Preparing for unexpected events is an important part of keeping children safe and healthy all year long. Events like the spread of a serious infection, an explosion, an earthquake, or a weather event, such as a hurricane, may cause health problems for large numbers of people, and especially for children.

Children make up one in four people in the United States and they have special needs during and after emergencies. Children are not just little adults; their bodies are different from adults’ bodies. Although younger children are often more affected than adults during disasters, there are concerns for children of all ages during emergencies because

• Children may not be able to follow directions or make decisions to keep them away from danger during a disaster.
• Children’s bodies use energy quicker than adults’ do, and they need food and water more often. This means that they will absorb poisons or dangerous chemicals faster than adults will.
• Children have thinner skin and breathe faster than adults do, making them more likely to take in harmful substances through the skin or breathe them in.
• Children are smaller than adults, but they have more skin in relation to their overall size, compared to adults. This means they have a higher chance of being harmed by certain chemicals or very hot or cold temperatures.
• Children are more likely to put their hands in their mouths, and spend more time outdoors and on the ground, making them more likely to come into contact with dangers in the environment.
• Children may not be able to explain how they are feeling, which can make it harder to identify a medical problem and treat them quickly.
• Children have more contact with others, and they have less developed immune systems to fight off infections. This means they are more likely to catch an illness that can spread from person to person.
• Some children have special healthcare needs. These can increase a child’s chance of getting sick during an emergency, especially if the child is separated from a parent or caregiver.

Caring for children during emergency procedures calls for planning and action before an emergency happens.

Progress on Including Children’s Needs During Emergencies

Although children have a greater chance of being harmed during an emergency, it takes special attention to children’s needs to make sure they are not passed over when emergency plans are made or carried out. Caring for children during emergency procedures, such as evacuation, decontamination, and sheltering, calls for planning and action before an emergency happens. For example, in an emergency, hospitals might have to care for a large number of children. Without planning ahead of time, hospitals may not have the right equipment and supplies to care for more than the usual number of young patients.

Agencies in local communities and at the state and national levels are working to make sure children are protected during disasters by taking steps, such as

• Making new or stronger connections between public health, children’s healthcare providers, children’s hospitals; schools and the Board of Education;
• Developing instructions for how to keep children healthy during an emergency and how to treat children who are sick or have special health care needs;
• Sharing information and ideas about including children’s needs in emergency plans and about how to carry out these plans during an emergency; and
• Preparing for the next event by reviewing what was learned from previous events and making improvements.

Moving Forward

Progress has been made, but there is still more work to do to protect children during emergencies. More research could determine how well emergency plans have protected children so far, how plans can be improved, and what can be done to serve children better during emergency events. For example, research could provide information on the mental health of children in disasters. Children respond to upsetting events differently, depending on their ages and states of development. Taking these differences into account in emergency plans might be one way to do a better job of caring for children.

Preparing to take care of children during a disaster is not always easy but planning now can protect their safety and health in the future.

Nearly 1 out of every 5 children in the United States has a special healthcare need. Children and youth with special healthcare needs (CYSHCN), also known as children with special healthcare needs (CSHCN), require more care for their physical, developmental, behavioral, or emotional differences than their typically developing peers. A special healthcare need can include physical, intellectual, and developmental disabilities, as well as long-standing medical conditions, such as asthma, diabetes, a blood disorder, or muscular dystrophy.

All children have unique needs in emergencies, but care for children with special healthcare needs is often more complex because of their various health conditions and extra care requirements. They may have a hard time moving from one place to another, urgent or constant medical needs, difficulty communicating or have trouble with transitioning to different situations. A disaster can present all these difficulties at once. Knowing what to do can help maintain calm and keep your family safe. Read more about the real stories of children with special healthcare needs preparing for and responding to emergencies.

Planning is key. It is important for families to have an emergency care plan in place in case a public health emergency like a natural disaster, act of terrorism, or disease outbreak occurs. If there is a child with special healthcare needs in your family, you and your family can prepare by developing a written emergency care plan and practicing your plan. For example, a plan can include medicines or assistance devices that your child needs. If possible, let your child help make the plan. Healthcare providers can work with families of children with special healthcare needs to make sure the child’s needs are covered in the family emergency plan and to identify support networks in your community.

Appropriate response. Stay as connected as possible with children and with others, as these connections can help in providing care and support in an emergency while distracting children to lessen their worries and anxiety. Talk to children about what is happening in a way that they can understand. Keep it simple and consider the child’s age and type of disability. For example, it may be hard to know how much information a child with autism is learning through television and conversations. Adults may have to look for clues that provide information on the feelings and fears of these children.

Children with special healthcare needs may need special support services, including medicine and medical equipment, which typically are not available in traditional emergency shelters. In addition, children requiring medical services are not legally able to provide consent for treatment. If your child has specific equipment needs, and/or the needed equipment requires electricity to operate, notify local Emergency Medical Services and other responders of these needs in advance of an emergency. The American College of Emergency Physicians (ACEP) and the American Academy of Pediatrics (AAP) developed an Emergency Information Form to help emergency care professionals and healthcare providers give appropriate care for children with special healthcare needs during an emergency. These children should also have access to appropriate resources for safe transportation during an emergency. Families can learn more about safe transportation for their child with special healthcare needs in AAP’s Transporting Children With Special Health Care Needs.

After the disaster. A disaster can have long-term effects on the mental and emotional health of all children. Coping with a disaster can be particularly difficult for children with disabilities. Children who have serious emotional and behavioral problems are at high risk for severe stress after a disaster or traumatic event. In many cases, it may help to maintain as much of a normal routine and environment as possible. It is important that parents, caregivers, and healthcare providers know how to help children cope after an emergency to support their health and well-being.

After a disaster, children may experience anxiety, fear, sadness, sleep disruption, distressing dreams, irritability, difficulty concentrating, and anger outbursts. Learn the signs of children’s mental stress to help them cope after a disaster.

Experiencing a disaster can cause stress for families. Young children, under 8 years of age, are at particular risk for mental health issues. Some children may develop disorders like anxiety, depression, and post-traumatic stress disorder after a disaster. Stress and emotional problems affect children’s physical health, quality of life and how they do at home, in school, and in their communities. It is important to keep children mentally and physically safe both during and after a disaster. Parents who are able to recognize the signs of children’s mental stress can best help their children cope and remain healthy.

Why are children at risk for mental health issues after a disaster?

Mental stress from a disaster can be harder on children because they

• Understand less about the situation,
• Feel less able to control events, and
• Have less experience coping with difficult situations.

Disasters can be particularly hard on children who have experienced trauma in the past or already have a mental, emotional, developmental, or behavioral disorder before the event occurs.

How can parents and caregivers help children cope after a disaster?

• Give your children opportunities to talk about what they went through or what they think about it. Encourage them to share concerns and ask questions.
• Allow your children to be with you or another trusted adult who can help them feel safe, calm, connected, and give them a sense of hope.
• Limit exposure to mass media coverage of the disaster and its aftermath. Children who were directly exposed to a disaster can become upset again if they see or hear reminders of what happened.
• Encourage your children to take action directly related to the disaster. This can help them regain a sense of control and manage their feelings. For example, children can help others after a disaster, including volunteering to help community or family members in a safe environment. Children, especially young children, should NOT participate in disaster cleanup activities.
• Work with teachers and other adults, who see your children in different situations, to share information about how each child is coping.

When should you seek help from a professional?

