Original Article

Assessing Disaster Preparedness Among Select Children’s Summer Camps in the United States and Canada

Authors: Megan Chang, MD, Alan Sielaff, MD, Stuart Bradin, DO, Kevin Walker, MD, Michael Ambrose, MD, Andrew Hashikawa, MD, MS


Objective: Children’s summer camps are at risk for multiple pediatric casualties during a disaster. The degree to which summer camps have instituted disaster preparedness is unknown. We assessed disaster preparedness among selected camps nationally for a range of disasters.

Methods: We partnered with a national, web-based electronic health records system to send camp leadership of 315 camp organizations a 14-question online survey of disaster preparedness. One response from each camp was selected in the following order of importance: owner, director, physician, nurse, medical technician, office staff, and other. The results were analyzed using descriptive statistics.

Results: A total of 181 camps responses were received, 169 of which were complete. Camp types were overnight (60%), day (21%), special/medical needs (14%), and other (5%). Survey respondents were directors (52%), nurses (14%), office staff (10%), physicians (5%), owners (5%), emergency medical technicians (2%), and other (12%). Almost 18% of camps were located >20 mi from a major medical center, and 36% were >5 mi from police/fire departments. Many camps were missing emergency supplies: car/booster seats for evacuation (68%), shelter (35%), vehicles for evacuation (26%), quarantine isolation areas (21%), or emergency supplies of extra water (20%) or food (17%). Plans were unavailable for the following: power outages (23%); lockdowns (15%); illness outbreaks (15%); tornadoes (11%); evacuation for fire, flood, or chemical spill (9%); and other severe weather (8%). Many camps did not have online emergency plans (53%), plans for children with special/medical needs (38%), methods to rapidly communicate information to parents (25%), or methods to identify children for evacuation/reunification with parents (40%). Respondents reported that staff participation in disaster drills varied for weather (58%), evacuations (46%), and lockdowns (36%). The majority (75%) of respondents had not collaborated with medical organizations for planning.

