In emergency preparedness there is the need to prospectively develop an approach to which interventions can be provided with available resources and the maximal amount of clinical effectiveness which can be attained by staff.

A panel of pediatric emergency preparedness experts employed our previously validated evidence based consensus process with a modified Delphi process for topic selection and approval. Interventions were chosen such that resources and staff efficiency would not exceed previously published data for non-disaster emergency care but allowing for standard emergency preparedness planning alterations in standards of care such as the assumption that usual numbers of staff would care for a disaster surge of four times the usual number of patients.

Using standard emergency preparedness assumptions of limited resources and staff efficiency, the panel agreed upon both methodologies for resource allocation and feasible interventions. A number of standard interventions would not be feasible and included detailed recording of vital signs, administration of vasoactive agents, prolonged resuscitation and central venous access.

By employing this approach to resource utilization described combined with the unique aspects of pediatric care, we can improve our planning and responses. This can be accomplished by understanding the needs of the population being served, learning how to focus on both pediatric needs and the expectations of the community with regard to care of children, adopting what has been learned in prior events in the United States and abroad, and developing prospective recommendations regarding essential interventions which can be performed in a disaster.