恐怖袭击与应急医学救援对策

近年来,恐怖袭击活动在世界范围内蔓延,已成为人类社会的公害。中提出了恐怖袭击的界定及其类型,按恐怖袭击手段可分为核、化、生、爆炸和劫持5种类型;按实施的意识形态可分为极端宗教型、极端民族型、极端邪教型、极端黑社会型、极右型和极左型等6种;按实施的范围可分为集团型、国家型和跨国型3种。恐怖袭击特点在于手段的残忍性、行动的诡秘性、恐怖袭击效果的惨烈性、发生时间和地点的不确定性和突发性,以及伤类伤情的复杂性和危重性。提出的应急医学救援对策包括：建立高效的医疗救援指挥机构;完善各种医疗救援应急预案;建立救援体系和救援基地;加强反恐训练,重视心理灾害的预防;建立反恐医学,“以人为本”搜救善后。     

应急医疗救援组织的训练方法与内容

应急医疗救援组织训练是根据突发事件和紧急事态的不同特征,组织开展的针对性紧急医疗救援训练活动。其主要目的在于提高应急医疗救援组织处置突发事件和紧急事态的基础知识水平与专业技能,掌握突发事件和紧急事态后伤病员发生的特点及相应的紧急救治需求,掌握医疗救援工作的组织要点,明确应急医疗救援组织在突发事件和紧急事态中组织指挥与紧急救治的方法。     

化学武器恐怖袭击的特点及其现场救治

化学恐怖一般指以有毒、有害化学品为武器的恐怖活动。由于有毒、有害化学品具有易生产，成本低，携带、使用方便，且可控、作用时间长、难于监测等特点，一旦发生将给社会稳定和人们心理造成极大的危害，对人民生命构成严重威胁，使现场医学救援十分困难。因此，了解化学恐怖的特点，掌握现场医学救援的基本原则和技能，以及开展反化学恐怖的医学救援研究，具有非常重要的意义。     

沙漠干热环境气候特点及其对抗震救灾医疗救援的影响

新疆地处南疆昆仑山断裂带、帕米尔高原-天山南北地震带、阿勒泰断裂带,具有地震突发的潜在性,这些地震带大多在平原盆地靠山脉附近,且往往多绿洲、人口密集,一旦地震突发,造成的破坏性巨大。地震突发时,对受灾地区进行医疗救援是灾难救援的重要组成部分,而实施灾难医学救援,救援环境具有不可选择性。新疆特殊的地理位置造就了复杂的气候特征,气候的变化是影响医疗救援不可忽视的现实问题。因此,了解新疆气候一般特点并分析其对医疗救援的影响,就显得尤为重要,本文对此问题探讨如下。     

航空医疗救援中重症疾病救护策略的研究

航空医疗救援是借助航空器作为交通工具,运用医学手段救助受困对象的活动,在救灾救援任务中发挥着举足轻重的作用。本文主要探讨了航空医疗救援活动中,航空特殊环境的特点及可能带来的危害;常见危重疾病的机上救治和护理要点。这有助于减少因医疗操作不当造成的损伤,从而使航空医疗救援活动安全、有序、高效地展开。     

海地地震医疗救援中挤压伤及挤压综合征救治体会

2010-01—13北京时间凌晨5：56分海地发生7．3级地震,造成20多万人死亡。中国国际救援队于震后约33h到达海地首都太子港,旋即展开搜救与医疗救援,在海地共进行了15d的地震灾害救援,救援外伤伤员2500名,其中挤压伤重伤员约20例,包括挤压综合征6例,笔者主要总结在这次海地地震医疗救援中的挤压伤和挤压综合征的救治体会。     

地震灾害的医疗救援体系的构建

汶川地震造成巨大人员伤亡、财产损失。在党中央、国务院、中央军委的统一指挥下，全军和武警部队约10万官兵投人救援行动。一场与时间赛跑，与死神抢夺生命的行动在神州大地展开。地震灾害救援中一个必须面对的难题就是数量巨大的等待救治的伤病员与有限的医疗资源之间的矛盾。地震、海啸等自然灾害发生后可造成大批的伤员同时发生，伤员伤势轻重不一，加上受灾地区卫生基础设施破坏殆尽，内科疾病多发，     

灾害伤员现场医疗救援

灾害造成大量人员伤亡,灾害救援要遵守及时性、科学性和区域性原则。现场医疗救援是灾害救援的重要环节,分拣是现场医疗救援的核心。根据急救和转运优先等级将伤员分拣为4个优先级别。现场救援对危及生命的损伤进行紧急救治。     

挪威爆炸事件医疗救援指挥决策与思考

指挥员是应急响应行动中的管理人员,其主要任务是在行动中做出决策[1].2011年7月22日下午,一名犯罪分子在挪威奥斯陆政府区引爆一枚汽车炸弹,而后在于特岛青年团活动现场实施连环射击,两次事件至少造成近90人死亡.事故医疗救援响应行动中,急救车指挥员调遣、分配、发放资源,合理配置就近医疗资源做出关键决策;医疗指挥员后送...     

