Comparison of Disaster Medical Assistant Team Training Before and After Severe Acute Respiratory Syndrome Era

Tzong-Luen Wang, MD, PhD; Aming Chor-Ming Lin, MD

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Abstract -- To understand the possible impact of severe acute respiratory syndrome (SARS) on DMAT training, we reviewed the training programs of 2 national and 10 local DMATs before and after SARS era. The requirements included (1) health needs assessment; (2) health surveillance; (3) medical care personnel; (4) medical equipment and supplies; (5) patient evacuation; (6) public health information; (7) vector control; (8) wastewater and solid waste disposal; (9) in-hospital care; (10) food/drug/medical device safety; (11) worker health and safety; (12) potable water; (13) mental health care; (14) victim identification/mortuary services; (15) veterinary services; (16) radiological/chemical/biologic hazard consultation; and new categories such as (1) understanding of biotechnology; (2) identification of a biological event, including surveillance system, environmental detection and laboratory diagnostics; (3) prophylaxis, post-exposure measures, and treatments; (4) system preparedness such as media and public education, communication and legislative activity; and (5) new development such as cytokines and pre-clinical diagnostics, antimicrobial use and immunomodulators. The average categories included in national DMATs training were significantly higher than those of local DMATs (14.5+0.5 vs. 11.0+2.0, P<0.05). However, the national DMATs have not updated their programs after SARS, whereas most of local DMATs have revised their training programs (14.5+0.5 vs. 14.0+1.0, P=NS). There were also more emphasis on radiological/chemical/biologic hazard consultation (9/10 local DMATs) and veterinary services (8/10 DMATs). Neither the national DMATs nor local DMATs have updated their education to fulfill the 5 new requirements. This study demonstrates that there is no major revising of training programs for DMATs, especially for national DMATs. Iit still needs more improvements in promoting the education/training for DMATs in Taiwan. The continuous education/training programs such as NBC (nuclear, biological and chemical) training may provide resolution for this problem.