Haiti Pediatric Action Blog
Deploying the Pediatric Emergency Decision Support System (PEDSS)


The Pediatric Emergency Decision Support System (PEDSS) is a sophisticated analytical tool to generate accurate estimates of injured children in a disaster, and to assist in emphasizing children's special needs. We are adapting the PEDSS earthquake module to Haiti and its disaster profile, thus generating authoritative best-practices-based recommendations on medical supplies, equipment, pharmaceuticals, and personnel requirements for childrens' needs in the disaster.

The Pediatric Emergency Decision Support System (PEDSS) was developed in collaboration with Childrens Hospital Los Angeles' Pediatric Disaster Resource and Training Center, for which Dr. Jeffrey Upperman is the Director and Dr. Robert Neches the Informatics Thrust Leader from USC Information Sciences Institute.

Approximately 35% of Haiti's population is under 15. It's been estimated that as many as a million children were orphaned or abandoned -- even before the disaster hit. Thus, the earthquake is a disaster of the highest magnitude, and children represent a major class of victims.

Thursday, January 28, 2010

News coverage of PEDSS work and Child victims

Articles referring to PEDSS group's work:
AFP: Almost half Haiti's injured may be children: study
Businessweek: Haitian Children Need Specific Relief Efforts
The plight of children is continuing to receive attention:
St. Petersburg Times: Haiti's most vulnerable victims
Haiti was a young nation even before the earthquake, with children making up nearly half the population. Now thousands of them are severely injured, psychologically devastated and orphaned. The United Nations Children's Fund estimates as many as 1 million lost at least one parent in the quake or have been separated from their families.

The disaster has left them in acute peril. Children are less able to fend for themselves for food and water or protect themselves against abuse, assault or abduction. Relief crews are trying to adapt, setting up child-only sections of refugee camps. But thousands still wander the streets. Without question, these victims deserve special attention.

Wednesday, January 27, 2010

Estimates of Injuries and Medications required

PEDSS 2010 Haiti Earthquake Assessment

Two additional documents:

PEDSS Work Cited

USC Press Release: Almost half of injured Haitians are likely to be children, pediatric emergency study indicates
A statistical study by a specialist group at Childrens Hospital Los Angeles and the University of Southern California indicates that the victims of the January 12 quake include an extraordinarily high number of children— more than 110,000, nearly half of the estimated total.

This information should guide relief workers on the ground, according to Jeffrey Upperman, M.D. and Robert Neches PhD, co-developers of the Pediatric Emergency Decision Support System (PEDSS), a software tool to help medical service providers more effectively plan for, train for, and respond to serious incidents and disasters affecting children.

The PEDSS group has set up a blog to help guide the choice and distribution of relief supplies. The numbers are if anything understated, according to Neches, but the calculations use the latest available reports from relief efforts on the ground.

PEDSS uses statistical methods to estimate how many of the potential victims of a disaster (so far, earthquakes have been most studied) in a given specific location (i.e., Los Angeles) will be children, and what they will need. Children have special needs for equipment, including thinner hypodermic needles, appropriate pharmaceuticals in childrens dosages, and medical specialists in pediatrics and in other areas.

LA Times Blog: A supply list for doctors heading to Haiti
After Haiti was hit by a magnitude 7.0 earthquake, it was instantly clear that medical help was needed. And doctors from around the world responded, traveling to the Caribbean nation to volunteer their services. (Check out this video to see how the humanitarian group Doctors Without Borders constructed an inflatable hospital to treat quake victims.)

Haiti But what kinds of injuries will those doctors encounter, and what kinds of medical supplies will they need to treat their patients?

They can ask researchers at Childrens Hospital Los Angeles and USC’s Information Sciences Institute, who have computed a partial answer with their Pediatric Emergency Decision Support System (or PEDSS for short).

It sounds like a contraption straight out of Star Trek, but it’s a real software tool that was developed to estimate the number and type of pediatric injuries that would follow a disaster such as an earthquake. By plugging in information specific to the Haiti quake, the Los Angeles researchers estimated that more than 110,000 children there are in need of medical care.

Tuesday, January 26, 2010

Take-aways: Answers to Two Good Questions from CNN

I was just interviewed for a CNN report about Haiti in which I was asked two very good questions about our work. Here are the answers I gave:

Q: What is the single take-away that you'd like the public to know?

The Haiti earthquake is above all a pediatric disaster. Because of the nature of the population, children will constitute a much, much higher percentage of the injured than other countries might expect. We very much hope that the special and different needs which caring for children entails will be recognized and factored into the response.

Q: What would you like the charitable organizations helping into Haiti to know?

I think our Pediatric Disaster Resource and Training Center has four key lessons to offer, which include what we've done with PEDSS, but go beyond it. They are:

1. It's important to understand the specific needs of the impacted population in the area, as we're trying to do
with PEDSS for children.

2. Those have "medical logistics" implications which can be quite different from what one might expect (for example, that earthquakes exacerbate respiratory problems) -- and that in turn dramatically impact what supplies are needed to do the most good.

3. That treatment practices need to adapt to conditions in ways very different from how you would treat patients at home, because limitations on both personnel and supply resources signficantly affect how to do the most good with the resources available.

4. Cooperation and information sharing are crucial. PEDSS is only a part of the battle toward doing things right. Today, everyone is going in with what they have, and no one else knows about it. Even if our requirements estimates are perfect, they still have to be put together with what we all have and what we still need. We still need ways to help everyone share what we have and go get the rest without omission or duplication. Otherwise, help will still be delayed and wasted.

What I failed to mention was a fifth lesson that occurred to me afterwards:

It's nice to think about what's needed, but we also need to help people with figuring out how to make the best use of what they have. Rarely will there ever be all that's needed.

Monday, January 25, 2010

Current TV Report on Children in Haiti

Children Orphaned in Haiti: Raw Video
Over one week since a catastrophic earthquake turned what was already a desperately poor part of the world into a full fledged humanitarian emergency, the staff of an orphanage in the Haitian capital of Port-au Prince are trying to figure out what to do with all the children who have recently lost their families.

Thursday, January 21, 2010

About PEDSS Software

Innovative information integration embedded in an advanced decision support tool is required to effectively determine supplies, equipment, and personnel needed to respond to an emergency -- and its long-term consequences.

Earth sciences information to predict/assess the nature of the event must be combined with demographic information to determine the human considerations. This must be combined with epidemiological knowledge of mortality and morbidity to determine the impact. Medical best practices knowledge driven by sophisticated planning tools is then needed to advise on responses.

Few tools do this. Lamentably, none address children's special needs and requirements -- the most precious and vulnerable part of our population. Special issues of treating children are not widely understood by non-pediatric care practitioners, yet in public health crises the burden of care often falls to those nearest rather than those specifically-trained.

Our team of clinicians, epidemiologists, and computer scientists at Childrens Hospital Los Angeles and USC Information Sciences Institute has developed a tool called PEDSS (Pediatric Emergency Decision Support System) to address this need for other disaster categories. This work was performed under the auspices of the Pediatric Disaster Resource and Training Center (PDRTC), which originated under DHHS funding to serve the Los Angeles County Disaster Resource Center network, and now provides nationwide services.