由反恐任务而引发对急救护理的思考

进入二十一世纪以来,全世界范围的恐怖活动愈演愈烈,目前全世界医疗急救机构都在着重探讨恐怖袭击后的院前急救工作。武警部队担负着处突、反恐的重任,为配合部队中心任务的完成,我们必须针对目前恐怖袭击的特点和伤情规律,有计划地做好平时的急救训练,切实提高护理人员在遇有恐怖袭击事件时的战地救护能力。     

恐怖活动特点及反恐行动卫勤保障模式探讨

近年来 ,恐怖分子频繁制造骇人听闻和震惊世界的恐怖袭击事件 ,对世界和平与人类安全构成了严重威胁。针对恐怖活动的特点及反恐应急行动中的卫勤保障工作 ,作者进行了初步探讨。1　恐怖活动的特点1 1　突发性　因恐怖势力相对弱小 ,恐怖活动筹划十分隐蔽 ,因此 ,恐怖袭击活动多在人们无法预测的时间突然发生。1 2　随意性　一般恐怖活动往往没有特定的袭击目标 ,随意性很大 ,但多数袭击目标集中于大城市、重要建筑和军用设施。1 3　高技术性　恐怖组织具有一些高科技成员 ,专门从事培训和袭击目标的策划 ,并提供各种支持和帮助。恐怖组织已…     

急救医疗在恐怖袭击事件发生时展开救援的思考与建议

急诊医疗服务体系(Emergency medical service system,EMSS)的任务,除急诊伤病员的院前院内救治等日常工作以外,还要有应对一些如恐怖袭击等特殊突发事件的急救能力。并保证这支应急队伍具备招之即来、组织有序、全能高效的综合应变能力。1院前急救与反恐怖袭击目前恐怖袭击活动在世界各地时有发生,美国的国家反恐中心统计,2004年全球各地共发生了3 192起恐怖活动,造成6 060人死亡,受害者总人数接近3万。而且随着国际局事和关系的变化,恐怖袭击事件较之以其它形式的暴力活动所导致的人员伤亡表现得更为突出。如美国的9·11事件、日本沙林…     

恐怖袭击应急医学救援的回顾与思考

“9·11”事件后10年来的反恐斗争再次充分表明,恐怖主义是当前的全球性问题和国际公害,反恐应急救援同样是涉及世界各国安危和切身利益的重大课题.本文介绍了当前国际恐怖活动的新特点,提出了恐怖袭击应急医学救援对策的进一步思考和待开展的研究内容.后者包括:进一步完善高效的医疗救援指挥机构;完善各种医疗救援应急预案;完善不同类型恐怖袭击的救援体系和救援基地;进一步提高全民反恐意识,重视心理灾害预防及其对策;进一步开展恐怖袭击应急医学救援的基础研究,如恐怖袭击致伤的新伤类新特点研究、恐怖袭击应激心理效应的病理生理学及防治研究,以及恐怖袭击现场的高效救治措施和新型装备研究等.     

城市维稳卫勤保障伤员救治的难点与对策

随着恐怖活动的逐渐增多,城市已成为恐怖袭击的主要目标。虽然恐怖活动的政治目的、袭击方式、暴力手段各不相同,但恐怖活动发生时造成的大量人员伤亡已引起国际社会的普遍关注。城市各类医疗救治机构在城市维稳中的主要任     

核恐怖袭击人员损伤特点与医学防护

当今和未来社会,核恐怖袭击事件可能严重危害民众的日常生活和工作,影响民众的身心健康和社会治安。各国政府已积极组织起来打击核恐怖袭击事件,我国政府对此亦高度重视。为使人们更好地认识和防范可能发生的核恐怖袭击事件,本文就核恐怖袭击事件杀伤因素的致伤作用、伤类分布和综合杀伤范围、医学防护和现场综合救治等方面进行探讨。     

恐怖活动动力学建模研究进展

采用数学和计算机建模研究恐怖活动是近几年关于恐怖活动研究的热点之一.本文介绍了3种常见的恐怖活动建模方法,并探讨了模型构建中所需关注的主要问题.     

