Caring for evacuated children housed in the Astrodome: creation and implementation of a mobile pediatric emergency response team: regionalized caring for displaced children after a disaster.

PREPARATION: LONG-TERM RESCUE AND DISASTER-RELIEF STRATEGIES: Located only 50 miles from the Gulf Coast and Galveston, Houston, Texas, is familiar with the challenges posed by hurricanes, tropical storms, and flooding. The hospitals of Houston and Harris County are no strangers to the aftermath of such natural disasters, themselves being victims of massive damage in 2001, when the entire Houston downtown area and Texas Medical Center complex, as well as a great portion of the city, were severely damaged by unexpected and unprecedented flooding in the wake of Tropical Storm Allison. City, county, and hospital officials are ever mindful of the need to learn lessons from the past and to have disaster-relief plans in effect. Texas Children’s Hospital (TCH), in particular, has participated in numerous citywide disaster drills and is well prepared to deal with many types of disasters that may occur within its region. Indeed, the TCH emergency center (TCHEC) alone evaluates more than 80 000 children per year and serves a large populous and a large geographic area. Hence, it is poised for participation in any large disaster-relief effort. Beginning on Friday, August 26, 2005, area officials and rescue and disaster-relief mechanisms were about to be tested. In the aftermath of Hurricane Katrina, Houston was faced with the sudden arrival of thousands of people, many in need of medical care. Although officials had prepared in advance for this event, a lack of pediatric provider involvement was associated with woefully inadequate strategies for providing emergency medical care for thousands of children and adolescents. AUGUST 29: LANDFALL The eye of Hurricane Katrina made landfall at 6:10 AM and crossed the wetlands/barrier islands between New Orleans, Louisiana, and the Gulf of Mexico. By 9:00 AM, officials learned that the lower Ninth Ward levee had failed to restrain the rising water of Lake Pontchartrain and that water was flowing unimpeded into the city. After the 17th Street levee was breached, more than 80% of the city experienced rising flood waters that reached heights of 20 feet in some areas.