To meet the challenge of responding to these volatile threats, the Advanced Hazmat Life Support(c) course has expanded the nuclear terrorism response training in its curriculum that already includes instruction on the medical management of victims of bioterrorism and other hazardous material (hazmat) exposures.
The added section on treatment of nuclear exposures was created by Keith Edsall, MD, of the United Kingdom, a consultant in radiation accident medicine. Dr. Edsall, who served as head of radiation medicine with the Defence Radiological Protection Service of the British Royal Air Force, also assisted in the development of training materials for radiation accident management courses as a member of the teaching faculty of the Radiation Emergency Assistance Center/Training Site at the Oak Ridge Institute of Science and Education in Tennessee. Whether from intentional acts of terrorism, inadvertent hazmat transportation or industrial incidents, natural disasters causing toxic releases, or an individual exposure to a toxic substance, the threat of hazmat exposures is at an all-time high, says Frank Walter, MD, course director and chief of the Division of Medical Toxicology at the University of Arizona Department of Emergency Medicine in Tucson.
Before Sept. 11, 2001, few would have thought, for example, that innocuous crop-dusting planes might be used for chemical or biological assaults on U.S. citizens, potentially dwarfing the death toll from the World Trade Center and Pentagon attacks. Or that an alleged al-Qaeda terrorist would be arrested in the U.S. in May for plotting to build and use a "dirty bomb." Thus, the AHLS course has taken on even greater significance in the past year. Since Sept. 11, 2001, the number of Advanced Hazmat Life Support(c) (AHLS) courses - which are offered internationally -- has more than doubled, training more than 1,000 emergency responders throughout the world. Participants have included paramedics, nurses, physicians, pharmacists, toxicologists, industrial hygienists and risk-management personnel from more than 26 countries, including the U.S., Canada, Greece, Mexico, Brazil, Switzerland, Italy and Australia.
Since 1998 the only course of its type in the world, the AHLS course is offered by the Arizona Emergency Medicine Research Center (AEMRC), a Center of Excellence at the University of Arizona College of Medicine in Tucson, in collaboration with the American Academy of Clinical Toxicology (AACT), the course focuses on educating emergency responders in the proper assessment and medical treatment of hazmat victims.
"The success of this course on the state and then the national level became the catalyst for its development into an international program," says Harvey Meislin, MD, AEMRC director and head of the new UA Department of Emergency Medicine.
Four years before Sept. 11, 2001, in 1998, Drs. Meislin and Walter and Tucson Fire Department Capt. Raymond Klein saw a need for an educational program on medical management of patients exposed to hazardous materials -- from common industrial agents to nuclear, biological and chemical weapons. They initially developed the AHLS course as a local program for Arizona paramedics and emergency medical technicians, later expanding it with assistance from Richard Thomas, PharmD, and other experts from AACT. In 1998, the program received funding that allowed the AEMRC to develop it into a national - and now an international - three-day course.
The program covers important hazmat properties; decontamination; rapid assessment and medical treatment of hazmat-exposed patients; antidotes and drug therapy; and establishment of hazmat-response systems in the community. Each course involves a board-certified toxicologist and medical doctor and is taught by AHLS verified instructors. The AHLS program trains other medical personnel to become AHLS instructors in order to bring the course to their regions of the country.
U.S. Department of Transportation data shows that every state is affected by hazmat incidents, some of which result in deaths and major injuries. USDOT data from 1998, found that damage from hazmat incidents cost more than $45 million. The costs of the Sept. 11, 2002, incident dwarfs that number.
A hazardous material is defined as any substance -- solid, liquid or gas -- capable of harming people, property or the environment. Five hundred years ago, Paracelsus, the father of modern toxicology and pharmacology, established a fundamental principle of toxicology when he said, "All substances are poisons, only the dose differentiates a poison from a remedy." In other words, hazardous materials are everywhere. "Hazmat exposures pose a common threat to communities and individuals in the U.S. and internationally," Dr. Walter says. "AHLS enables health care providers to become the guardian angels of the front-line heroes -- the firefighters, medics and law enforcement officers who respond to hazmat incidents and terrorist attacks. AHLS also enables health care providers to provide state-of-the-art medical therapy for victims of hazmat incidents and toxic terrorism."
Upcoming courses include:
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