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Medical Countermeasures for Children in Radiation and Nuclear Disasters: Current Capabilities and Key Gaps

Published online by Cambridge University Press:  02 November 2018

Aaron H. Gardner
Affiliation:
Eagle Medical Services, LLC, San Antonio, TX
Eric J. Dziuban*
Affiliation:
U.S. Centers for Disease Control and Prevention (CDC), National Center on Birth Defects and Developmental Disabilities, Atlanta, GA
Stephanie Griese
Affiliation:
CDC, Office of Public Health Preparedness and Response, Atlanta, GA
Nairimer Berríos-Cartagena
Affiliation:
Gap Solutions Inc., Herndon, VA
Jennifer Buzzell
Affiliation:
CDC, National Center for Environmental Health, Atlanta, GA
Karen Cobham-Owens
Affiliation:
Carter Consulting, Inc., Atlanta, GA
Georgina Peacock
Affiliation:
U.S. Centers for Disease Control and Prevention (CDC), National Center on Birth Defects and Developmental Disabilities, Atlanta, GA
Ziad Kazzi
Affiliation:
CDC, National Center for Environmental Health, Atlanta, GA
Joanna M. Prasher
Affiliation:
CDC, Office of Public Health Preparedness and Response, Atlanta, GA
*
Correspondence and reprint requests to Dr Eric J. Dziuban, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, 4700 Buford Hwy, Mailstop E-88, Atlanta, GA 30342 (e-mail: esv8@cdc.gov)

Abstract

Objective

Despite children’s unique vulnerability, clinical guidance and resources are lacking around the use of radiation medical countermeasures (MCMs) available commercially and in the Strategic National Stockpile to support immediate dispensing to pediatric populations. To better understand the current capabilities and shortfalls, a literature review and gap analysis were performed.

Methods

A comprehensive review of the medical literature, Food and Drug Administration (FDA)-approved labeling, FDA summary reviews, medical references, and educational resources related to pediatric radiation MCMs was performed from May 2016 to February 2017.

Results

Fifteen gaps related to the use of radiation MCMs in children were identified. The need to address these gaps was prioritized based upon the potential to decrease morbidity and mortality, improve clinical management, strengthen caregiver education, and increase the relevant evidence base.

Conclusions

Key gaps exist in information to support the safe and successful use of MCMs in children during radiation emergencies; failure to address these gaps could have negative consequences for families and communities. There is a clear need for pediatric-specific guidance to ensure clinicians can appropriately identify, triage, and treat children who have been exposed to radiation, and for resources to ensure accurate communication about the safety and utility of radiation MCMs for children. (Disaster Med Public Health Preparedness. 2019;13:639-646)

Type
Systematic Review
Copyright
Copyright © 2018 Society for Disaster Medicine and Public Health, Inc. 

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