Biomedical Engineering Reference
In-Depth Information
care workers must be careful not to engage too
aggressively in therapeutic behavioral interven-
tions shortly after a disaster. Certain aspects of
cognitive behavioral therapy, such as having the
victim describe their experience; can actually be
detrimental if the victim feels coerced into doing
so, such as in a group therapy setting. Rather,
experienced disaster workers recommend ongoing
monitoring of children at risk with timely inter-
vention for symptoms of anxiety, depression and
posttraumatic stress disorder [46].
Table 10.4
Potassium Iodide Administration in
Children Exposed to 0.05 Gray (5 rad) or More of
Radioactive Iodine (FDA, 36)
Age
KI Dose (mg)
Volume of solution
prepared from a 130mg
Tablet
a
, ml (tsp)
12-17 yrs. (
≥
70 kg)
130
40 (8)
4-17 yrs (<70 kg)
65
20 (4)
1mo-3 yrs
32
10 (2)
Birth-1mo.
16
5 (1)
a
Home preparation: Crush one 130mg KI tablet in a small bowl into a
fine powder. Add four teaspoons (20ml) of water and mix. Add four
teaspoons (20ml) of raspberry syrup, low-fat chocolate milk, orange juice,
or flat soda. Resulting mixture is 16.25mg KI per teaspoon (5ml). Dose
as above. If using 65mg KI tablet then use same instructions as for 130mg
KI tablet, but double the volume administered.
References
1. National Center for Disaster Preparedness.
Pediatric preparedness for disasters and
terrorism: a national consensus conference,
Columbia University Mailman School of
Public Health, Executive summary 2003
at http://www.childrenshealthfund.org/CHF2286V
Final_adj.2.pdf(accessed12/3/2004).
2. Glasser, P. Baker. Hostage takers in Russia argued
before explosion: Chechen gave orders by phone,
investigators say.
Washington Post
, page A01,
Tuesday, September 7, 2004.
3. E. K. Motoyama. Respiratory physiology in infants
and children. In: (E. K. Motoyama and P. J. Davis
eds)
Smiths' anesthesia for infants and children
,
11-67. St. Louis: Mosby, 1996.
4. K. J. Sullivan and N. Kissoon. Securing the child's
airway in the emergency department.
Pediatr
Emerg Care
. 18:108-118, 2002.
5. American Academy of Pediatrics, Committee on
Environmental Health and Committee on Infec-
tious Diseases. Chemical-biological terrorism and
its impact on children: a subject review (RE9959).
Pediatrics
105:662-670, 2000.
6. E. L. Lynch and T. L. Thomas. Pediatric consider-
ations in chemical exposures: are we prepared?
Pediatr Emerg Care
20:198-208, 2004.
7. J. R. Hill and K. A. Rahimtulla. Heat balance and
the metabolic rate of newborn babies in relation to
environmental temperature; and the effect of age
and of weight on basal metabolic rate.
J Physiol
180:239-265, 1965.
8. P. R. Holbrook. Pediatric disaster medicine.
Crit
Care Clin
. 7:463-470, 1991.
9. R. M. Perkin and D. L. Levin. Shock in the pediatric
patient: Part 1.
J Pediatr
. 101:163-169, 1982.
10.4 Mental Health Considerations in
Pediatric Victims of Terrorism
Several studies have documented a high incidence
of anxiety, depression and post-traumatic stress
disorder in children exposed to disaster [36-38].
Risk factors for these adverse psychiatric outcomes
include prior history of mental illness in the child,
lack of coping by parent or caregiver, specific
externally obvious signs of post-traumatic stress
disorder in the father, repeated media exposure
to scenes from the disaster and proximity to the
disaster [39-41]. With respect to proximity to
the disaster, researchers have demonstrated that the
subjective perception of threat to life (either self
or close family member) is more important than
preordained objective features [42]. Finally, chil-
dren who experience greater pain during hospital
recovery are at higher risk of serious psychiatric
sequelae later on [43].
Effective mental health interventions for pedi-
atric disaster victims arise from a developmental
understanding of children's psychological cap-
abilities and needs [44]. The aforementioned risk
factors for mental health pathology can be used
to set up appropriate surveillance systems in the
wake of a disaster [45]. Promotion of family cohe-
siveness, limitation of repeated exposures of chil-
dren to trauma during and after the disaster event
and reestablishment of routines (school, play, etc.)
all bolster innate resilience in children. Health
