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The public health system has a specialized body of knowledge and expertise in bioterrorism and public health emergency management that can assist in the development and delivery of continuing medical education (CME) programs to meet the needs of emergency medical services (EMS) providers.
Methods:
A nationally representative sample of the basic and paramedic EMS providers in the United States was surveyed to assess whether they had received training in weapons of mass destruction, bioterrorism, chemical terrorism, radiological terrorism, and/or public health emergencies, and how the training was provided.
Results:
Local health departments provided little in the way of training in biologic, chemical, or radiological terrorism to responders (7.4%–14.9%). State health departments provided even less training (6.3%–17.3%) on all topics to EMS providers. Training provided by the health department in bioterrorism and public health emergency response was associated with responder comfort in responding to a bioterrorism event (OR = 2.74,95% CI 2.68,2.81).
Conclusions:
Local and state public health agencies should work with the emergency medical services systems to develop and deliver training with an all-hazards approach to disasters and other public health emergencies.
The possibility of natural disasters and public health emergencies, coupled with the possibility of terrorism, support the need to incorporate emergency preparedness into the curricula for every health professional school.
Methods:
A survey methodology was employed to assess attitudes toward and knowledge of emergency preparedness among health profession students including schools of medicine, nursing, dentistry, and public health. The survey was targeted to graduating students, administered prior to the institution of an emergency preparedness curriculum, and then repeated as an annual survey.
Results:
The survey found that 51.8% had been present at a disaster site as non-responders, while only 12.1% ever had been present as a responder. With regard to baseline class room exposure, >50% reported no exposure to such key concepts as incident command, triage, all-hazards planning, surge, and aspects of terrorism. In addition, at the baseline, most students felt they had no competency in emergency preparedness. For example, only 10% of students felt competent with personal protective equipment. While exposure both as a responder and student was low, 82.5% of students felt that emergency preparedness should be a mandatory topic in their education. Lastly, with a minimal curriculum change students showed statistically significant increases on knowledge testing.
Conclusions:
While exposure was low for emergency preparedness topics and most did not recognize how information they had been taught might be applicable to emergency preparedness, there was a strong desire for additional training. In addition, simple curricular adjustments can lead to significant improvements in knowledge.
After the Genoa Summit of 2001 in Italy, when one protestor was killed while demonstrating, “retreat method” summits became predominant. The Windsor Hotel, located on a mountain next to Lake Toya in Hokkaido, Japan was selected to host the G8 summit in 2008.
Methods:
The G8 Hokkaido-Lake Toya Summit was held 07–09 July 2008. Emergency medical services and systems were constructed. The Japanese Ministry of Health, Labour and Welfare developed a plan for emergency medical services and preparedness in response to potential nuclear, biological, or chemical terrorist attacks.
Results:
The Windsor Hotel is located 75 kilometers from Sapporo, where there are four Level-1 treatment areas in four hospitals. In the Windsor Hotel, O-type (Rh -) blood was prepared for foreign guests. Four helicopters were on standby near the Windsor Hotel for emergency transportation. One Mobile Intensive Care Unit car was located near the foothill for the provision of emergency treatment. The expert medical team of the Windsor Hotel was present in the hotel's medical office. More than 200 doctors with disaster and emergency expertise were commissioned to the summit. During the summit, 68 patients were treated, including one patient who was transferred to Sapporo by helicopter.
Conclusions:
An emergency medical system was established for the G8 Hokkaido-Lake Toya Summit with the collaboration of many organizations.
The response to incidents with chemical and radioactive substances has been shaped primarily by firefighters' experiences with hazardous material (HAZMAT) accidents. Globally, HAZMAT tactics consist of the main elements of: (1) appropriate use of personal protective equipment; and (2) cordons regulating access into and egress from designated zones. Detection and casualty decontamination are far less uniformly organized.
Methods:
Review and analysis of open-source (medical-and first responder-oriented) English and German Ianguage literature; informal questionnaire survey of first responders in several European countries.
Results:
The initial on-scene measures during a HAZMAT response—cordoning off the scene and rescue out of the contaminated area—are done uniformly by fire service responders. In most cases, emergency decontamination of casualties at the scene (disrobing and flushing), is performed by firefighters, however, reliability appears variable. The probability of a coordinated patient handover from fire personnel to emergency medical services (EMS) staff is rated “low” by most sources.
In many countries, specialized casualty decontamination units have been commissioned and are operated by a variety of services: fire, EMS, military and civil protection.
Hospital decontamination facilities are in most countries still the exception and depend mosdy on local commitment. Substantial detection usually invalues only simple measurements performed by the first responders; specialized support is planned to be given mainly by military, civil protection and specialized laboratories.
Conclusions:
Initial on-scene response to chemical/radiological incidents is fundamentally similar in most countries. However, distinctive differences beyond the first steps restrict the transferability of organizational solutions.