盡管近期一項(xiàng)調(diào)查顯示現(xiàn)在已經(jīng)有越來(lái)越多的麻醉學(xué)住院醫(yī)師培訓(xùn)項(xiàng)目包含了治療大規(guī)模殺傷性武器（weapons of mass destruction）受害者的必需培訓(xùn)項(xiàng)目，但是所有培訓(xùn)項(xiàng)目都應(yīng)當(dāng)提供大規(guī)模殺傷性武器的相關(guān)培訓(xùn)。

在美國(guó)135個(gè)麻醉學(xué)住院醫(yī)師培訓(xùn)項(xiàng)目中，有90個(gè)已經(jīng)做出了積極響應(yīng)。其中37％有正式的大規(guī)模殺傷性武器培訓(xùn)項(xiàng)目，42％將其做為必需培訓(xùn)項(xiàng)目。這些培訓(xùn)項(xiàng)目集中在密西西比河?xùn)|部，所有培訓(xùn)項(xiàng)目都開(kāi)始于2001年紐約911恐怖襲擊之后。2004年10月在美國(guó)拉斯維加斯舉行的美國(guó)麻醉醫(yī)師年會(huì)上公布了調(diào)查結(jié)果。

邁阿密大學(xué)麻醉學(xué)和內(nèi)科學(xué)助理教授Keith A. Candiotti醫(yī)學(xué)博士進(jìn)行了這項(xiàng)調(diào)查，他說(shuō)：“盡管培訓(xùn)麻醉學(xué)工作人員處理大規(guī)模殺傷性武器的項(xiàng)目明顯增加，由于現(xiàn)實(shí)的威脅，要在所有麻醉學(xué)項(xiàng)目中提供這種類型的培訓(xùn)看起來(lái)仍然需要謹(jǐn)慎樂(lè)觀。”

在許多大規(guī)模傷亡處理模型中，從患者被送到醫(yī)院開(kāi)始，就由麻醉科工作人員負(fù)責(zé)處理。而如果醫(yī)院沒(méi)有一個(gè)健全的患者-處理系統(tǒng)來(lái)確保對(duì)患者進(jìn)行消除污染處理，或者沒(méi)有防護(hù)服，醫(yī)護(hù)人員就將直接暴露于毒性物質(zhì)的威脅之下。

Candiotte博士說(shuō)：“即使這種恐怖事件相當(dāng)罕見(jiàn)，但是一旦真的發(fā)生了，這些事件能夠迅速摧毀現(xiàn)有的醫(yī)療設(shè)施。如果沒(méi)有充分準(zhǔn)備，醫(yī)療工作者將成為大規(guī)模殺傷性武器的犧牲品。為了做好充分準(zhǔn)備，相關(guān)教育和培訓(xùn)是十分必要的。”根據(jù)Candiotti博士的說(shuō)法，理想的大規(guī)模殺傷性武器擴(kuò)大培訓(xùn)項(xiàng)目清單包括：患者-處理方案、配備沖淋設(shè)施的消毒隔離區(qū)、配備呼吸設(shè)備的化學(xué)防護(hù)服、以及儲(chǔ)備足夠數(shù)量的治療大規(guī)模殺傷性武器損傷的抗生素和藥物。

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.