Children may need continued mental health support for months or longer following a major disaster. Consider talking to a professional (e.g., pediatrician, school counselor, child psychologist, or someone who specializes in children’s emotional needs) if:

• Your child continues to be very upset (e.g., anxious, fearful, sad, angry) for more than 2-4 weeks after the disaster,
• Your child’s problems become worse over time instead of better,
• Your child’s reactions affect their schoolwork or relationships with friends or family

Helping a child cope with disaster can be challenging for parents. Any time you feel it is necessary, reach out for professional help and support for you and your child. CALL or TEXT Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Hotline: 1-800-985-5990; People with deafness or hearing loss can use their preferred relay service to call 1-800-985-5990.

Disasters affect children differently than they do adults. Learn more about the unique needs of children during and after disasters.

• Children’s bodies are different from adults’ bodies.
  • They are more likely to get sick or severely injured.
    • They breathe in more air per pound of body weight than adults do.
    • They have thinner skin, and more of it per pound of body weight (higher surface-to-mass ratio).
    • They have less fluid in their bodies, so fluid loss (e.g. dehydration, blood loss) can have a bigger effect on children.
  • They are more likely to lose too much body heat.
  • They spend more time outside and on the ground. They also put their hands in their mouths more often than adults do.
• Children need help from adults in an emergency.
  • They don’t fully understand how to keep themselves safe.
    • Older children and adolescents may take their cues from others.
    • Young children may freeze, cry, or scream.
  • They may not be able to explain what hurts or bothers them.
  • They are more likely to get the care they need when they have parents or other caregivers around.
  • Laws require an adult to make medical decisions for a child.
  • There is limited information on the ways some illnesses and medicines affect children. Sometimes adults will have to make decisions with the information they have.
• Mental stress from a disaster can be harder on children.
  • They feel less of a sense of control.
  • They understand less about the situation.
  • They have fewer experiences bouncing back from hard situations.

Regardless of your child’s age, he or she may feel upset or have other strong emotions after an emergency. Some children react right away, while others may show signs of difficulty much later. How children react or common signs of distress can vary according to age. Knowing how to help children cope after an emergency can help them stay healthy in future emergencies.

An emergency can happen anywhere and at any time. It is important for parents to know what steps they can take before, during, and after an emergency to protect their family. Parents ensure that family members are ready and know what to do when emergencies happen.

Before an Emergency

A little preparation now can make a big difference later.

Here are some steps you can take to help keep your family safe and healthy when an emergency happens:

• Prepare an emergency kit that includes a 3-day supply of necessities for each person in your family, such as food, medicine, water, games, flashlight, and special toys to help keep your children calm during an emergency.
• Make a plan to contact family members, especially if you are not together when an emergency strikes. If your children are old enough, teach them how to call 911 and memorize important phone numbers. Create a reunification plan as part of the family communication plan to reunite you with your loved ones as soon as it is safe to do so.
• Review with your children the different types of emergencies that can happen in your area and the warning signs for those emergencies. For example, if tornadoes are common, your children should know what to do during a tornado. This includes knowing the signs of an approaching storm and instructions on how to take shelter during a tornado.
• Be informed, stay informed, and get vital information, such as emergency warnings and alerts, from reliable news sources and your local emergency management agency.

Getting your children to help with preparing for an emergency can teach them the basics of staying safe and will make emergencies less stressful because they will be prepared and empowered. Ask them what items they think should go in an emergency kit and plan.

Help protect your child during the school day.

In the United States, about 69 million children are separated from their parents or caregivers every work day to attend school or child care. You can help protect your children, even when you are not with them, through the following steps:

• Find out the school or childcare center’s emergency plans. Every school and childcare center should have a written emergency plan with information, such as how to contact parents in an emergency and where children will go if evacuated. Also, ask how you can contact the school or childcare center during an emergency and how parents and caregivers will reunite with their children.
• Update your emergency contact information. Make sure that the school has up-to-date emergency contact information for your child. Notify the school every time your address or phone number changes. Keeping a backpack emergency card with your child is one way to make sure that emergency contact information – as well as other important information like medications and allergies – is handy.

During an Emergency

Different emergencies may require different actions. Protect your family by knowing what to do.

Each emergency is different and may require different actions to keep you and your family safe. Local authorities will share safety instructions and updates on television, radio, the Internet, or social media pages, like Twitter and Facebook. Depending on the emergency, authorities may ask you to stay where you are (“shelter in place”), or they may recommend that you go somewhere else (“evacuate”).

If you have children in a school in the exposed area, school authorities may evacuate your children to a safer place or emergency shelter. In these cases, do not go to your children during the emergency. This can put you and your children at greater risk. Wait until emergency or school authorities say it is safe for you to pick up your children.

After an Emergency

Recovery can take time. Get the support you need to help you and your child in the aftermath of an emergency.

Reuniting After an Emergency

Children may be away from their parents – or accidentally separated– during an emergency. Having a reunification plan and knowing reunification resources can help you reunite with your loved ones as soon as it is safe to do so.

Helping Children Cope

Regardless of your child’s age, he or she may feel upset or have other strong emotions after an emergency. Some children react right away, while others may show signs of difficulty much later. How children react or common signs of distress can vary according to age. Knowing how to help children cope after an emergency can help them stay healthy in future emergencies.

Being prepared for an emergency isn't just about staying safe during a storm or a disaster. It's also about how to stay comfortable, clean, fed, and healthy afterwards—when a storm or disaster may have knocked out electricity.

If you lost power, how would you eat? The refrigerator wouldn’t keep your food cold. The microwave couldn’t warm things up. You might not get clean water out of your faucets. How would you find out if it was safe to play outside? Not from your TV or computer!

If power is out, you also might not be able to go to the store or the bank. Being prepared means having your own food, water, cash, and other supplies to last for at least three days, and possibly longer if you are in a remote or hard-to-reach area. 

What should go in your kit?

Remember that your kit will depend on your own needs. Once you take a look at the basic items, consider what unique needs your family might have, such as supplies for pets or seniors. Use the list below to get started:  

• Water—at least a gallon per person, per day
• Non-perishable food (such as dried fruit, peanut butter, or energy bars)
• First aid kit
• Cash
• Prescription medicines
• Extra batteries or an alternative power source
• Matches in a waterproof container (allow an adult to help)
• Toothbrush, toothpaste, soap
• Paper plates, plastic cups and utensils, paper towels
• Battery-powered or hand-cranked radio
• Sleeping bag or warm blanket for each person
• Flashlights
• Whistle to signal for help
• Can opener (manual)
• Local maps
• Pet and service animal supplies
• Baby supplies (formula, diapers, etc.)
• Extra pair of eyeglasses

An emergency kit has all of the things that you and your family may need during an emergency in which you may have to stay inside for longer than usual or the electricity could go out. Making a family emergency kit can be fun for the family to do together. Here’s how to have a family emergency kit treasure hunt:

1. You will need a large plastic bin or box to put things into.
2. Answer the following questions to guide your treasure hunt.
3. Check items off the list as you put them into your emergency kit box.
4. Place an updated copy of your checklist inside your large plastic bin or box once your kit is put together to know what is inside the kit and to know where you can always find your checklist.

An emergency kit is a collection of items that you may need in an emergency.

Do you have a child in your house who has a disability or special needs? View our checklist for Families with Children and Youth with Special Healthcare Needs (CYSHCN).

Do you have the things every family needs during an emergency?

• 3-day water supply (at least a gallon per person per day)
• 3-day supply of non-perishable food (dried fruit, canned tuna fish, peanut butter, etc.)
• Manual can opener
• Mess kits, paper plates, plastic cups, utensils
• Paper towels
• First aid kit
• Flashlights with extra batteries
• Battery-powered or hand-cranked radio with extra batteries
• Whistle to signal for help
• Local maps
• Sleeping bag or warm blanket for everyone in your family
• Cell phone with charger, extra battery, and solar charger
• Extra set of car keys and house keys
• Change of clothes appropriate for your climate and sturdy shoes – for each person in the house
• Matches in a waterproof container or re-sealable plastic bag
• Toothbrush, toothpaste, soap, and hand sanitizer
• Cash or traveler’s checks
• Copies of important family documents (medical records, insurance policies, ID card, bank records) in waterproof, portable container
• Family and emergency contact information
• At least a two-week supply of prescription medicines for each family member, including medicine name, dose, pharmacy name and number, and doctor’s name and number
• Non-prescription medicines, such as pain relievers, anti-diarrhea medicine, antacids and laxatives

Do you have children?

