Maniscalco P M
George Washington University School of Medicine and Health Sciences, USA.
Emerg Med Serv. 2001 Apr;30(4):46-51, 55.
The problems posed by terrorism to not only the emergency response community, but to national security at large can be overwhelming. Adoption of what would be considered prudent and effective business practices by implementing a disciplined and effectively structured central strategy cannot be overencouraged. The emerging strategy must take into account the existing emergency response infrastructures and build upon existing capacity in an effort to achieve greater readiness. This technique is no different than the training and issuance of radiological response equipment to emergency responders in the 1950s by the then Civil Defense Agency. The training that is offered, especially to EMS providers, needs to be institutionalized to ensure that our peers, on a regular basis, revisit curriculum content. Incorporating a training module within the existing DOT NHTSA initial and refresher EMT and paramedic educational curricula could easily achieve this goal. Implementing fiscal support to the local emergency response agencies in a sustainable manner is a must. The costs associated with training, equipping and servicing the equipment and medication stores are budget-busters. This is a threat to national security and, as such, the federal government needs to rise to the challenge of supporting the local response organizations that will meet this threat head-on during the aftermath of an attack. As previously mentioned, when the U.S. faced its last large national security threat (Soviet nuclear missiles), we witnessed the materialization of a comprehensive agenda that provided most of the attributes we desire with the contemporary problem of terrorism. There is no single solution to the problem of terrorism. In fact, it will take many individuals and functional areas to come together and stop viewing the threat as a "cash cow." The improved response capacity for acts of terrorism will have an inevitable "spillover benefit" of better trained and equipped emergency responders for everyday emergencies; which will inevitably be our "payday."
恐怖主义给应急响应团体乃至整个国家安全带来的问题可能是压倒性的。大力鼓励通过实施一套严谨且结构有效的核心战略来采用被视为审慎且有效的业务做法。新出现的战略必须考虑到现有的应急响应基础设施，并在现有能力的基础上加以建设，以实现更高的准备状态。这种做法与20世纪50年代当时的民防机构向应急响应人员培训和发放放射应急设备并无不同。所提供的培训，尤其是针对紧急医疗服务提供者的培训，需要制度化，以确保我们的同行定期复习课程内容。在现有的美国运输部国家公路交通安全管理局紧急医疗技术员和护理人员初始及复习教育课程中纳入一个培训模块，就能轻松实现这一目标。以可持续的方式为地方应急响应机构提供财政支持是必不可少的。与培训、装备以及设备和药品储备的维护相关的成本会使预算超支。这对国家安全构成威胁，因此，联邦政府需要迎接挑战，支持那些在袭击发生后将直面这一威胁的地方响应组织。如前所述，当美国面临上一次重大国家安全威胁（苏联核导弹）时，我们看到了一个全面议程的实现，该议程具备我们应对当代恐怖主义问题所需的大部分要素。恐怖主义问题没有单一的解决方案。事实上，需要众多个人和职能领域共同努力，不再将这一威胁视为“摇钱树”。提高对恐怖主义行为的应对能力将不可避免地带来“溢出效益”，即应急响应人员在日常紧急情况中得到更好的培训和装备；而这将不可避免地成为我们的“回报”。