Conclusions: A substantial proportion of camps were missing critical components of disaster planning. Future interventions must focus on developing summer camp-specific disaster plans, increasing partnerships, and reassessing national disaster plans to include summer camp settings.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Ablah E, Tinius AM, Konda K. Pediatric emergency preparedness training: are we on a path toward national dissemination? J Trauma 2009;67(2 Suppl):S152-S158.
2. American Academy of Pediatrics. The youngest victims: disaster preparedness to meet children’ needs. https://www.aap.org/en-us/Documents/disasters_youngest_victims_disaster_preparedness.pdf. Accessed October 1, 2016.
3. Cicero MX, Baum CR. Pediatric disaster preparedness: best planning for the worst-case scenario. Pediatr Emerg Care 2008;24:478-481.
4. Ginter PM, Wingate MS, Rucks AC, et al. Creating a regional pediatric medical disaster preparedness network: imperative and issues. Matern Child Health J 2006;10:391-396.
5. Graham J, Shirm S, Liggen R, et al. Mass-casualty events at schools: a national preparedness survey. Pediatrics 2006;117:e8-e15.
6. Hohenhaus SM. Practical considerations for providing pediatric care in a mass casualty incident. Nurs Clin North Am 2005;40:523-533.
7. Markenson D, Redlener I. Pediatric terrorism preparedness national guidelines and recommendations: findings of an evidence-based consensus process. Biosecur Bioterror 2004;2:301-319.
8. Shirm S, Liggen R, Dick R, et al. Prehospital preparedness for pediatric mass-casualty events. Pediatrics 2007;120:e756-e761.
9. Burke RV, Iverson E, Goodhue CJ, et al. Disaster and mass casualty events in the pediatric population. Semin Pediatr Surg 2010;19:265-270.
10. Hamele M, Poss WB, Sweney J. Disaster preparedness, pediatric considerations in primary blast injury, chemical, and biological terrorism. World J Crit Care Med 2014;3:15-23.
11. Murray JS. Disaster care: public health emergencies and children. Am J Nurs 2009;109:28-31.
12. Hardin E. Disaster planning and management. Top Emerg Med 2002;24:71-76.
13. Garrett AL, Grant R, Madrid P, et al. Children and megadisasters: lessons learned in the new millennium. Adv Pediatr 2007;54:189-214.
14. American Camp Association. Camp trends: trend fact sheet. http://www.acacamps.org/press-room/aca-facts-trends. Accessed February 1, 2016.
15. Maag C, Bowley G. Tornado kills 4 in Iowa Boy Scout camp. http://www.nytimes.com/2008/06/12/us/13tornado.html. Published June 12, 2008. Accessed January 31, 2017.
16. KOAA. Summer camp evacuated due to Hayden Pass fire. http://www.koaa.com/story/32430529/crews-build-line-around-hayden-pass-fire. Published July 12, 2016. Accessed January 30, 2017.
17. Chacon DJ. Details of deadly flash flood that killed Boy Scout raise questions of oversight. http://www.santafenewmexican.com/news/local_news/details-of-deadly-flash-flood-that-killed-boy-scout-raise/article_ba4cd170-af60-5eb7-a7af-22f77c9a41b8.html. Published September 26, 2015. Accessed January 31, 2017.
18. Associated Press. Norwegian mass murderer Breivik makes Nazi salute at court. http://www.bostonherald.com/news/international/2017/01/norwegian_mass_murderer_breivik_makes_nazi_salute_at_court. Published January 10, 2017. Accessed February 2, 2017.
19. Landon J. Threats made against Jewish community centers around the country. http://www.fox2detroit.com/news/local-news/229941451-story. Published January 18, 2017. Accessed February 2, 2017.
20. Council on School Health, Walton EA, Tothy AS. Creating healthy camp experiences. Pediatrics 2011;127:794-799.
21. Olympia RP, Hollern K, Armstrong C, et al. Compliance of camps in the United States with guidelines for health and safety practices. Pediatr Emerg Care 2015;31:178-185.
22. American Camp Association. Standards-at-a-glance, 2012 edition. http://www.acacamps.org/sites/default/files/resource_library/accreditation/Revised%201_16%202016-Standards_at_a_Glance_.pdf. Updated January 2016. Accessed February 4, 2017.
23. American Camp Association. State laws & regulations. http://www.acacamps.org/resource-library/state-laws-regulations. Accessed February 4, 2017.
24. Martin SD, Bush AC, Lynch JA. A national survey of terrorism preparedness training among pediatric, family practice, and emergency medicine programs. Pediatrics 2006;118:e620-e626.
25. Olympia RP, Wan E, Avner JR. The preparedness of schools to respond to emergencies in children: a national survey of school nurses. Pediatrics 2005;116:e738-e745.
26. Olympia RP, Rivera R, Heverley S, et al. Natural disasters and mass-casualty events affecting children and families: a description of emergency preparedness and the role of the primary care physician. Clin Pediatr (Phila) 2010;49:686-698.
27. American College of Emergency Physicians. Emergency information form for children with special health care needs. https://www.acep.org/clinical---practice-management/emergency-information-form-for-children-with-special-health-care-needs. Accessed September 5, 2016.
28. Stamell EF, Foltin GL, Nadler EP. Lessons learned for pediatric disaster preparedness from September 11, 2001: New York City trauma centers. J Trauma 2009;67(2 Suppl):S84-S87.
29. Markenson D, Redlener I. Pediatric emergency preparedness for natural disasters, terrorism and public health emergencies. http://academiccommons.columbia.edu/catalog/ac:126146. Published March 2007. Accessed September 1, 2016.
30. Blake N, Stevenson K. Reunification: keeping families together in crisis. J Trauma 2009;67(2 Suppl):S147-S151.
31. Dolan MA, Krug SE. Pediatric disaster preparedness in the wake of Katrina: lessons to be learned. Clin Pediatr Emerg Med 2006;7:59-66.
32. Broughton DD, Allen EE, Hannemann RE, et al. Getting 5000 families back together: reuniting fractured families after a disaster: the role of the National Center for Missing & Exploited Children. Pediatrics 2006;117( 5 Pt 3 ):S442-S445.
33. UNICEF. Unaccompanied and separated children in the tsunami-affected countries: guiding principles. http://www.unicef.org/protection/Separated-20Children-20Guiding-20Principles-20Tsunami(1).pdf. Accessed September 26, 2016.
34. Allen GM, Parrillo SJ, Will J, et al. Principles of disaster planning for the pediatric population. Prehosp Disaster Med 2007;22:537-540.
35. American Academy of Pediatrics. Pediatric preparedness resource kit. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Children-and-Disasters/Pages/Pediatric-Preparedness-Resource-Kit.aspx?nfstatus=. Accessed September 5, 2016.
36. American Camp Association. Severe weather season is now year-round-preparing your camp. http://www.acacamps.org/resource-library/severe-weather-season-now-year-round-preparing-your-camp. Accessed September 5, 2016.
37. Save the Children. Disasters happen. It’ how we prepare for them that makes the difference. http://www.savethechildren.org/site/c.8rKLIXMGIpI4E/b.8777055/k.18AB/Get_Ready_Get_Safe_Plan_Ahead.htm. Accessed October 5, 2016.
38. American Red Cross. Resources for schools: how to prepare your school, staff and students for disasters and emergencies. http://www.redcross.org/get-help/prepare-for-emergencies/resources-for-schools#Tips-for-School. Accessed October 5, 2016.