边防海岛医疗救援组织的效能优势研究

组建边防海岛医疗救援组织,是和平时期应对突发事件的医疗救援和储备卫勤保障力量的有效途径和方法。海岛医疗救援组织的效能是指其在平时突发事件或战时卫勤保障中的紧急医疗救援的效果与效益。海岛四面环水,战时易遭敌多种方式袭击,造成人员伤亡大、伤员伤情复杂,后方卫勤支援困难。在突发事件医疗救援和战伤救治工作中,医疗救治措施的干预时机至关重要,措施及时有效可挽救生命,否则可能出     

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。     

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。     

化学恐怖及其医学防护研究

化学恐怖是恐怖活动的一种重要方式,化学武器的扩散和化学毒物的泛滥使化学恐怖更为频发和多样化。化学恐怖具有突发性、隐蔽性、中毒途径多、伤害规模大和社会影响广的特点。医学防护是控制化学恐怖伤害的中心环节。反化学恐怖医学研究将赋予防化医学研究以新的重要内容,防化医学研究为反化学恐怖医学研究奠定了基础。应及早确立反化学恐怖医学研究原则、主题和研究战略。     

The invisible sentry

Radiological imaging may enable the recognition and documentation of acts of terror. Search by X-rays can assist in the detection of weapons, drugs, contraband, and hidden persons. Fluoroscopy, backscatter imaging, and computed tomography are being employed for the evaluation of luggage, humans, trucks, and containers. The identification of drugs and explosives is possible by additional spectral analysis. The images can show individuals nearly naked, which may lead to a discussion on violation of privacy and dignity. There are, however, clinical questions raised about the exposure to X-rays and the possible absence of informed consent. Finally, although the use of X-rays is part of terror prevention, it has been part of the terror, too. The Stasi, the secret service of the German Democratic Republic, used diagnostic X-rays and ionizing radiation in order to control opponents of the political system.     

David Josephs MBChB MFCM

Abstract

International relations is fundamentally about people. Psychology provides a wide range of tools to understand the rise of Islamic fundamentalist terrorism and offers part of the framework for its resolution. Western societies need to avoid being consumed with fear, revenge or anger which might lead to polarisation and perpetuate the cycle of violence. Understanding the enemy and the virulence of their ideas is essential to winning the hearts and minds of their potential supporters through dialogue, public diplomacy and foreign policy. The West needs to build trust, relationships, reputation and address double standards in its behaviour in order to build a global coalition of people with shared values. The concept of ‘war on terror’ has been damaging, not least by inhibiting western societies from the self-reflection required to overcome the challenge of terrorism.     

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.     

The polity of academic medicine: Status of faculty governance

How should academic medical departments be governed? Models of governance span a wide spectrum between autocracies, in which important decisions are made by a single individual, to democracies, in which each member enjoys a voice in decision making. Despite the fact that more participatory governance models are the norm in practice settings outside of academia, many academic physicians seem to take an autocratic model more or less for granted. In fact, however, most medical schools and universities do not mandate a governance system that vests authority in a powerful chairperson, and departments frequently enjoy more latitude than they suppose in determining how to govern themselves. Because an organization’s effectiveness is powerfully influenced by its governance structure, academic physicians should give serious consideration to this subject, to ensure that academic medicine is well prepared to meet the many challenges now before it     

Profession and professionalisation in medical radiation science as an emergent profession

PurposeDeregulation, reduced operating costs, new ways of organising the professional workforce, increasing competition within the healthcare sector and increasing consumer expectations are factors that challenge any health profession. This paper, which forms part of the first author's doctoral study on continuing professional development in medical radiation science, details the journey of medical radiation science as a profession in Australia. Specifically, the paper examines the challenges confronting practitioners in their struggle to be recognised as a profession in its own right.FindingsThe challenges facing medical radiation science practitioners included low professional self-esteem and apathy, which adversely affects their willingness and ability to continue learning and to assume increasing work responsibilities which are essential attributes of a health professional. Low self-esteem and apathy are also preventing practitioners from venturing beyond their comfort zone of daily workplace practices. This ultimately impacts on their ability to advance clinical practice in response to a constantly changing health care system.ConclusionDespite the current difficulties confronting the profession, it is possible for practitioners to assume a more proactive role in moving the profession forward. As part of the solution to improving practitioners’ low self-esteem and to rekindling their enthusiasm for the profession, the authors propose that continuing professional development programs should go beyond simply assisting practitioners in advancing clinical competence. They should also aim to empower practitioners to develop their reflective skills. Reflection is now widely promoted in healthcare professions as one of the means of enhancing clinical practice and improving healthcare delivery. To this end, educational designers should incorporate reflection into professional development programs as both a learning goal and a strategy. Helping practitioners to become more reflective provides an effective way to address the major challenges that are currently confronting the medical radiation science profession.     

Evaluating and writing education papers compared with noneducation papers

The field of medical education research is growing rapidly, but educational research has been widely criticized for its lack of a scientific approach, poor theoretical frameworks or study designs, deficient research methods and reporting quality, and lack of meaningful outcomes that would inform practice. There have been recent calls for greater accountability and return on investment for all research efforts and clinical practice. The impact of medical education on important health outcomes such as patient care is unclear but likely underestimated. A better understanding of the role and the structure of medical education research is called for, and in this review, the author outlines a framework for reading, reviewing, and (hopefully) pursuing and carrying out medical education research. Medical education research methodologies are discussed, along with guidelines for reading articles. A structured guideline is suggested and provided for interested readers and reviewers of educational research. Although there are challenges to be faced, they provide endless possibilities to expand and improve on medical education research and to bring it to its full fruition, alongside traditional clinical research. Education is critical to important outcomes, and a greater emphasis should be placed on understanding medical education research.