NEW YORK (Reuters
Health) - Few US hospitals are prepared to handle victims of chemical
and biological terrorism such as the 1995 nerve gas attack in
a Tokyo subway, according to a new report.
In a survey
of nearly 200 hospital emergency departments, researchers found
that fewer than 20% had plans for dealing with patients exposed
to biological or chemical weapons such as deadly anthrax bacteria
or sarin--the nerve gas used in the Tokyo incident.
A team led
by Donald Clark Wetter of the US Public Health Service office
in New York City reports the findings in the May issue of the
American Journal of Public Health, journal of the American Public
Health Association.
Specifically,
Wetter and his colleagues looked at whether the hospitals had
the antibiotics to treat 50 victims of an anthrax attack or the
equipment for dealing with 50 sarin victims, such as an isolated
decontamination unit. Hospitals were also asked whether they had
overall plans of action for biological and chemical terrorism.
Urban hospitals
were three times more likely to have such plans than rural hospitals
were. More than 60% of the hospitals surveyed were in rural areas,
and all hospitals were in four states: Alaska, Idaho, Oregon and
Washington.
More than
one third of all hospitals lacked sufficient antibiotic supplies
to handle the anthrax scenario, and just 29% had enough of the
drug atropine to treat sarin patients. Far fewer had the decontamination
facilities and other supplies for handling a sarin attack. Just
6% had all of the "minimum recommended physical resources"
to deal with a sarin incident.
These findings,
Wetter's team writes, "while not surprising, are nonetheless
disturbing: they indicate that hospital emergency departments
generally are not prepared in an organized fashion to treat victims
of incidents involving chemical or biological weapons."
But other
experts caution that putting too many resources into preparing
for hypothetical attacks would be a "disastrous detour for
public health."
In an editorial
accompanying the report, authors led by Dr. Victor W. Sidel of
Montefiore Medical Center in New York City argue that it "does
not make sense" to prepare for an attack without a true measure
of the risk.
The editorialists
question why Wetter and his colleagues did not look at the hospitals'
ability to provide more routine care and respond to "common
complaints" like long waits.
"Both
seem to us to be much more prevalent public health needs than
preparation for a bioterrorist attack," Sidel and his colleagues
write.
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