Dr. William Bernhard Says RTs Will Play Critical Role in Case of a Bio or Chemical Attack

Where can respiratory therapists expect to find themselves if a biological or chemical terrorist attack hits their community?

In the case of the latter, says William Bernhard, MD, retired physician and long-time expert in the field of bio and chemical outbreaks, right in the middle of the emergency department. "The main role I see for the respiratory therapist in the case of nerve agents will be maintaining the airway until the antidotes are able to work." Because the treatment window for chemical weapons is so short -- victims must receive the antidotes literally within a couple of hours of exposure -- RTs will be working alongside physicians and nurses in the ED to keep people breathing during the critical early stages.

In the case of bio-weapons such as inhaled anthrax, RTs will likely not be called in until the victims reach the intensive care unit. "The role of the RT, unfortunately, is going to happen when the patient is hemorrhaging into the lungs and on a ventilator." At that point, fatalities will be high; some estimates put the mortality rate for inhaled anthrax at 90 to 100 percent. RTs, he says, are used to caring for critically ill patients, but a widespread outbreak of inhaled anthrax would be unlike anything they've ever encountered. "There will be a certain amount of psychological trauma," he warns, for therapists and their colleagues in the hospital.

The best way for RTs to ensure that they can deal with these scenarios, continues Dr. Bernhard, is to get ready for them now. "We need educational programs to educate our people to their role." As an instructor in "train the trainer" programs in chemical and biological agents for the U.S. Army -- not to mention a key player in medical rescue efforts during Desert Storm -- Dr. Bernhard knows what he's talking about. "RTs have to be able to handle chemical and biological attacks." Luckily, there are a lot of resources at their disposal.

Chief among them: a satellite broadcast offered free of charge to interested groups and organizations by the U.S. Army Medical Research Institute of Infectious Disease, or USAMRID. According to Dr. Bernhard, this three-day live, interactive broadcast, entitled "Biological and Chemical Warfare and Terrorism: Medical Issues and Response," is designed specifically to inform and educate health professionals about the proper medical response in the event of an intentional biological or chemical agent release.

The program, which will be presented by world-renowned experts from USAMRIID, the U.S. Army Medical Research Institute of Chemical Defense (USAMRICD), and other organizations, will be aired on November 28, 29, and 30, from 12:30 to 4:30 EST, and will be available throughout the Continental United States, Alaska, Hawaii, Puerto Rico, and Southern Canada. A taped rebroadcast will be aired on December 8 and 9 from 10:30 to 4:30 EST. Registration information and specific course information can be viewed on-line at: http://www.biomedtraining.org/.

Dr. Bernhard believes the program could be easily offered to RTs through their state societies and/or hospital departments. The only requirement is a "smart room" capable of handling a satellite hookup.

For more information about the course and other educational programs offered by USAMRID, visit their web site at: http://www.usamriid.army.mil/education/index.html.