Fifty-four million people with disabilities live in the United States, a group that is disproportionately vulnerable to disasters. In addition, many individuals have chronic health problems that are worsened by disaster conditions, particularly if they require supplemental oxygen, renal support, and mobility aids; are paralyzed; or are obese. These special populations are ill-defined, and planning for them is believed to be inadequate across a wide range of activities, pointing to a need for information to bolster disaster preparedness. Many issues that are potential barriers to care during a disaster have been identified. fully
Apart from a shortage of intensive care beds and qualified ICU personnel, patients who require a high nursing-to-patient ratio, advanced technologic interventions, or extra supportive care may cause additional strain on the capability of the ICU to continue to provide care to existing patients as well as incoming patients. The suggestions in this article are important for all who care for special populations both before and after a disaster or pandemic occurs, including front-line clinicians, hospital administrators, and public health or government officials. Although it is important for all providers to be familiar with the potential implications for a disaster or pandemic on special populations, Table 1 provides an overview of the suggestions of most interest to each group.
The Special Populations topic panel identified 14 key questions in six areas, and literature searches were conducted for evidence to address these questions. An online resource for the key questions list was used, and corresponding search terms were identified. Literature searches were conducted for articles published from 1985 to 2013 to find evidence upon which to base recommendations. English-language articles were included, and non-English-language articles were reviewed and pertinent literature translated. Given the lack of high-quality data upon which to make evidence-based recommendations, expert opinion suggestions were developed with consensus achieved using a modified Delphi method. Full details regarding the methods used by the panel are provided in the “Methodology” article by Ornelas et all in this consensus statement.
Table 1 – Primary Target Audiences for Suggestions
|SuggestionNumber||Primary Target Audience|