Consider including these items:

• Books, games, puzzles, or other fun things to do
• A favorite stuffed animal or blanket
• Paper and pencil/markers/crayons
• Identification to be carried by each child in case your family members become separated

Do you have a baby or toddler?

Consider these items in addition to the basic kit, if appropriate:

• A well-stocked diaper bag (at least one pack of diapers, at least two packs of baby wipes, baby powder, diaper rash cream, baby wash and lotion, and re-sealable plastic bags (gallon size) for stashing dirty diapers and clothes)
• Ready-to-feed infant formula in single serving cans or bottles (for formula-fed infants only)
• Disposable cups
• 1-2 boxes of nursing pads (if disposable, reusable will require laundry and bleach daily)
• Burp rags or smaller blanket
• Pacifiers (at least two)
• Teething tablets or gel
• Infant pain reliever with Acetaminophen
• Bulb syringe
• Toddler snacks
• Extra clothes
• Extra emergency blankets (at least two)
• Receiving blankets (at least two)
• Thermos (to keep formula cool or warm longer)
• Small camp stove for boiling water for sanitizing

Do you have pets?

Stock up on items your pet may need during a disaster.

• Water (3-day supply per pet)
• Pet food (3-day supply)
• Food/water bowls
• Medical records
• Two-week supply of medicines (if any)
• Pet Emergency Kit Checklist [PDF – 172KB]
• Disposable litter trays for cats
• Cat litter, newspaper or paper toweling
• Puppy pads
• Disposable bags for clean up
• Crate or sturdy carrier
• Recent photos of your pets (in case you are separated and need to make “Lost” posters)
• Toys and/or treats
• Blanket
• Extra collar with nametag and contact information
• Extra leash

Consider adding additional items to your kit based on your family’s needs.

• Medical alert bracelet or necklace (if your child has a long-standing medical condition, such as asthma or diabetes, or needs special attention, see our additional checklist for families of Children and Youth with Special Healthcare Needs)
• Fire extinguisher
• Wrench or pliers to turn off utilities
• Household chlorine bleach and medicine dropper to disinfect water
• Glasses and contact lens solution
• Feminine supplies and personal hygiene items
• Moist towelettes or baby wipes
• Toilet paper (at least two rolls)
• Tissues
• Sunblock
• Hand sanitizer
• Extra emergency blankets for everyone in your family
• Garbage bags and plastic ties (for personal sanitation)
• Dust mask, plastic sheeting, and duct tape to help filter contaminated air and shelter in place
• Latex gloves or an alternative (such as nitrile or vinyl gloves) for individuals with latex allergies

Tips and reminders to make sure your family emergency kit is always ready to go:

• Keep canned or packaged food in a cool, dry place (check the expiration dates at least twice per year)
• Store boxed food in tightly closed plastic or metal containers
• Replace water supply every six months
• Review your needs every year and update your kit as your family’s needs change (update medical and personal records at least once per year)
• Prepare separate kits for your home, work, and your vehicle since you never know where you’ll be when an emergency happens
• If you can’t contact your doctor or pharmacy in a disaster, ask for help from emergency responders or staff at emergency shelters or service centers

If a child with special healthcare needs is part of your family it is very important to be prepared for an emergency in which you may have to stay inside for longer than usual or in the event the electricity goes out. An emergency kit is necessary for all families, and especially important for families of children with special healthcare needs.

An emergency kit has all of the things that you and your family may need during an emergency. In addition to the common items found on the emergency kit checklist for kids and families page, the checklist described here contains items that are specific for families of children and youth with special healthcare needs (CYSHCN). Each family’s kit will vary depending on the individual needs of their child. It is best to have all of these things collected before an emergency, stored in a container, and kept in a place that is safe and easy to get to in the event of an emergency. Making a family emergency kit can be fun for the family to do together. Here’s how to have a family emergency kit treasure hunt:

1. You will need a large plastic bin or box to put things into.
2. Answer the following questions to guide your treasure hunt.
3. Check items off the list as you put them into your emergency kit box.
4. Place an updated copy of your checklist inside your large plastic bin or box once your kit is put together to know what is inside the kit and to know where you can always find your checklist.

Do you have all of your child’s medical information and general supplies?

• A current copy of your child’s Care Plan Current medical information and records, including the following:
  • An electronic copy (on a CD, flash drive, or phone app)
  • A paper copy in a waterproof bag
• Special dietary foods and supplies (3-day supply)
• Items or toys that calm or entertain your child
• An extra medical alert bracelet or necklace for your child
• Identification to be carried by each child in your family in case your family members become separated

Do you have back-up power and supplies?

• An AC adaptor for your car to charge small electrical equipment, such as a nebulizer
• Battery powered versions of medical equipment your child uses
• Extra batteries for medical equipment, hearing aids and communication devices
• Back up charger(s) for cell phone (such as a hand-cranked USB cell phone emergency charger, a solar charger, or a battery pack; some weather radios have a built in hand crank charger)
• Backup chargers for a laptop or tablet (such as a 12V USB adapter that plugs into a car, an inverter, or into a battery jump pack with a USB port)
• If your family has a generator for backup power support, never use a generator indoors due to deadly fumes. Learn more about generator safety
• If available to your family, consider backups for non-electric equipment, such as a manual wheelchair or other walking aids

Do you know how to get emergency medical supplies and medicines for your child?

• Talk with your child’s doctor about how to get an emergency supply of medicines. If your child takes medicine given by a clinic or hospital, talk with their staff about how to plan for a stoppage due to a disaster
• Ask your pharmacist how long each medicine can last and storage needs of the medicines
• Keep a copy of your child’s prescription information in your wallet and car, including the name, location and phone number of an out-of-town pharmacy in case your regular pharmacy is closed

Do you have all the medical supplies and medicines for your child?

• Two-week supply of all prescription medicines your child will need (consult your child’s doctor on the recommended amount(s) to keep in your kit)
• Two-week supply of medical care items, such as needles, nasal cannulas, bandages, etc.
• Cooler and chemical ice packs for storing and keeping medicines cold
• A copy of all prescription information for your child’s medicines and the phone number of an out-of-town pharmacy in case your regular pharmacy is closed

Tips and reminders to make sure your family emergency kit is always ready to go:

• Keep canned or packaged food in a cool, dry place (check the expiration dates at least twice per year)
• Store boxed food in tightly closed plastic or metal containers
• Replace water supply every six months
• Review your needs every year and update your kit as your family’s needs change (update medical and personal records at least once per year)
• Prepare separate kits for your home, work, and your vehicle since you never know where you’ll be when an emergency happens
• If you can’t contact your doctor or pharmacy in a disaster, ask for help from emergency responders or staff at emergency shelters or service centers

A biologic threat is an infectious disease with the potential to spread and cause an outbreak.

Infectious diseases are illnesses caused by germs (such as bacteria and viruses). Some infectious diseases require close contact between two people, like when people speak to each other. Other infectious diseases can only spread by germs carried in air, water, food, or soil, or by biting insects or by animals.

Biologic threats may spread naturally, as in a worldwide flu outbreak or be released intentionally in a bioterrorism attack. Anthrax was intentionally released in 2001 to cause harm.

