2024;36(1):102.

Article  Google Scholar 

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