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PREVMED 1 > PREVMED Test 2 > Flashcards

PREVMED Test 2 Flashcards

1
Q

What is coaming?

A

a raised frame to keep out water

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2
Q

What is distillation?

A

total process the distilling plant forms, including evaporation/condensation

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3
Q

What is free available chlorine?

A

Chlorine available in the forms of hypochlorus acid and hypochlorite ions

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4
Q

What is a micron?

A

A unit of length, one millionth of a meter

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5
Q

What is point of use?

A

a treatment device applied to a single tap used for the purpose of reducing contaminants in drinking water

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6
Q

WHat is potable water?

A

water is suitable for human consumption, bathing, laundry, personal hygiene

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7
Q

What is reverse osmosis?

A

The reverse of the natural osmosis achieved by external application of sufficient reverse pressure to cause the solvent to flow in its unnatural direction

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8
Q

What is colilert/colisure?

A

test used to detect total coliform and e-coli in potable water

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9
Q

WHat is total coliform?

A
  • group of closely related, mostly harmless bacteria that live in soil and water as well as guts of animals
  • total coliform = general quality of water, likelihood of fecal matter
  • presence/absence is standard for water
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10
Q

what is E. coli?

A

Escherichia Coli, fecal coliform bacteria

  • commonly found in intestines
  • strong indication of sewage/animal waste
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11
Q

WHat is the instruction for potable water afloat?

A

NAVMED P-5010-6, appendix B

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12
Q

What is the BUMEDINST for potable water?

A

BUMEDINST 6240.10

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13
Q

What chemical is used in port and what is used at sea?

A

Chlorine in port

Bromine at sea

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14
Q

What are common responsibilities of NAVSEASYSCOM?

A

responsible for shipboard potable water systems

  • including treatment facilities/processes to assure safe drinking water
  • **a) Design
  • **b) Construction
  • **c) Maintenance
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15
Q

What is NAVFAC responsible for?

A

Promulgating instructions for ship-to-shore potable water connections
- providing potable from approved source at berthed facility

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16
Q

What is the Chief of BUMED responsible for?

A
  • establishing/promulgating health standards for water quality afloat
  • promulgate instructions, notices, other pubs reflecting afloat water quality req’s
  • Establish shipboard reqs for med surveillance of potable water systems
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17
Q

What is the CO’s responsibilities for water?

A

Promulgating water sanitation bill to ensure:

  • receipt
  • transfer
  • treatment
  • storage
  • distribution
  • surveillance provided and followed
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18
Q

Engineering Dept responsibilities with waters?

A
  • supply potable water
  • potable water system components that:
  • Recieve
  • store
  • distribute
  • produce
  • treat
  • HALOGEN AND pH TESTING
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19
Q

What is MED Dept responsible for with potable waters?

A
  • Weekly BACTI Testing
  • Daily Halogen Testing
  • MDR will notify CO of any discrepancies
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20
Q

What is the minimum usage requirements for water/person on a ship?

A

50 Gal/person/day

- NAVSEASYSCOM specification

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21
Q

What are water hours?

A

Not less than 2 gal/man/day

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22
Q

WHat is seawater used for?

A

marine sanitation device systems

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23
Q

How many potable water tanks are on a DDG?

A

4 potable water tanks

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24
Q

What are the approved water technologies by NAVSEA?

A

Distillation
Reverse Osmosis
other NAVSEA approved water tech

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25
Q

What are ship water treatment plants capable of processing?

A

Potable Water from bacteriologically contaminated water

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26
Q

What must potable water go through to be potable?

A

disinfected to maintain required halogen residual level in potable water tanks

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27
Q

What waters should we avoid making potable water?

A
  • harbors or from polluted seawater
  • when ships are operated in close formation
  • when stripping/discharging waste bilge water forward of saltwater intakes
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28
Q

Who is the Ship-to-Shore approved source for water?

A

Environmental Protection Agency approved public water system

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29
Q

What are the US military sources from other established forces?

A
  • British Royal Navy
  • Canadian Forces
  • Royal Australian Navy
  • Other OCONUS US Military reps ashore/Navy Environmental Prev Med Units (NEPMU)
  • Shore-to-ship from unapproved source
  • Seawater is used aboard ships for: fire mains, decon, marine sanitation devices (MSDs) flushing
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30
Q

What are the three types of distillation PLANTS?

