Psychological EMS a Plausible, (developmental immaturity, normal dependence on adult caregivers who might be injured or dead), or be reunited with families Less effective coping skill of Child psychiatry children who suffer injury involvement, cognitive or witness parental, therapy, research for sibling death preventing pediatric (psychological posttraumatic stress immaturity) disorder a Greater anxiety over Pediatric counseling of reported incidents, parents and children a hoaxes, media coverage, etc Less capacity to cope with Community and regional influx of critical pediatric planning with significant patients, loss of routine pediatric input hospital transfer protocols, limited ability to expand pediatric hospital bed capacity through NDMS, inappropriately sized equipment for young children but unproven or unstudied, and/or not intuitively obvious EMS, emergency medical services; NDMS, national disaster medical system Adapted from Henretig FM, Cieslak TJ, Eitzen EM Jr Biological and chemical terrorism J Pediatr 2002;141:311–326 Copyright © 2002 Elsevier With permission TABLE 132.3A CLINICAL FEATURES OF BIOLOGIC AGENTS OF TERRORISM Specialized laboratory services would likely be required to rapidly identify biologic agents or confirm a diagnosis of disease caused by them Further, work with most of these agents is very hazardous As such, a national Laboratory Response Network (LRN) has been established to facilitate the timely detection of bioterrorism-related diseases This network involves laboratories at local, state, and federal levels The latter include the CDC and the U.S Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick in Frederick, Maryland If pediatric emergency care providers suspect such an illness, they should immediately inform their hospital microbiology laboratory and infection control office as well as the local public health departments, to effect prompt notification and transport of specimens to the appropriate laboratory TABLE 132.3B TREATMENT OF BIOLOGIC AGENTS OF TERRORISM ... Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick in Frederick, Maryland If pediatric emergency care providers suspect such an illness, they should immediately inform their hospital