Exercise your pediatric plans in an afternoon
Five ready-to-run, HSEEP-aligned tabletop exercises built for healthcare coalitions, hospitals and pediatric-serving organizations. Each kit is a complete package — scenario, slides, facilitator script, evaluation forms and after-action template — that a planner can localize and deliver in about three hours, virtually or in person.
Why tabletop, and why pediatric
Children make up 25% of the population and are a routine part of every mass-casualty, outbreak, evacuation, and reunification response — and an often overlooked one in the plans that govern those responses. A discussion-based tabletop is the fastest way to find out whether your coalition's and facilities' plans actually account for them.
What these exercises test
- Plan content and structure — whether coalition and member-organization plans include pediatric-specific considerations.
- Integration — how coalition-level strategies connect to facility procedures and local response partners.
- Gaps and opportunities — in pediatric planning, operational coordination and resource sharing.
How the discussion is framed
- No-fault environment. Plans, systems and processes are under evaluation — not people. Disagreement is expected.
- Existing assets only. Players respond with the plans, staff and resources they have today.
- Recommendations over issues. Naming a gap is useful; proposing the fix is the point.
- Plausible by assumption. Some scenario details are deliberately withheld to surface what a plan should cover.
How a kit works
Every kit follows the same three-hour structure and the same six-file sequence, so once your team has run one, the other four are familiar. Only the scenario, the module themes and the discussion questions change.
Read First — Overview and Instructions
Orientation to the kit, what must be customized, and the flow from preparation to after-action.
SitMan and Facilitator Guide
The backbone document: objectives, roles, structure, slide-by-slide script, scenario injects and breakout questions. Restricted to Facilitators and Evaluators.
Host and Facilitator Slides
Agenda, schedule, breakout instructions, injects, module question slides and hotwash prompts. What players see during the exercise.
Participant Placemat
One page: agenda, objectives, scenario summary and breakout table. Sent to players in advance so they arrive prepared. Includes print specs.
Evaluator Guide and Observation Form
Role guidance and forms to record strengths, gaps, challenges and "not discussed." Electronic entry encouraged.
After-Action Report (AAR) and Improvement Plan (IP) Template
After-Action Report and Improvement Plan: objectives, findings and corrective actions with assigned owners and due dates.
Host
Runs the room and the clock — slides, breakout timing, technical setup and troubleshooting, especially in virtual delivery.
Facilitator
One per breakout. Keeps discussion on the objectives, draws in quiet voices, keeps a "parking lot." Ideally the facility Emergency Manager or plan owner.
Evaluator
Observes each breakout and completes the Observation Form. Should know the existing plans for the focus area.
Player
Anyone with an active role in the response — clinical, operations, EMS, public health, school and coalition partners.
Scribe (optional)
Captures report-out notes so the Facilitator can stay focused on guiding the discussion. Worth assigning for larger groups.
The five kits
Each addresses one focus area where pediatric needs most often diverge from adult planning. All five share the same three objectives and the same structure; each has its own fictional scenario, module themes and breakout questions. Scenarios assume the incident affects only your local area.
Triage and Decontamination
A school bus crash beside an industrial zone leaks a chemical compound. Symptomatic children self-evacuate to nearby facilities with minimal triage; hospitals receive patients without complete field decon while parents insist on staying with them; delayed-onset symptoms then demand regional tracking and follow-up.
Response Coordination · Medical Surge · Information Sharing
Aligning pediatric triage protocols across EMS and hospitals, sharing tag and status data, and prioritizing children with pre-existing needs when field decon status is unclear.
Surge decon with modesty, parental accompaniment and trauma-informed care; contaminated pediatric equipment; small-PPE and warming supplies; regional mutual support.
Tracking exposed children for delayed symptoms, behavioral health and risk communication to families, pediatric antidotes, and shared after-action review across EMS, public health and hospitals.
Pediatric Trauma Surge
A charter bus with 45 middle-school students rolls down a rural embankment with limited cell service, distant EMS and helicopters grounded by weather. Dozens of pediatric trauma patients hit hospitals that quickly reach capacity, while parents and media converge on emergency departments.
Response Coordination · Medical Surge · Information Sharing
Notification and activation triggers for pediatric trauma events, capacity assessment, coalition communication platforms and redundancy for PIOs and trauma coordinators.
Field and facility triage systems, patient distribution and diversion decisions, pediatric trauma equipment, ED throughput, OR and imaging capacity, and triggers for mutual aid.
Psychological trauma and staff support, scene-to-disposition tracking and reunification, children with special needs, school and bus-company coordination, security, and fatality management.