A

Steam - Uses steam from power plant/aux boiler
Waste Heat - heat derived from diesel engine jacket
Vapor Compression type - uses electrical energy

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31
Q

What does Reverse Osmosis do?

A
  • Single/triple pass
  • removes suspended particles, 1 micron in size
  • Through high pressure pump, produces potable water from 20-25% of total
  • Single pass RO plants, additional chlorine/bromine required
  • Triple pass RO for SUBS, no extra disinfection required, better than distilled
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32
Q

What are some specific things to never do with potable water tanks? Exterior coating standard?

A
  • NEVER FILL WITH BALAST WATER!

- Coating is NSF/ANSI standard

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33
Q

Explain specifics about VENTS and Overflow lines?

A
  • located to reduce accidental contamination
  • screened openings w/18guage or finer; non-corrosive mesh

Unauthorized termination points:

  • food service space
  • medical
  • toilets
  • electrical/electronics room
  • exterior of ship
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34
Q

Explain Water Level measurements?

A 
Automatic Level guage
- DIRECT READ GUAGE
Petcocks
- VALVES AT VARIOUS INTERVALS
Sounding Tubes
- 100ppm FAC for 2 min
Must be labeled "POTABLE WATER USE ONLY"
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35
Q

What are requirements for water filling connections?

A
  • Clearly labeled
  • Color coded DARK BLUE
  • 18 inches from deck
  • turned face downward
  • screw caps with keeper chains
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36
Q

How must potable water lines/piping be connected?

A

NEVER BE CROSS CONNECTED TO ANY NON-POTABLE SYSTEM

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37
Q

Why is an air gap important?

A

Allows potable water to be distributed to non-potable water tanks and appropriate backflow device

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38
Q

For Sanitary requirements: What are Potable Water Hose Lockers?

A
  • Vermin Proof
  • Locked
  • 18 inches off the deck
  • Printed, step-by-step instructions for disinfection
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39
Q

For Sanitary Requirements: What is important about the Potable water hose?

A
  • examined routinely
  • Removed from use when cracks develop in lining or leaks occur
  • shall not be used for any other purpose
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40
Q

How are potable water hoses supposed to be?

A
  • Clearly Labeled “POTABLE WATER ONLY”
  • Labeled every 10 ft
  • Coupling is color coded DARK BLUE
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41
Q

How should the Potable Water Hose Locker be labeled?

A

Potable Water Hose

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42
Q

For potable water transfer: What should be tested prior to initial transfer of water?

A

Halogen

  • residual should be a minimum standard 0.2 ppm, boost if not at standards
  • if within standards (0.2) nothing else is required
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43
Q

Who needs to make shore to ship potable water connections?

A
  • Supervised by authorized shore station/ship personnel
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44
Q

WHo notifies MDR prior to making potable water hose connection?

A

Engineering

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45
Q

WHo makes recommendations to ENG about halogen residual?

A

MDR

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46
Q

Can potable water hoses be submerged?

A

NO, never, keep dry

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47
Q

Who must be advised to relative necessary procedures, safeguards, and disinfection of potable water from DOUBTFUL sources?

A

CO

- minimum halogen residual for DOUBTFUL WATER is 2.0

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48
Q

Who approves of FDA approved use for surface disinfection such as iodine for food contact surfaces on a ship?

A

MDR

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49
Q

WHat is Halogen residual?

A

Chlorine/Bromine

  • quick indication if water has been improperly treated
  • absence may = contamination
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50
Q

What is Bacteriological testing of water?

A
  • ensure fitness for human consumption

- assess adequacy of disinfection process

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51
Q

WHat happens when potable water with sufficient halogen residual is warmed?

A

Chlorine evaporates

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52
Q

For Halogen residual: what must the ship maintain at?

A

0.2ppm FAC or TABR after Tx

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53
Q

When is Halogen residual testing done?

A
  • Daily
  • In conjunction with Bacterial testing
  • prior to receipt of potable water
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54
Q

When is ENG Dept required to check Halogen level of potable water tanks?

A

30min after contact with receiving entity

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55
Q

For Microbiology quality: What are the sample ratios with number of personnel on the vessel?

A 
400 or less
- no less than 4 samples
400-800
- 8 samples
800+
- 12 samples
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56
Q

For Microbiology Quality: How many of the ships ice machines and potable water tanks are tested?

A

1/4 of Ice machines

1/4 of potable water tanks

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57
Q

When is the Emergency Potable Water Tank tested?

A

Monthly

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58
Q

For Repeat monitoring: Regarding positive samples, how many repeat samples are required and from where?

