美国：所有麻醉医师都急需进行大规模杀伤性武器的相关培训

尽管近期一项调查显示现在已经有越来越多的麻醉学住院医师培训项目包含了治疗大规模杀伤性武器（weapons of mass destruction）受害者的必需培训项目，但是所有培训项目都应当提供大规模杀伤性武器的相关培训。

在美国135个麻醉学住院医师培训项目中，有90个已经做出了积极响应。其中37％有正式的大规模杀伤性武器培训项目，42％将其做为必需培训项目。这些培训项目集中在密西西比河东部，所有培训项目都开始于2001年纽约911恐怖袭击之后。2004年10月在美国拉斯维加斯举行的美国麻醉医师年会上公布了调查结果。

迈阿密大学麻醉学和内科学助理教授Keith A. Candiotti医学博士进行了这项调查，他说：“尽管培训麻醉学工作人员处理大规模杀伤性武器的项目明显增加，由于现实的威胁，要在所有麻醉学项目中提供这种类型的培训看起来仍然需要谨慎乐观。”

在许多大规模伤亡处理模型中，从患者被送到医院开始，就由麻醉科工作人员负责处理。而如果医院没有一个健全的患者-处理系统来确保对患者进行消除污染处理，或者没有防护服，医护人员就将直接暴露于毒性物质的威胁之下。

Candiotte博士说：“即使这种恐怖事件相当罕见，但是一旦真的发生了，这些事件能够迅速摧毁现有的医疗设施。如果没有充分准备，医疗工作者将成为大规模杀伤性武器的牺牲品。为了做好充分准备，相关教育和培训是十分必要的。”根据Candiotti博士的说法，理想的大规模杀伤性武器扩大培训项目清单包括：患者-处理方案、配备冲淋设施的消毒隔离区、配备呼吸设备的化学防护服、以及储备足够数量的治疗大规模杀伤性武器损伤的抗生素和药物。

WMD Training Urged for All Anesthesiologists

Although a recent poll has shown that more anesthesiology residency programs now have mandatory training in treating victims of weapons of mass destruction (WMD), all programs are being urged to offer WMD training.

Of the 135 anesthesiology residency programs in the United States, 90 responded. Of these, 37% had a formal WMD training program and 42% of those made the training mandatory. The training programs were concentrated east of the Mississippi River, and all programs began their training after the terrorist attack on New York on September 11, 2001. The findings of the poll were presented at the annual meeting of the American Society of Anesthesiologists in Las Vegas (NV, USA) in October 2004.

“While there has been a marked increase in the training of anesthesiology personnel to deal with WMD, due to the apparent threat, it seems prudent to have this type of training available in all anesthesiology programs,?stated Keith A. Candiotti, M.D., assistant professor of anesthesiology and internal medicine, University of Miami (FL, USA), who conducted the poll.

In many models of mass casualty management, anesthesia personnel are responsible for treating patients immediately on arrival at the hospital. If the hospital does not have a patient-management system that ensures decontamination or protective gear for doctors to wear, they can be exposed to toxic substances.

“Even though such terrorist events are rare, when they do occur they can rapidly overwhelm the existing medical services,?noted Dr. Candiotti. Healthcare workers may fall victim to WMD if they are not adequately prepared. For better preparation, improvements in education and training are needed.?The ideal checklist for expanding WMD programs includes a patient-management program, a decontamination area with shower facilities, chemical protective gear with a breathing device, and a stockpile of antibiotics and medications to treat WMD exposure, according to Dr. Candiotti.