Why Children are Vulnerable to Biologic Threats

Children are more likely to get sick and have a more severe illness from a biologic threat compared to healthy adults for several reasons. First, children’s immune systems are not fully developed, which means they can more easily get an infection and may have a harder time fighting off the infection. Second, germs can spread rapidly because children typically have frequent, close contact with other children or family members and they put their hands in their mouths more often than adults. Third, children may not understand how to protect themselves or understand the importance of safety measures. For instance, they may not follow recommendations to prevent the spread of germs, like wearing a facemask or proper hand washing.

Protecting Children from Biologic Threats

Treatments for biologic threats vary depending on the germs that are causing the illness. However, there are ways to protect your family in the event of an infectious disease emergency:

• Prepare an emergency kit. In the event of widespread illness, it is possible that services and facilities in the community – like restaurants, public transportation, and banks – will close temporarily. Similar to preparedness for other types of emergencies, it is important that you have essential supplies at home, including at least a 3-day supply of water and food that will not spoil, as well as any medicines that your family members need daily.
• Stay informed. In an emergency, seek out information early and often. Public health authorities will communicate the things you can do to protect yourself and your family. The Centers for Disease Control and Prevention (CDC) will provide information through television, radio, the Internet, or social media pages, such as Twitter and Facebook.
• Know your family’s medical history. It may be necessary to take antibiotics, receive vaccines, or take other medicines to treat an infection. Healthcare professionals want to know about your family’s health and any medical problems you and your relatives have had in the past. You can help by keeping a written medical history for your family that includes the following items:
  • Medical conditions
  • Allergies
  • Medicines that family members are taking
  • Each child’s weight

A chemical emergency occurs when a hazardous or poisonous chemical is released into the environment and has the potential to harm people’s health. Chemical releases can be unintentional, such as the release of toxic gas from a volcanic eruption or an industrial accident, or intentional, such as in a terrorist attack.

Hazardous chemicals have several different sources. Military organizations developed chemical weapons for war, such as nerve agents that prevent the nervous system from working or mustard agents that cause blisters in the eyes and on the skin. Some hazardous chemicals used in manufacturing industries, like benzene or chlorine, are found in household cleaners. These types of hazardous chemicals could harm people on purpose or could be released accidentally.

People are in potential danger when hazardous chemicals are released accidentally or used to harm people specifically. Children are at greater risk than adults during a chemical emergency.

Protecting Your Family During a Chemical Emergency

Each chemical emergency is different and may require different actions to keep families and children safe. During an emergency, you may have to evacuate or to shelter in place, depending on how close you are to the incident. In most cases, emergency authorities (local police, emergency coordinators, or government on the radio and on the television emergency broadcast system) will let you know where to go to protect yourself and your family.

When Should I Evacuate?

In some chemical emergencies, emergency authorities decide when it is safe to evacuate the immediate area and give instructions for going to an emergency shelter, if necessary. If you have children in a school in the exposed area, school authorities may evacuate your children to a safer place or emergency shelter. In these cases, do not go to your children during the emergency. This can put you and your children at greater risk. Wait until emergency or school authorities say it is safe for you to pick up your children.

When Should I Stay Where I Am?

Some chemical emergencies make going outdoors or leaving the immediate area too dangerous. When this happens, emergency authorities will tell you to shelter in place (stay indoors where you are). If you have children at school, they may have to stay at the school. In these cases, do not go to your children during the emergency. This can put you and your children at greater risk. Wait until emergency or school authorities say it is safe for you to pick up your children.

If you and your children are in a vehicle during a chemical emergency, you should not try to shelter in the vehicle unless you have no other choice. Vehicles are not airtight enough to give adequate protection from chemicals.

What if the Chemical Gets on My Children or Me?

Many chemicals can go through clothing and be absorbed through the skin. If exposed to hazardous chemicals, you will need to quickly decontaminate (reduce or remove the chemical so it is no longer dangerous to you). You can decontaminate by removing your clothing, disposing of it properly, and washing your body. If you and your child are exposed, decontaminate yourself first and then decontaminate your child. Wash your hands with soap and water after decontaminating another person to ensure that you do not contaminate yourself or anyone else.

Radiation, sometimes known as electromagnetic waves, is energy that comes from a source and travels through space at the speed of light. Radioactive atoms in the source (called radioactive material) give off radiation in waves or particles. Each of us is exposed daily to radiation from natural sources, including the sun and the earth. Small traces of radiation are present in food and water. Radiation from manmade sources, such as x-ray machines, are released in controlled amounts to minimize harmful effects.

However, in a radiation emergency, such as a nuclear power plant accident, transportation accident, dirty bomb explosion (a mixture of explosives and radioactive powder or pellets), or nuclear blast, you could be exposed to a large amount of radiation that could be harmful to your health and the health of your family.

Health Effects of Radiation

The physical area affected by radiation depends on the amount of radiation released, the direction and speed of the wind, and the weather conditions. During a radiation emergency, radioactive material may be released into the air and breathed into the lungs, or it may get into the body through open wounds. Radioactive material can contaminate the local food supply and get into the body through eating or drinking tainted food.

Radioactive material on the skin can be easily washed off (decontamination) so that it does not expose you or others to radiation. When radioactive material gets inside the body, it is called internal contamination. Radiation causes more health problems over time, so the sooner that internal contamination can be removed from the body, the fewer and less severe will be the health effects. These health effects can range from relatively mild, such as skin reddening or vomiting, to very serious, such as cancer or death. The health effects that might occur depend on the amount of radiation absorbed by the body (the dose), the type of radiation, and the way and the amount of time that the person was exposed. In some cases, the harmful health effects of radiation might not occur for many years. If you think you may have internal contamination after a radiation emergency, see a health care provider as soon as it is safe to do so.

External contamination occurs when radioactive material, in the form of dust, powder, or liquid, comes into contact with a person’s skin, hair, or clothing. In other words, the contact is external to a person’s body. People who are externally contaminated can become internally contaminated if radioactive material gets into their bodies. People who are externally contaminated with radioactive material can contaminate other people or surfaces that they touch. For example, people who have radioactive dust on their clothing may spread the radioactive dust when they sit in chairs or hug other people.

If radioactive material is on your clothes, you can remove the outer layer of your clothing, getting it away from you will reduce the external contamination and decrease the risk of internal contamination. It will also reduce the length of time that you are exposed to radiation. If possible, place the clothing in a plastic bag or leave it in an out-of-the-way area, such as the corner of a room. Keep people away from it to reduce their exposure to radiation. Keep cuts and abrasions covered when handling contaminated items to avoid getting radioactive material in them. Wash all of the exposed parts of your body using lots of soap and lukewarm water to remove contamination. This process is called decontamination. Try to avoid spreading contamination to parts of the body that may not be contaminated, such as areas that were clothed.

Protecting Children in a Radiation Emergency

During a radiation emergency you may have to shelter in place instead of evacuating, depending on how close you are to the incident. CDC recommends that you get inside, stay inside, and stay tuned.
You can decrease you and your family’s exposure to radiation by limiting the amount of time exposed to radioactive material, putting more distance between you and the radiation source, and shielding yourself with heavy and dense material between you and the radiation source. In most cases, emergency authorities (local police, emergency coordinators, or government on the radio and/or television emergency broadcast system) will let you know where to go keep yourself and your family safe.

Why Children are More Vulnerable to Radiation

Although anyone exposed to radiation may experience harmful health effects, children are more likely to get sick from radiation exposure than healthy adults. Children have more cells that are growing and dividing rapidly, their organs and tissues are growing, and they have a longer lifespan ahead of them, giving cancers more time to develop. Children have thinner skin and breathe in more air for their size than adults, so they could absorb more radiation. Children may not know what to do or how to keep themselves safe by limiting their exposure to radiation in an emergency.