爆炸恐怖袭击与应急医学救援

在各种恐怖活动中,爆炸恐怖最为多见。本文介绍了当今国际爆炸恐怖袭击的现状及我国面临的现实威胁,系统阐述了爆炸恐怖袭击的种类、所致损伤的伤类伤情特点、爆炸现场伤员的紧急救治原则与内容、掩埋伤员的搜寻与挖掘、伤员的搬运与医学后送及其特殊要求。     

卫生防疫在处置突发事件中的重要性及措施

自9.11事件以来,恐怖袭击事件时有发生,未来高技术局部战争及突发事件中传统的保障方式将受到严峻的挑战.因此,研究和探讨未来高技术局部战争及突发事件中卫生防疫保障及控制传染病的重要性及措施,加强卫生防疫准备,提高卫生防疫综合保障能力,具有重要的现实意义.     

生物恐怖威胁特点及医学防御对策

2001年发生于美国的炭疽芽孢邮件事件引起了人们对生物战剂恐怖威胁的关注，也对生物恐怖剂的医学防范和流行病学的科学认识提出了挑战，因此，公共健康和医学工作者迫切需要了解生物恐怖袭击引起损害的预防和治疗措施。本文介绍了生物恐怖的概念、特点、恐怖活动可能使用的生物战剂清单，以及炭疽杆菌、鼠疫耶尔森菌、天花病毒、出血热病毒、肉毒毒素等A类生物战剂的致病特征以及医学防护对策。     

The Omagh bombing--a medical perspective

The bomb in Omagh on the 15th August 1998 was responsible for the largest loss of life of any single terrorist incident in the whole of the "Troubles" in Northern Ireland. However, the medical response to this tragedy provided an excellent opportunity for the civilian and military agencies to work together. As a consequence of this a number of lessons were drawn which are presented in the paper. Whatever the outcome of the peace process these lessons will have an important role in the future, since history would suggest that there is little possibility of the terrorist threat ever completely.     

Chemical terrorism for the intensivist

The use of chemical agents for terrorist attacks or military warfare is a major concern at the present time. Chemical agents can cause significant morbidity, are relatively inexpensive, and are easy to store and use. Weaponization of chemical agents is only limited by the physicochemical properties of some agents. Recent incidents involving toxic industrial chemicals and chemical terrorist attacks indicate that critical care services are frequently utilized. For obvious reasons, the critical care literature on chemical terrorism is scarce. This article reviews the clinical aspects of diagnosing and treating victims of chemical terrorism while emphasizing the critical care management. The intensivist needs to be familiar with the chemical agents that could be used in a terrorist attack. The military classification divides agents into lung agents, blood agents, vesicants, and nerve agents. Supportive critical care is the cornerstone of treatment for most casualties, and dramatic recovery can occur in many cases. Specific antidotes are available for some agents, but even without the antidote, aggressive intensive care support can lead to favorable outcome in many cases. Critical care and emergency services can be overwhelmed by a terrorist attack as many exposed but not ill will seek care.     

Effect of September 11th terrorist attacks on the self-reported health status of Department of Defense health care beneficiaries

This study examined the changes in the self-reported health status of Department of Defense health care beneficiaries associated with the September 11th terrorist attacks. Responses to a single-item, general health measure from pre- and post-September 11 quarterly survey events for the calendar year 2001 were analyzed to compare the unfavorable health response rates before and after the attacks. Increases in rates of unfavorable health status following the terrorist attacks were reported by the total population and 39 of 44 subgroups examined. Statistically significant increases in unfavorable health were reported by active duty personnel and dependents of active duty personnel; beneficiaries under the age of 44 years; beneficiaries affiliated with the Army and Marines; and beneficiaries in the Mid-Atlantic, Mid-West/Central, and Pacific Rim regions. These findings suggest that stress associated with the likelihood of being deployed or having a family member deployed following the terrorist attacks significantly contributed to the increase in unfavorable health response reported on the post-September 11 survey.     

Early mental health intervention in combat situations: the USS Stark

The United States Army Europe Stress Management Team (USAREUR SMT) is designed to assist victims of hostage, terrorist, and disaster situations. Early intervention is intended to prevent the development of chronic posttraumatic stress disorder. This paper describes the operation of the SMT following the missile attack on the USS Stark in the Persian Gulf. Therapeutic approaches as well as some observation on the group process are described. The therapeutic principles and organizational flexibility necessary for early mental health intervention in disaster situations are illustrated.     

