An Emergency of Unpreparedness; First Responders Lack Training in Responding to terrorism.(OPED)

Article excerpt


Tommy Thompson, secretary of Health and Human Services, recently assured Americans they are much safer from a bioterrorism attack than they were a year ago, saying that training of hospital emergency responders is the "centerpiece" of his efforts.

His intentions are well-placed, and emergency physicians are dedicated to the safety of our patients and to being prepared for medical emergencies. However, the nation still does not have a training program for emergency physicians and nurses to detect and treat biologic agents. This is especially troubling when, as we witnessed on September 11 and during the anthrax attacks last fall, the place people most likely will go after a biologic, chemical or nuclear attack is a local emergency department.

Billions of federal dollars have been spent to improve the nation's response to terrorism, including creation of a new department to coordinate activities. Yet, not one dollar has been designated by the federal government for a program to train emergency physicians and nurses to detect and treat biologic agents.

This is because there are serious flaws in our understanding of what is needed to effectively respond to medical emergencies from biologic agents. Part of the problem may be that many of the nation's policy-makers still do not recognize the role of emergency physicians and nurses in disasters.

Clearly, emergency physicians and nurses have joined prehospital providers as first responders, especially in biologic attacks. This was demonstrated when nine of the 11 recent inhalation anthrax patients became seriously ill and drove themselves - bypassing EMS or other first responders - to an emergency department where they were diagnosed and treated.

Quick detection and treatment - as well as quarantine of patients infected with highly contagious agents such as smallpox - clearly will be essential to preventing mass casualties. Yet most emergency physicians and nurses are not currently trained to detect and treat biologic agents or even to protect themselves. Bioterrorism training has not been incorporated into the curriculum for medical students and residents, and the nation's 35,000 emergency physicians are not receiving regular training through their annual continuing medical education courses.

To save lives in a bioterrorist attack, emergency physicians and nurses must be trained to detect, triage and treat biologic agents, including those that are weaponized and act differently from those occurring in nature. …