It is especially important for children to follow instructions to protect themselves from radiation and to receive medical attention after a radiation emergency as soon as emergency officials say it is safe to do so.
During pregnancy, a developing baby is vulnerable to radiation exposure. Pregnant women should take extra precautions during a radiation emergency. It is possible for nursing mothers to pass radioactive materials to their babies through their breastmilk. They should consider not breastfeeding if other milk sources are available until they can see their healthcare professional.

Treating Radiation Exposure

Some medical countermeasures are available for limiting or removing internal contamination, depending on the type of radioactive material involved. Medical professionals will determine if the following medicines are needed:

• Potassium Iodide (KI)
• Prussian Blue
• DTPA (Diethylenetriamine pentaacetate)
• Neupogen

Severe weather can be dangerous and quickly turn into an emergency, which can be devastating for children. The type of severe weather you could experience may depend on where you live. However, no matter where you live or what type of severe weather you may be up against, there are steps you can take to make sure you and your family stay healthy and protected.

How Severe Weather Impacts Children

Children’s bodies are different from adults in ways that make them more likely to get sick or injured, especially during a severe weather event. First, children are smaller and still developing. Falls or flying objects can easily damage their internal organs during earthquakes, tornadoes, or other severe weather. Second, children’s bones are still growing and they are more likely to break or fracture. Third, children’s immune systems are still developing so they are more susceptible to germs that can make them sick. For example, if drinking water or food becomes contaminated with germs due to loss of electricity or unsanitary conditions, children can develop diarrhea or vomiting and quickly become dehydrated. A vomiting or diarrheal illness that is mild in adults can be serious in children.

Children rely on adults for their protection and may not understand what to do to keep themselves safe if separated from their caregivers. For example, they may not know when severe weather poses a threat to their health and safety, or they may not be physically capable of escaping a dangerous situation. They may have trouble following directions or communicating their needs or wants.

Protecting Children During Severe Weather

Some severe weather events are predictable while others may happen with little or no warning. By doing the following, you can help keep yourself and your family safe and healthy in any weather emergency:

• Prepare an emergency kit that includes supplies you will need if you and your family cannot leave your home (shelter in place) because of severe weather. Your emergency kit should have a 3-day supply of food that cannot spoil, water, flashlight, first aid supplies, and special medicines or medical equipment that your family needs.
• Make a plan for special steps that you can take to protect your family during severe weather events where you live. A family communication plan is important in case family members are separated or not together when a weather emergency happens.
• Be informed, stay informed before, during, and after an emergency about any warnings or safety instructions given by local authorities. Having a battery-powered, solar, or hand-crank radio will help you get important local updates on the situation, even if you lose electricity.

Learn about additional steps that you need to take for different severe weather events:

• Extreme Heat
• Floods
• Hurricanes
• Landslides and Mudslides
• Lightning
• Tornadoes
• Tsunamis
• Winter Weather

Natural Emergencies are on the Rise

In 2015, losses from flooding and other storms exceeded $14.7 billion. Compared to the average number of emergencies occurring from 2005 to 2014, the number of climate-based and geophysical emergencies in the U.S. during 2015 were 1.6 and 1.2 times higher, respectively. The number of victims from geophysical emergencies (1.64 million) was 63% higher for victims during the years, 2005-2014.

Source: Annual Disaster Statistical Review 2015, Centre for Research on the Epidemiology of Disasters (CRED)

Children are different from adults. They may be more vulnerable to chemicals and organisms they are exposed to in the environment because:

• Children’s nervous, immune response, digestive and other bodily systems are still developing and are more easily harmed;
• Children eat more food, drink more fluids, and breathe more air than adults in proportion to their body size – so it is important to take extra care to ensure the safety of their food, drink and air;
• They way children behave – such as crawling and placing objects in their mouths – can increase their risk of exposure to chemicals and organisms in the environment.

Mold

After homes have been flooded, moisture can remain in drywall, wood furniture, cloth, carpet, and other household items and surfaces and can lead to mold growth. Exposure to mold can cause hay-fever-like reactions (such as stuffy nose, red, watery or itchy eyes, sneezing) to asthma attacks. It is important to dry water-damaged areas and items within 24-48 hours to prevent mold growth. Buildings wet for more than 48 hours will generally contain visible and extensive mold growth.

Some children are more susceptible than others to mold, especially those with allergies, asthma and other respiratory conditions. To protect your child from mold exposure, you can clean smooth, hard surfaces such as metal and plastics with soap and water and dry thoroughly. Flood water damaged items made of more absorbent materials cannot be cleaned and should be discarded. These items include paper, cloth, wood, upholstery, carpets, padding, curtains, clothes, stuffed animals, etc.

If there is a large amount of mold, you may want to hire professional help to cleanup the mold. If you decide to do the cleanup yourself, please remember:

• Clean and dry hard surfaces such as showers, tubs, and kitchen countertops.
• If something is moldy, and can't be cleaned and dried, throw it away.
• Use a detergent or use a cleaner that kills germs.
• Do not mix cleaning products together or add bleach to other chemicals.
• Wear an N-95 respirator, goggles, gloves so that you don't touch mold with your bare hands, long pants, a long-sleeved shirt, and boots or work shoes.

Homes or apartments that have sustained heavy water damage will be extremely difficult to clean and will require extensive repair or complete remodeling. We strongly advise that children not stay in these buildings.

Carbon Monoxide

NEVER use portable generators indoors! Place generators outside and as far away from buildings as possible. Do not put portable generators on balconies or near doors, vents, or windows and do not use them near where you or your children are sleeping. Due to loss of electricity, gasoline- or diesel-powered generators may be used in the aftermath of floods. These devices release carbon monoxide, a colorless, odorless and deadly gas. Simply opening doors and windows or using fans will not prevent carbon monoxide buildup in the home or in partially enclosed areas such as a garage. In 2001 and 2002, an average of nearly 1,000 people died from non-fire-related carbon monoxide poisoning, and 64% of nonfatal carbon monoxide exposures occurred in the home. Learn about the dangers of carbon monoxide indoors.

If your children or anyone else in your family starts to feel sick, dizzy or weak or experiences a headache, chest pain or confusion, get to fresh air immediately and seek medical care as soon as possible. Your child’s skin under the fingernails may also turn cherry-red if he/she has been exposed to high levels of carbon monoxide. Fetuses and infants are especially vulnerable to the life-threatening effects of carbon monoxide.

Install a carbon monoxide detector that is Nationally Recognized Testing Laboratory (NRTL) approved (such as by UL). These are generally available at local hardware stores. Carbon Monoxide is lighter than air, so detectors should be placed closer to the ceiling. Detectors should be placed close enough to sleeping areas to be heard by sleeping household members.

Contaminated Water

While all people need safe drinking water, it is especially important for children because they are more vulnerable to harm from contaminated water. If a water source may be contaminated with flood waters, children, pregnant women and nursing mothers should drink only bottled water, which should also be used to mix baby formula and for cooking. We also recommend you sponge bathe your children with warm bottled water until you are certain your tap water is safe to drink.

Your child may or may not show symptoms or become ill from swallowing small amounts of contaminated water. Symptoms can vary by contaminant. If your child drinks water contaminated with disease-causing organisms, he/she may come down with symptoms similar to the “stomach flu.” These include stomach ache, nausea, vomiting, and diarrhea, and may cause dehydration.

Some contaminants, such as pesticides and gasoline, may cause the water to smell and taste strange, and others such as lead and disease-causing organisms may not be detectable. Drinking water contaminated with chemicals such as lead or gasoline may not cause immediate symptoms or cause your child to become ill but could still potentially harm your child’s developing brain or immune system.

Because you cannot be sure if the water is safe until private wells are professionally tested or city water is certified as safe by local officials, we urge parents to take every precaution to make sure their child’s drinking water is safe.