Patient Tracking and Reunification
A mass-injury event on a school field trip sends unaccompanied children — some without identification, some unable to communicate — to multiple facilities. Media names the hospitals, families flood phone lines and lobbies, and reunification sites must open across several coalition members at once.
Response Coordination · Medical Surge · Information Sharing
Regional systems and agreements for tracking across facilities, shared tools for unaccompanied minors, and accounting for non-verbal, medically complex and neurodiverse children.
Coordinated family messaging, shared call-center staffing, aligned social media and school outreach, and the legal and privacy agreements that let partners verify families fast.
Pediatric Safe Areas and Family Reunification Centers, activation and staffing, custodial-release verification, language access, and mental-health and comfort resources on site.
Evacuation and Patient Transport
Severe weather damages infrastructure across a suburban and rural region and forces at least one hospital into full evacuation. Debris and weather delay ambulances, patients wait in staging, and pediatric patients arriving at partner facilities need continuity of care, tracking and family support.
Response Coordination · Continuity of Health Care Service Delivery · Information Sharing
Decision triggers across member facilities, prioritizing critical pediatric patients, real-time pediatric bed availability, and activating transport agreements and mutual aid.
Pediatric evacuation equipment and transport assets, ambulance availability and staging management, alternate holding strategies, and situational awareness of delays and surge impacts.
Unaccompanied minors and behavioral health during evacuation, cross-facility tracking tools, coordination with public health and emergency management, transport security, and lessons learned.
Infection Control and Surge
Clusters of a novel pediatric respiratory illness push ED visits up 150% and facilities toward capacity. Non-clinical areas are repurposed as PPE, pediatric medications and respiratory support run critically low; by Module 3 facilities are operating above 300% capacity with pediatric ICU, surgical and behavioral health resources under severe strain.
Response Coordination · Medical Surge · Information Sharing
Surge-plan triggers during outbreaks, triage when isolation needs differ by facility, just-in-time pediatric infection-control training, and telehealth or specialty consultation.
Sharing pediatric PPE, medications and equipment; infection control in non-traditional spaces; alternate care sites and decompression; decontaminating reusable pediatric equipment; supply thresholds and MOUs.
Emergency credentialing and staffing, cohorting and PPE for surge-area staff, support for behavioral-health and neurodiverse patients, subspecialty resources, and cross-facility after-action review.
Getting started
The kits are designed for minimal preparation. Here is the shortest path for a team running its first tabletop, and what experienced exercise programs tend to change.
Running your first kit
- Pick the focus area that matches a known gap, a high-risk hazard or a recent incident. Download the kit.
- Read File 1, then File 2 end to end. Get leadership commitment to support and take part.
- Fill in the must-customize fields: exercise name, date, time, location and controller contact — in the SitMan, slides, placemat and AAR/IP.
- Name a Facilitator and an Evaluator for each breakout group (and a Scribe for larger groups). Brief them from Files 2 and 5.
- Send the placemat (File 4) to players in advance.
- Run the slides. Keep the timings; keep the no-fault tone.
- Hold the hotwash, collect observation forms, and complete the AAR/IP (File 6) with owners and due dates.
Leave the scenario, objectives and questions as written the first time through. Validated content lets you concentrate on facilitation.
If you already run exercises
- Rewrite objectives to the capabilities and plans you need to validate this cycle — keep them measurable.
- Localize injects: swap hazards, locations and constraints to mirror regional risk, staying within the same hazard family.
- Swap in facility-specific discussion questions or add slides; update the Evaluator Guide to match any changes.
- Adjust module timing, add report-outs between modules, or run breakouts by role instead of facility.
- Add locally relevant evaluation topics to the Observation Form; use your own AAR/IP format if preferred.
- Brand the placemat and slides with your coalition's logo.
- Link findings to your multi-year training and exercise plan so the next drill picks up the same corrective actions.
Shifting a scenario to a different hazard family tends to invalidate the discussion questions and Evaluator forms. If a change needs new questions, update the slides and Evaluator Guide together.
Program alignment. The kits follow HSEEP 2020 doctrine for program management, design and development, conduct, evaluation and improvement planning, and map to the Health Care Preparedness and Response Capabilities for Health Care Coalitions (Response mission area; Public Health, Healthcare and EMS core capability).
Developed by the Western Regional Alliance for Pediatric Emergency Management (WRAP-EM) with Emergency Preparedness Solutions, LLC. Development of these materials was supported by the U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response, under award number 6 U3REP190616. The content is solely the responsibility of the authors and does not necessarily represent the official views of HHS ASPR.