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Joint Training as Key Resource

Cornelius Bartels MD PhD MPH

IBBS - Federal Information Centre for Biological Security

BWC Experts Conference

Geneva, 23 - 27 August 2010

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2 October 2001, Florida

Patient male, 63 years delivered in the ER of JFK Medical

Centres, Atlantis

Impaired consciousness, fever,muscle aches, nausea

Working diagnosis: Bacterial meningitis

Rapid deterioration of patients condition, despite maximal

intensive care

Death at 4 Oct showing septic-toxic shock

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Diagnosis: Pulmonary Anthrax

© NEJM

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�

© böcklin

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Bioterrorism as cross-sectoralthreat potential

Acute perception in politics and society

Often delayed recognition of attack

Insufficient knowledge and experience for risk assessment

Insufficient experience with related disease patterns

Rapid depletion of staff and structural resources

Training deficits in first response structuresPublic health servicesPrimary care facilitiesLaw enforcement agencies

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Oct. 10th 2001, Berlin

© team pauli

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Integrated Management

DetectionPrimary care

Laboratories

Public Health

Manage-ment

Public HealthResponse centres

Treatment

Primary care

Treatment centres

InvestigationForensics

Laboratories

Law enforcement

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The AMBIT Concept

Multidisciplinary approach to integrated Management

Modular construction

Focus on practical training

Real life exercises

Video assisted training

Orientation to recent standard of knowledge

Didactical sustainability

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Didactic approach

Alternating use of different techniques Lectures (25%)Practical exercises (20%)Crisis management simulations in small groups (25%)Demonstrations (10%)Supervised media training (10%)Guided analysis und discussion in the Plenum (10%)

Redundancy

Simplicity

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Networking as key to successful management

StAKoB

Standing working group of treatment and response centres

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Elements of joint approach

Training

Contact

First response

Recognition

Investigation

Action

Communication

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Stage 1: Establishing contact

The Outbreak (PH) The Threat (LE)

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Stage 2: Joint first response (LEPH)

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Stage 3: Joint action (LEPH)

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Video assisted training

Highly contagious suspect, ill with monkeypox

Intent to leave Germany by plane

Two possible scenarios:

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Handbooks

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Evaluation by reality?

© bartels

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July 22th 2006: Admission of a patient with Lassa feverat the special isolation ward in Frankfurt/Main

© Feuerwehr Frankfurt/M