If you have a flooded well, do NOT turn on the pump, and do NOT flush the well with water. Contact your local or state health department or agriculture extension agent for specific advice on disinfecting your well. Learn about how to manage a flooded well.

Your public water system or local health agency will inform you if you need to boil water prior to using it for drinking and cooking. Learn about emergency disinfection of drinking water.

Tap water that has been brought to a rolling boil for at least 1 minute will kill disease-causing organisms. Boiling will not remove many potentially harmful chemicals, and may actually increase concentrations of heavy metals (including lead), which can be harmful to a child’s developing immune system. Chemically treating tap water with either chlorine or iodine will kill many disease-causing organisms, but will not remove harmful chemicals or heavy metals.

Household Items Contaminated by Floodwaters

Drinking Water Containers: Clean thoroughly with soap and water, then rinse. For gallon-sized containers, add approximately 1 teaspoon of bleach to a gallon of water to make a bleach solution. Cover the container and agitate the bleach solution thoroughly, allowing it to contact all inside surfaces. Cover and let stand for 30 minutes, then rinse with potable water.

Kitchenware and Utensils: In general, metal and glazed ceramic that are thoroughly washed and dried can be sanitized and kept. Follow local public health guidance on effective and safe sanitation procedures. Wood items must be thrown away, as these items can absorb contaminants or grow mold from the exposure to flood water and they cannot be properly sanitized.

Children's Toys and Baby items: Throw away ALL soft or absorbent toys because it is impossible to clean them and they could harm your child. Throw away ALL baby bottles, nipples, and pacifiers that have come in contact with flood waters or debris.

Other Flood Topics

Teenagers: Teens are still growing and developing, especially their reproductive, nervous and immune systems. Teens are less likely to understand dangers and may underestimate the dangers of certain situations, or they may be reluctant to voice their concerns about potential dangers. Whenever possible, teens should not participate in post-flood clean-up that would expose them to contaminated water, mold and hazardous chemicals. Older teens may help adults with minor clean-ups if they wear protective gear including goggles, heavy work gloves, long pants, shirts, socks, boots and a properly fitting N-95 respirator.

Older Adults and People Living with Chronic Diseases: Flooding often leads to the development of micro-organisms and the release of dangerous chemicals in the air and water. Older adults and people living with chronic diseases are especially vulnerable to these contaminants.

Bleach: Household bleach contains chlorine, a very corrosive chemical which can be harmful if swallowed or inhaled. It is one of the most common cleaners accidentally swallowed by children. Children – especially those with asthma – should not be in the room while using these products. Call Poison Control at (800) 222-1212 immediately in case of poisoning.

Formerly Flooded or Debris-filled Areas: Children in these areas may be at risk of exposure to dirt and debris that may have been contaminated with hazardous chemicals like lead, asbestos, oil and gasoline. Children can be exposed by direct contact through their skin, by breathing in dust particles or fumes, or by putting their hands in their mouths.

Mosquitoes and Disease-Causing Pests: Flood water may increase the number of mosquitoes and other disease-causing pests. To protect your child, ensure that they use insect repellents containing up to 30% Deet, Picardin, or Oil of Lemon Eucalyptus. The American Academy of Pediatrics recommends that Deet not be used on infants less than 2 months of age and that Oil of Lemon Eucalyptus not be used on children under 3 years of age. Other ways to protect children include staying indoors while the sun is down, wearing light colored, long sleeved shirts and pants, covering baby carriages and playpens with mosquito netting, and clear standing water or empty flower pots, etc of water.

Heat-related illnesses are common, yet preventable on hot days. Children and pregnant women need to take extra precautions to avoid overheating on days of extreme heat. Dehydration, heat stroke, and other heat illnesses may affect a child or pregnant woman more severely than the average adult.

Why are children more susceptible to extreme heat?

• Physical characteristics – Children have a smaller body mass to surface area ratio than adults, making them more vulnerable to heat-related morbidity and mortality. Children are more likely to become dehydrated than adults because they can lose more fluid quickly.
• Behaviors – Children play outside more than adults, and they may be at greater risk of heat stroke and exhaustion because they may lack the judgment to limit exertion during hot weather and to rehydrate themselves after long periods of time in the heat. There are also regular reports of infants dying when left in unattended vehicles, which suggests a low awareness of the dangers of heat events.

How do I know if my child is dehydrated?

• Decreased physical activity
• Lack of tears when crying
• Dry mouth
• Irritability and fussiness

What should I do if my child has become dehydrated?

• Have the child or infant drink fluid replacement products
• Allow for rehydration to take a few hours, over which children should stay in a cool, shaded area and sip fluids periodically
• Call your doctor if symptoms do not improve or if they worsen

How do I know if my child has suffered a heat stroke?

Heat stroke, a condition in which the body becomes overheated in a relatively short span of time, can be life-threatening and requires immediate medical attention.

• Skin is flushed, red and dry
• Little or no sweating
• Deep breathing
• Dizziness, headache, and/or fatigue
• Less urine is produced, of a dark yellowish color
• Loss of consciousness

What should I do if my child has suffered a heat stroke?

• Immediately remove child from heat and place in a cool environment
• Place child in bath of cool water and massage skin to increase circulation (do not use water colder than 60F – may restrict blood vessels)
• Take child to hospital or doctor as soon as possible

How can children be protected from the effects of extreme heat?

• Hydration – Make sure children are drinking plenty of fluids while playing outside, especially if they are participating in sports or rigorous physical activity. Fluids should be drunk before, during and after periods of time in extreme heat.
• Staying indoors – Ideally, children should avoid spending time outdoors during periods of extreme heat. Playing outside in the morning or evenings can protect children from dehydration or heat exhaustion. Never leave a child in a parked car, even if the windows are open.
• Light clothing – Children should be dressed in light, loose-fitting clothes on extremely hot days. Breathable fabrics such as cotton are ideal because sweat can evaporate and cool down the child’s body.

How do I care for my infant during hot weather?

• Check your baby’s diaper for concentrated urine, which can be a sign of dehydration.
• If your infant is sweating, he or she is too warm. Remove him or her from the sun immediately and find a place for the baby to cool down.
• Avoid using a fan on or near your baby; it dehydrates them faster.
• A hat traps an infant’s body heat and should only be worn in the sun to avoid sunburn.
• Never leave an infant in a parked car, even if the windows are open.

Why are pregnant woman especially at risk during periods of extreme heat?

An increase in the core body temperature of a pregnant woman may affect the fetus, especially during the first trimester.

How can pregnant women protect themselves from the effects of extreme heat?

• Wear light loose fitting clothing
• Stay hydrated by drinking six to eight glasses of water a day
• Avoid caffeine, salt, and alcohol
• Balance fluids by drinking beverages with sodium and other electrolytes
• Limit midday excursions when temperatures are at their highest
• Call doctor or go to emergency room if woman feels dizzy, short of breath, or lightheaded

Wildfires expose children to a number of environmental hazards, e.g., fire, smoke, psychological conditions, and the byproducts of combustion. After a wildfire, children may be exposed to a different set of environmental hazards involving not only their homes, but also nearby structures, land, and recovery activities.

Wildfires and Smoke Impact on Children's Health

Children’s lungs are still growing and developing so they are especially vulnerable to wildfire smoke and ash. Tiny particles (PM2.5) in wildfire smoke can also affect the health of people who are expecting and other vulnerable groups.

Children who breathe in wildfire smoke may experience:

• Chest pain and tightness;
• Trouble breathing;
• Wheezing;
• Coughing;
• Burning in the nose, throat, and eyes;
• Dizziness;
• Or other symptoms, including longer term health impacts.

Wildfire smoke and ash can be particularly harmful to children with asthma, allergies, or other chronic health. Children are also more vulnerable to experiencing stress and mental health effects from disasters, including wildfires.

