Resources for educating staff, physicians on terrorist threats

Physicians and staff might be eager for more education on terrorist threats and how the health care system can respond. Two sources can help you improve the quality of care:

One is an on-line presentation dealing with medical issues related to potential terrorist activities. The lectures were presented at New York University Medical Center in New York City and are available free on the World Medical Leaders web site at During the lectures, New York University Medical Center faculty discussed hands-on experiences and emergency preparedness for potential biological and chemical attacks in the wake of the World Trade Center disaster.

The presenters stressed how essential it is that physicians be up-to-date on key diagnostic factors, treatments, and reporting procedures. They reviewed chemical and biological agents most likely to be used in an attack. In addition, the presenters discussed what to expect in the psychological and social arenas following a terrorist attack. Speakers included Robert S. Hoffman, MD, medical director of the New York Poison Control Center, as well as leading experts on infectious diseases, and psychiatry.

Another source of information comes from The Association for Professionals in Infection Control and Epidemiology (APIC). In cooperation with the Centers for Disease Control and Prevention (CDC), APIC offers a bioterrorism readiness plan to serve as a reference document and initial template to facilitate preparation of bioterrorism readiness plans for individual institutions.

Bioterrorism Readiness Plan: A Template for Healthcare Facilities outlines the steps necessary for responding to the biological agents most likely to be employed in any future biological attack: smallpox, botulism toxin, anthrax, and plague.

The Bioterrorism Readiness Plan provides information on the unique characteristics, specific recommendations, management, and follow-up appropriate for each of these biological agents. It covers the description, etiology, and mode of transmission of each agent and the necessary isolation precautions, patient management, and post-discharge planning associated with each.

The document also provides details regarding post-exposure management, prophylaxis, and decontamination consistent with each pathogen; laboratory support and diagnosis; and protocols for the cleaning, disinfection, and sterilization of equipment and environment. The plan outlines patient/visitor/public health precautions, and contains some discussion of the psychological and mental health aspects of a bioterrorist event.

APIC says the format of the Bioterrorism Readi-ness Plan is easily adapted to suit the individual needs of institutions, offering what it calls a "cookie-cutter" approach to creating specific bioterrorism readiness plans. With the mounting concerns regarding threats of bioterrorism throughout the country, the timely appearance of this accessible device is meant to allow infection control professionals and health care epidemiologists in all health care facilities to prepare appropriate plans utilizing established networks to satisfy the needs of unique situations.

There is no charge for downloading the plan at For print and disk copies, the charge for APIC members is $10.00, or $18.00 for nonmembers to cover the cost of handling and shipping. Contact APIC at 1275 K St. N.W., Suite 1000, Washington, DC 20005-4006. Telephone: (202) 780-1890.