On Monday, April 28, a widespread power outage (“blackout”) occurred across the entire peninsular territory, affecting nearly 50 million people and creating an unprec­edented situation in our country.

The frequency of similar events—considered disas­ters (“an unfortunate event that severely disrupts the normal order of things,” according to the Royal Spanish Academy)—has increased in recent times, highlighting the need for effective planning strategies in emergency services. An adequate response is crucial to mitigate their impact^(1,2).

Electricity is a critical resource in hospitals. All medical devices, diagnostic equipment, communications, lighting, climate control, elevators, and information systems cease to function when the power grid fails⁽³⁾. Although gener­ators automatically activate in the event of an outage to ensure continuity of emergency care, a prolonged electri­cal failure can compromise the function of medical equip­ment, including essential devices on which the survival of some patients depends (Figure 1). For this reason, the proven vulnerability of the energy infrastructure—and the possibility of power disruptions—makes its proper man­agement an essential component of disaster plans⁽³⁾.

The literature suggests that the level of disaster pre­paredness is largely determined by available human re­sources⁽¹⁾. Although the World Health Organization’s Hospital Safety Index (HSI) provides a standardized and internationally accepted checklist to evaluate hos­pital readiness, no comprehensive or legally regulated tool exists to formally assess hospital preparedness for disasters⁽¹⁾.

From the Disaster Working Group of the Spanish So­ciety of Pediatric Emergency Care (SEUP), we believe that the experience of Pediatric Emergency Departments (PEDs) during the blackout—through the detection of shortcomings in their disaster plans—represents an import­ant opportunity to assess their preparedness. Reviewing plans and managing both material and human resources may reveal potential areas for improvement, and strength­ening these aspects can lead to a more effective response during catastrophic events⁽⁴⁾.

We encourage PEDs to use this experience to imple­ment new plans and/or review existing ones, paying spe­cial attention to the various challenges they faced on the day of the blackout: contingency plans, alternative com­munication systems when regular phone networks fail, alternatives for internal patient transport when elevators stop working, staff mobilization, and more. In reviewing disaster plans, the publication “Actuación ante un desas­tre. Guía de elaboración de un Plan de Catástrofes externas para los Servicios de Urgencias Pediátricas” (available at https://seup.org/pdf_public/gt/Catastrofe_2.pdf), devel­oped by the SEUP Disaster Working Group, may serve as a useful tool.

The blackout of April 28 demonstrated the fragility and dependence of our infrastructures, even in highly prepared environments such as PEDs. Therefore, we must use this ex­perience to revise plans and strengthen the physical resourc­es needed to successfully face future disaster scenarios.

References

1. Parra Cotanda C, Rodrigo García R. Impact of a guide for developing an external disaster plan in pediatric emergency departments. An Pediatr (Barc). 2020;92(6):367–8. Available from: https://doi.org/10.1016/j.anpedi.2019.09.004
2. Murphy JP, Bergström C, Gyllencruetz L. Rural hospital inci­dent command leaders’ perceptions of disaster prepared­ness. BMC Emerg Med. 2025;25:12. Available from: https://doi.org/10.1186/s12873-025-01201-3
3. Munasinghe NL, O’Reilly G, Cameron P. Establishing the do­mains of a hospital disaster preparedness evaluation tool: a systematic review. Prehosp Disaster Med. 2022;37(5):674–86. Available from: https://doi.org/10.1017/S1049023X22001212
4. Beyramijam M, Farrokhi M, Ebadi A, Masoumi G, Khankeh HR. Disaster preparedness in emergency medical service agen­cies: a systematic review. J Educ Health Promot. 2021;10:1280. Available from: https://doi.org/10.4103/jehp.jehp_1280_20