How to Protect Children During a Smoke Event

Reduce Outdoor Activities:

• Use AirNow to check your local air quality. If you are in an area with poor air quality, it may be best to stay inside. Wait until air quality improves before you are active outdoors.
• Children should stay and play indoors! During smoky times, reduce your child’s exposure by keeping them inside.
• If outside, wear a mask that will help protect from smoke. Cloth masks will not protect from wildfire smoke, but an N95 respirator mask or an equivalently rated mask can provide some protection if properly fitted for children.

Keep the Air in Your Home Clean:

• If you have central air, run your HVAC system. If you have a central air system in your home, use it to filter the air. Use high-efficiency filters (rated MERV-13 or higher) and replace the filters frequently. Learn about your system and use the appropriate settings (“Recirculate” and “On” rather than “Auto”). If your system has a fresh air option, close the intake.
• If you have a window air conditioner, close the outdoor air damper. Make sure that the seal between the air conditioner and the window is as tight as possible.
• Use a portable air cleaner. Use a portable air cleaner in one or more rooms. Run continuously with doors and windows closed. If you can't get a portable air cleaner, consider using a DIY Air Cleaner.
• Create and use a “clean air room”. Clean air rooms can help reduce your exposure to smoke while staying indoors.
• Keep your air space cool while windows are closed. Use air conditioners, heat pumps, fans, and window shades to keep your clean air space comfortably cool on hot days.
• Avoid activities that create pollution. Avoid activities such as frying foods, sweeping, vacuuming, cleaning with chemicals, and using gas, propane, or wood-burning stoves and furnaces.

Volcanic ash consists of tiny pieces of rock and glass that is spread over large areas by wind. During volcanic ash fall, people should take measures to avoid unnecessary exposure to airborne ash and gases.

Short-term exposure to ash usually does not cause significant health problems for the general public, but special precautions should be taken to protect susceptible people such as infants and children. Most volcanic gases such as carbon dioxide and hydrogen sulfide blow away quickly. Sulfur dioxide is an irritant volcanic gas that can cause the airways to narrow, especially in people with asthma. Precaution should be taken to ensure that children living close to the volcano or in low-lying areas (where gases may accumulate) are protected from respiratory and eye irritation.

While children face the same health problems from volcanic ash particles suspended in the air as adults (namely respiratory and irritation of the nose, throat, and eyes), they may be more vulnerable to exposure due to their smaller physical size, developing respiratory systems, and decreased ability to avoid unnecessary exposure. Small volcanic ash particles - those less than 10 micrometers in diameter - pose the greatest health concern because they can pass through the nose and throat and get deep into the lungs. This size range includes fine particles, with diameters less than 2.5 micrometers, and coarse particles, which range in size from 2.5 to 10 micrometers in diameter. Particles larger than 10 micrometers do not usually reach the lungs, but they can irritate your eyes, nose, and throat. The volcanic ash may exacerbate the symptoms of children suffering from existing respiratory illnesses such as asthma, cystic fibrosis, or tuberculosis.

Precautions for Children if Ash is Present

• Always pay attention to warnings and obey instructions from local authorities.
  • Check the Air Quality Index forecast for your area.
  • Stay alert to news reports about volcanic ash warnings.
• Keep children indoors.
  • Children should avoid running or strenuous activity during ash fall. Exertion leads to heavier breathing which can draw ash particles deeper into the lungs.
  • Parents may want to plan indoor games and activities that minimize activity when ash is present.
  • If your family must be outdoors when there is ash in the air, they should wear a disposable mask. If no disposable masks are available, make-shift masks can be made by moistening fabric such as handkerchiefs to help to block out large ash particles.
  • Volcanic ash can irritate the skin; long-sleeved shirts and long pants should be worn if children must go outdoors.
• Children should not play in areas where ash is deep or piled-up, especially if they are likely to roll or lie in the ash piles.
• Children should wear glasses instead of contact lens to avoid eye irritation.
• Create a “clean room” where children sleep and play to help to minimize exposure to ash in indoor air.
  • Keep windows and doors closed. Close any vents or air ducts (such as chimneys) that may allow ash to enter the house.
  • Run central air conditioners on the "recirculate" option (instead of "outdoor air intake"). Clean the air filter to allow good air flow indoors.
  • Avoid vacuuming as it will stir up ash and dust into the air.
  • Do not smoke or burn anything (tobacco, candles, incense) inside the home. This will create more indoor pollutants.
  • If it is too warm or difficult to breathe inside with the windows closed, seek shelter elsewhere.
• A portable room air filter may be effective to remove particles from the air.
  • Choosing to buy an air cleaner is ideally a decision that should be made before a smoke/ash emergency occurs. Going outside to locate an appropriate device during an emergency may be hazardous, and the devices may be in short supply.
  • An air cleaner with a HEPA filter, an electrostatic precipitator (ESP), or an ionizing air cleaner may be effective at removing air particles provided it is sized to filter two or three times the room air volume per hour.
  • Avoid ozone generators, personal air purifiers, "pure-air" generators and "super oxygen" purifiers as these devices emit ozone gas into the air at levels that can irritate airways and exacerbate existing respiratory conditions. These devices are also not effective at removing particles from the air.

School is back in session. As you stock up on pencils, take first-day pictures, and adjust to new bus schedules, take a few, quick steps that can keep your child safer during an emergency.

From tornadoes to water main breaks, emergencies can occur with little or no warning—even during the school day. As children head back to school, take a few steps to help protect your child from an emergency and to reunite with your child quickly and safely.

Protecting Your Child Is as Easy as A-B-C

Ask how you would be reunited with your child in an emergency or evacuation

• If students had to evacuate, where should you go to pick them up?
• How would the school notify you in the event of emergency?

Bring extra medication, special foods, or supplies your child would need if you were separated overnight

• What essential supplies would your child need if separated from you overnight? (Medications? Inhaler? Milk? Diapers? Battery pack for special equipment?)
• Does the school have an emergency stockpile of these items or could you bring extras to be kept at school?
• What is the school policy for how and when medicine can be administered to your child?

Complete a backpack contact information card and tuck one in your child’s backpack and your wallet

• Emergencies are chaotic! Make sure your child or their school knows how to reach you, and who should be called if your phone isn’t working.
• Download and complete your own backpack card.

Follow these A-B-C’s so that emergencies are less chaotic, children can be kept safe, and families can be reunited safely as soon as possible.

Separation from one’s family during or after an emergency can have mental and physical effects on children. The faster children reunite with the people they know and love, the better their outcomes will be.

What is Reunification?

Reunification is the process of ensuring that children return to the care of their parent(s) and family as quickly as possible after an emergency.

The vast majority of parents in the United States work outside the home. An estimated 69 million children in the United States are in school or child care on any given weekday. Emergencies increase the possibility for children to become separated from their parents or legal guardians. During the evacuation or sheltering process, parents may find that they are at work and their children are in child care, school, a recreational facility, or other location.

How to Reunite with Your Children

A family emergency plan will have important information, such as phone numbers, emergency contacts, and multiple meeting places. School and childcare centers will also have emergency plans in place to reunite children with their loved ones following an emergency.

Until families are reunited after an emergency, it is important to stay informed of emergency warnings and updates. Social media will play a key role in providing information, and children who use social media can use functions on Facebook, for example, to let their loved ones know they are safe.

It may be necessary to use additional reunification resources, such as the American Red Cross’ Reconnecting Families program, the National Center for Missing and Exploited Children’s 24-hour hotline, or FEMA’s information page for reunification systems.

