Annals of Emergency Medicine
Volume 48, Issue 2 , Pages 194-199.e2 , August 2006

Lessons Learned From Clinical Anthrax Drills: Evaluation of Knowledge and Preparedness for a Bioterrorist Threat in Israeli Emergency Departments

Presented orally at the 14th World Congress for Disaster and Emergency Medicine, May 2005, Edinburgh, Scotland.

  • Adi Leiba, MD

      Affiliations

    • Israeli Defense Forces Home Front Command, Ramat-Gan, Israel.
    • ,
  • Avi Goldberg, MD

      Affiliations

    • Israeli Defense Forces Home Front Command, Ramat-Gan, Israel.
    • ,
  • Ariel Hourvitz, MD, MHA

      Affiliations

    • Israeli Defense Forces Home Front Command, Ramat-Gan, Israel.
    • ,
  • Yoram Amsalem, MD

      Affiliations

    • Israeli Defense Forces Medical Corps, Chemical Biological Radiological & Nuclear Medicine Branch, Ramat-Gan, Israel.
    • ,
  • Adi Aran, MD

      Affiliations

    • Israeli Defense Forces Medical Corps, Chemical Biological Radiological & Nuclear Medicine Branch, Ramat-Gan, Israel.
    • ,
  • Gali Weiss, RN, MHA

      Affiliations

    • Israeli Defense Forces Home Front Command, Ramat-Gan, Israel.
    • ,
  • Ronit Leiba, MA

      Affiliations

    • Department of Biostatistics, Rambam Medical Center, Haifa, Israel.
    • ,
  • Yoav Yehezkelli, MD, MHA

      Affiliations

    • Israeli Defense Forces Medical Corps, Chemical Biological Radiological & Nuclear Medicine Branch, Ramat-Gan, Israel.
    • ,
  • Avishay Goldberg, PhD

      Affiliations

    • Faculty of Health Sciences, Ben Gurion University, Department of Emergency Medicine, Beer-Sheva, Israel.
    • ,
  • Yehezkel Levi, MD

      Affiliations

    • Surgeon General Headquarters, Israeli Defense Forces Medical Corps, Ramat-Gan, Israel.
    • ,
  • Yaron Bar-Dayan, MD, MHA

      Affiliations

    • Israeli Defense Forces Home Front Command, Ramat-Gan, Israel.
    • Corresponding Author InformationAddress for correspondence: Y. Bar-Dayan, MD, MHA, Department of Healthcare Systems Management, the Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel, 16 Dolev st. Neve Savion, Or-Yehuda, Israel; 972-5-077-86-215; fax 972-8-978-3200

Received 24 June 2005 ,Revised 27 September 2005 ,Accepted 19 October 2005.

References 

  1. Inglesby TV , O’Toole T , Henderson DA , et al.   Anthrax as a biological weapon, 2002 (updated recommendations for management) . JAMA . 2002;287:2236–2252
  2. Dudley JP . New challenges for public health care (biological and chemical weapons awareness, surveillance and response) . Bio Res Nurs. . 2003;4:244–250
  3. Shadel BN , Rebmann T , Clements B , et al.   Infection control practitioners’ perceptions and educational needs regarding bioterrorism (results from a national needs assessment survey) . Am J Infect Control . 2003;31:129–134
  4. Poles L . The Israeli medical response plan for an unusual biological event . Harefuah . 2002;141:22–28
  5. Cinty SK , Saravolatz L , Nafziger D , et al.   Differentiating inhalational anthrax from other influenza-like illnesses in the setting of a national or regional anthrax outbreak . Arch Intern Med. . 2004;164:674–676
  6. Klein KR , Atas JG , Collins J . Testing emergency medical personnel response to patients with suspected infectious disease . Prehospital Disaster Med. . 2004;19:256–265
  7. Tur-Kaspa I , Lev EI , Hendler I , et al.   Preparing hospitals for toxicological mass casualties events . Crit Care Med. . 1999;27:1004–1008
  8. Swartz MN . Recognition and management of anthrax (an update) . N Engl J Med. . 2001;345:1621–1626
  9. Temte JL , Zinkel AR . The primary care differential diagnosis of inhalational anthrax . Ann Fam Med. . 2004;2:438–444
  10. Artenstein AW , Neill MA , Opal SM . Bioterrorism and physicians . [letter] Ann Intern Med. . 2002;137:626
  11. Steed CJ , Howe LA , Pruitt RH , et al.   Integrating bioterrorism education into nursing school curricula . J Nurs Educ. . 2004;43:362–367
  12. Filoromo C , Macrina D , Pryor E , et al.   An innovative approach to training hospital-based clinicians for bioterrorist attacks . Am J Infect Control . 2003;31:511–514
  13. Terndrup T , Nafziger S , Weissman N , et al.   Online bioterrorism continuing medical education (development and preliminary testing) . Acad Emerg Med. . 2005;12:45–50
  14. Woods R , McCarthy T , Barry MA , et al.   Diagnosing smallpox (would you know it if you saw it?) . Biosecur Bioterror. . 2004;2:157–163

 Supervising editor: Jonathan L. Burstein, MDAuthor contributions: AL, AG, AA, and YY planned the study. AL and AG conducted the study. AL planned drills, wrote the anthrax test, and wrote the article. AH participated in primary planning of the study as former Home Front Command chief medical officer. AL, AG, YA, AA, and YB-D were members in the expert committee of the study and participated in some of the drills. YA and AA evaluated the manuscript. GW and AG supervised the conduct of the study. YA, AA, and GW evaluated study results. RL was responsible for statistical analysis. RL and YB-D were responsible for quality control. YY was an expert consultant in CBRN medicine. YY and AG revised the manuscript. YL was chairman of the supervising committee of the study (Supreme Health Authority). YB-D revised the study plan and article. Y-BD was the research group leader and takes responsibility for the paper as a whole.Funding and support: The authors report this study did not receive any outside funding or support.Publication dates: Available online February 2, 2006.Reprints not available from the authors.

PII: S0196-0644(05)02038-X

doi: 10.1016/j.annemergmed.2005.12.006

Annals of Emergency Medicine
Volume 48, Issue 2 , Pages 194-199.e2 , August 2006

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