Radiological and nuclear terrorism: are you prepared?

Another terrorist attack on our nation is virtually inevitable. Most believe that it is not a question of if but when. The form of the terrorism, the time, and the place will not be of our choosing. Radiology professionals (radiologists, technologists, radiologists’ assistants, and nurses) will be involved in caring for the victims of the attack, whether the method employed is chemical, biological, radiological, or nuclear. If chemical or biological weapons are used, we must be ready to help with the diagnoses and follow-up care of these patients. Probably the greatest challenges to the radiology community will arise if the terrorist act involves a radiological or a nuclear explosive device. Understanding terrorists’ goals of creating pandemonium and causing economic disruption is important. Radiology professionals need to be prepared to be resources for the medical community in providing patient care and for the community at large, especially if the terrorist attack involves detonation of a nuclear device, an attack on a nuclear power plant, or the use of a simple radiation dispersal device in a highly populated area.     

Deaths due to terrorist bombings in Istanbul (Turkey)

Our study was based on a retrospective analysis of terrorist bombing related deaths in Istanbul (Turkey) between 1976 and 2000. A total of 45,714 autopsy case reports from the Morgue Department of Council of Forensic Medicine were reviewed for this study. There were 120 (0.26%) deaths due to terrorist bombing. Terrorist bombing related deaths were significantly higher during the years of increasing terrorism events in Turkey. Ninety-eight (81.7%) of cases were male and 22 (18.3%) of cases were female. The most frequent age groups of victims and terrorists was between 21 and 30 years of age (n=60; 50% of the total cases). In 49 events only one death occurred. The highest mortality was 24 in a single event. In this study, we have renewed of characteristics traumatic lesion to ascertain the cause of deaths and other autopsy findings in victims and terrorists. We also emphasize that scene investigation and medico-legal autopsy are the most important procedures provide appropriate information about deaths due to terrorist bombings.     

炭疽恐怖袭击直接经济损失评估方法

以炭疽杆菌芽孢气溶胶恐怖袭击为例,对城市地区遭受非传染性生物剂攻击的直接经济损失评估方法进行研究.将经济损失分为死亡损失、医疗损失、环境洗消、经济活动停顿4个方面构建评估模型,最后以北京某商业区为例,对遭受炭疽杆菌芽孢气溶胶恐怖袭击的经济损失进行计算和分析.相关评估方法可以对生物恐怖袭击后政府资源调配、经济援助等决策提供支持和依据.     

Critical care delivery: the experience of a civilian terrorist attack

It has been recognised for some time that a terrorist incident was threatened in the U.K. and it has been noted previously in the JRAMC that the locations for terrorist atrocities are likely to be more diverse than previously experienced. July 7th 2005 witnessed the first terrorist suicide bombing on the U.K. mainland, targeting the public transport system in London. These attacks were unprecedented in both scale and intensity but they were anticipated in London. However there were clear difficulties, relating to multiple sites, their location underground and early problems with communication (2). This article highlights some of the experiences and learning points of the Intensive Care Medicine Service at the Royal London Hospital (RLH) in the wake of the July 7th bombings. The RLH was the single biggest receiver of casualties (195); seven of whom were admitted to the Intensive Care Unit. The Defence Medical Services have tri-service representation (both regular and reserve) at the RLH in Emergency Medicine and Pre-hospital Care, Surgical Services and Intensive Care Medicine.     

武警部队实施反恐怖作战卫勤保障的思考

 为加强武警部队反恐怖作战卫勤保障的准备工作,作者分析了现代恐怖事件发生的突然性、破坏的巨大性,方法的多样性、目标的不确定性.提出了各级卫生人员应预有准备,加强反恐怖作战卫勤保障预案建设;深入研究卫勤保障的特点、原则、方法,加强理论指导;强化卫生人员训练,提高救治效能;加大经费投入,装备相应器材.建立强有力的应急机动卫勤保障力量,提高综合卫勤保障的效能.     

Estimation of radiation-induced health hazards from a "dirty bomb" attack with radiocesium under different assault and rescue conditions

In the case of a terrorist attack by a "dirty bomb", blast injuries, external irradiation and the incorporation of radioactivity are to be expected. Departing f...