Wake-up call from Hurricane Katrina

Following Hurricanes Katrina and Rita in 2005, the National Center for Missing and Exploited Children’s hotline for those events received over 34,000 calls. In addition, it took six months to reunify 5,192 missing children and their families. The worst storm in U.S. history forced more than 300,000 children to enroll in new schools around the country, sometimes very far from the communities they once knew.

As the National Commission on Children and Disasters, the Institute of Medicine, and other experts have noted, children “are not simply small adults,” and emergency management planning and policies must address their unique needs.

Emergencies or hazards

Emergencies or hazards may include the following:

• Earthquakes
• Extreme Heat
• Floods
• Hurricanes
• Landslides and Mudslides
• Tornadoes
• Tsunamis
• Volcanoes
• Wildfires
• Winter Weather
• Lightning
• Terrorist Acts

Importance of Planning

Emergencies can happen at any time and anywhere. On any given weekday, an estimated 69 million children are in school and child care, and they may be particularly vulnerable because they are away from their families. Schools, childcare facilities, and families can help keep children safe by having emergency preparedness plans in place.

For Schools

Emergencies can happen during the school day. Educators and school administrators play important roles in helping children stay safe before, during, and after emergencies. In addition to fire drills, many schools hold lockdown drills in response to the increasing number of school shootings. These drills, also known as shelter-in-place drills or active shooter drills, help students and staff practice staying safe in the event of a potential emergency, such as an armed intruder.

For Childcare Providers

Childcare providers play a vital role in keeping children safe. This is especially true in emergencies. It is important that childcare providers prepare and are ready to protect the children in their care. Many childcare facilities also have lockdown drills to protect children and adults in the event of an emergency. These procedures vary by state.

For Families

It is important that children know what to do in an emergency. Having a plan to reunite with family members is an important part of any emergency preparedness plan. Ask all family members, including children, to help make an emergency plan. Choose a meeting spot. Make emergency contact cards for children to carry in their school bag or backpack. Help older children memorize important names and phone numbers (parents, other trusted adult).

Parents and caretakers can learn about the school safety drills that are taking place in their child’s school or childcare facility from the school principal and safety officials.

Teachers and early care and education (ECE) providers have an important role to play in helping children both prepare for and recover after a public health emergency.

Public health emergencies and disasters affect millions of children worldwide each year. These emergencies and disasters include natural events (such as severe weather, earthquakes, fires, floods, and tsunamis) and man-made events (such as acts of terrorism). An emergency or disaster can be destructive to a child’s physical environment, as well as affect their mental health. As a teacher or ECE provider, you are committed to keeping schools and ECE programs safe and supporting children and their families. If your students experience an emergency or disaster, there are steps you can take to help your students cope and recover.

How can I help my students cope and continue to support their recovery from a disaster?

• Talk to children about what happened in a way they can understand. Keep it simple and appropriate for each child’s age. (Learn more about common reactions by age range)
• Provide children with opportunities to talk about what they went through or what they think about it. Encourage them to share concerns and ask questions. Younger children may draw pictures or may play with toys to express what they think and feel.
• Children react, in part, to what they see from the adults around them. When teachers deal with a disaster calmly and confidently, they can provide the best support for their students.
• Children who were directly exposed to a disaster can become upset again; behavior changes resulting from the event may be long lasting and can worsen or return if these children see or hear reminders of what happened. Be aware that that this could happen and know what resources are available at your school for children and families, should you need to report concerns to the appropriate people at your school.
• Proceeding with normal daily routines, such following familiar schedules when to eat and when to play, can help reduce stress. However, while recovering from disasters, children may have a hard time focusing on learning, they may need more time than usually to master new skills and concepts.

It is difficult to predict how some children will respond to disasters and traumatic events. Because parents, teachers, and other adults see children in different situations, it is important for them to work together to share information about how each child is coping after a traumatic event.

After a disaster, teachers and ECE providers may also be struggling with severe posttraumatic symptoms and personal losses. This might prevent them from effectively participating in post-disaster intervention for the children in their care. In this case, it is important that teachers and ECE providers take care of themselves first and seek help from a professional. CALL or TEXT Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Hotline: 1-800-985-5990; People with deafness or hearing loss can use their preferred relay service to call 1-800-985-5990.

Disasters are stressful events that can cause substantial harm to communities and families. After a disaster, children may develop symptoms of anxiety, depression, and post-traumatic stress disorder. Mental health plays an important role in physical health, school performance, behavior, and long-term quality of life. Therefore, it is important to keep children physically and mentally safe during and after a disaster.

Why are children at risk for mental health issues after a disaster?

Emotional stress from a disaster can be harder on children because they:

• Understand less about the situation;
• Feel less able to control events;
• Have less experience dealing with stressful situations; and
• May not be able to communicate their feelings, such as fear or anxiety.

In addition, children who have previously experienced trauma or have a pre-existing mental, emotional, developmental, or behavioral disorder can be particularly vulnerable before a disaster occurs. For example, children with autism, as well as infants and toddlers, may have difficulty communicating their thoughts and feelings. Parents and caregivers can take steps to help their children cope with traumatic events.

How can parents and caregivers help children cope with a disaster?

Before:

• Discuss plans for emergencies and include your child in creating emergency supply kits and emergency action plans.
• Have a plan to reunite with family members as children may be separated from their caregivers during an emergency. If family members cannot return to their home, having an alternative meeting location, such as a community center, can help them reunite after a disaster.
• Learn about safety drills taking place in your child’s school or early care and education facility from the administrators and safety officials. Since drills vary by state, you can also look on your state’s Department of Education web page. Talk with your child’s teacher or early care and education professionals about how to help your child see safety drills as empowering rather than frightening.

After:

• Answer your child’s questions truthfully in a way that they can understand. You can also correct misinformation about the event.
• Set an example for your child by managing your stress and returning to your normal routine and encouraging your child to do the same. Proceeding with your normal daily routine, such as eating meals as a family or returning to school and work, can help reduce stress.
• If your child’s routines and environment are disrupted, and if you and other caregivers are not able to provide the same consistent care as before, talk about the changes, how long they will last, and what you are doing to create routines and structures.
• Give your child opportunities to talk about what they went through, or what they think about it. Encourage your child to share concerns and ask questions.
• Allow your child to be with you or another trusted adult who can help your child feel safe and calm and give them a sense of hope. Children can handle disruptions in care better if they know they are temporary.
• Limit exposure to media coverage of the disaster and its aftermath. Children who are directly exposed to a disaster can become upset again if they see or hear reminders of what happened.
• Work with teachers and other adults, who see your child in different situations, to share information about how your child is coping.

When should parents and caregivers seek help from a professional?

Immediately after a disaster, children and adolescents may have these common emotional and behavioral reactions:

• Ages 1 to 5: Acting anxious, such as fear of being separated from caregiver or other new or increased fears, anger and frustration, unusual disobedience, withdrawing from others, less interest playing, and difficulty sleeping.
• Ages 6 to 10: Increased anxiety such as fear of returning to school or other new or increased fears, anger and frustration, unusual disobedience, withdrawing from others, less interest in playing, sleep problems, and difficulty concentrating on tasks.
• Ages 11 to 18: Rebellious behavior, antisocial behavior, increased anxiety and depression, sleep problems or excessive sleeping.

A child’s emotional reactions after a disaster can vary. Consider talking to your child’s healthcare professional if:

• Your child continues to be very upset (anxious, fearful, sad, angry) for more than 2 to 4 weeks after the disaster;
• Your child’s problems worsen instead of improve over time; or
• Your child’s reactions affect their behavior in early care and education settings, their schoolwork or relationships with friends or family for a prolonged period.

Helping a child cope with a disaster can be a challenge for parents. Any time you feel it is necessary, reach out for professional help and support for you and your child. CALL or TEXT Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Hotline: 1-800-985-5990; People with deafness or hearing loss can use their preferred relay service to call 1-800-985-5990.