A
  • Original Service Connection source
  • one upstream
  • One Downstream
  • Collect samples within 24hrs of pos sample
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59
Q

Potable water testing procedures: What do you use to determine Chlorine/Bromine?

A
  • DPD #1 = Test for FAC(free available chlorine)/TBR(total bromine residual)
  • DPD #4 = test for chloramines (total chlorine) residual
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60
Q

Potable water testing procedures: Color Comparator test kit accuracy?

A

+/- 10%

- human error will be the major flaw

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61
Q

Potable Water Testing Procedures: Portable Spectrophotometer accuracy?

A

+/- 2%

  • more accurate because no human error
  • machine does all the work
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62
Q

What are source contamination?

A
  • Cross connections with non-potable water
  • leaks in bulkheads between potable water/fuel/ballast/wastewater tanks, bilges
  • leaks in non-potable piping through water tanks
  • excessive storage time of water in tanks
  • improper disposal of chems/liquids through potable water-sounding tubes
  • potable hoses for non-potable water
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63
Q

For water disinfecting procedures what are approved methods for disinfecting shipboard potable water?

A

Chlorine and Bromine

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64
Q

What are automatic chlorine disinfectants?

A

In-line chlorinators

- injects hypochlorite into system proportionately to flow of water

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65
Q

How is Bromine dispensed in potable water?

A

via resin impregnated cartridge

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66
Q

What are the two types of brominators?

A

In-line Brominator
- preset to 0.7ppm bromine to water normally
- can deliver 2.0ppm when necessary
Recirculation Brominator
- draws water, injects into small batch, water recirculated
- delivers 0.7ppm bromine to water

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67
Q

What is the BATCH METHOD?

A

Manual Chlorine disinfection

  • may result in over-chlorination
  • uses CALCIUM HYPOCHLORITE (HTH)
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68
Q

What is the chlorine dosage calculator?

A

select desired ppm
select strength/type of chlorine used
- 5% Sodium Hypochlorite (liquid measure)
- 10% Sodium Hypochlorite (liquid measure)
- 65-70% Calcium Hypochlorite (dry measure)

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69
Q

What is the Chlorine dosage rule of thumb?

A

One ounce HTH/5,000 gal water = 1.0 ppm

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70
Q

What are the required Halogen residuals used for disinfection of potable water?

A
  • Approved source = 0.2 ppm FAC/TBR after 30 min contact time
  • Unapproved source = 2.0 ppm FAC/TBR after 30 min contact time
    • if brominator cannot get TBR of 2.0 use BATCH METHOD
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71
Q

Disinfection Steps: Method 1?

A
  • Add chlorine to achieve 10ppm FAC through tank
  • Perform Bacteriological testing
    • negative = use water
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72
Q

Disinfection steps: Method 2?

A
  • Spray/apply directly 200ppm FAC to all tank surfaces
  • flush inlet/outlet pipes with 10ppm
  • perform bacteriological testing
    • negative = use water
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73
Q

Disinfection steps: Method 3?

A
  • fill 5% of tank Vol w/50ppm FAC Solution
  • hold for 6 hours
  • perform bacteriological testing
    • negative = use water
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74
Q

How can you control taste/odor problems with potable water?

A 
Chlorination method
- Chlorinate to 5.0 ppm FAC
- Distribute at 2.0 ppm FAC
Steam method
- Requires NAVSEA approval
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75
Q

How do we request outside assistance for potable water issues?

A

Contact NEPMU via TYCOM Med Officer

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76
Q

Storage requirements for potable water water agents?

A
  • 6 ounce bottles
  • stow in a locked box mounted on a bulkhead
  • Preferred in ENG office space
  • Metal Box like first aid locker
    • Three 1/4inch holes drilled in bottom to release gas
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77
Q

What are the requirements for storing Calcium Hypochlorite?

A
  • No More than 48, 6oz bottles in individual locker/bin
  • all lockers/bins/enclosures containing HTH labeled “HAZARDOUS MATERIAL, CALCIUM HYPOCHLORITE”
    • RED LETTERS
    • WHITE BACKGROUND
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78
Q

What is the shelf life of Bromine cartridges in storage?

A

2 years from date of manufacture

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79
Q

What is the water sanitation bill?

A

posted conspicuously in areas where potable water/associated materials are:

  • processed
  • treated
  • stored
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80
Q

Who is ultimately responsible for Water Sanitation bill?

A

CO

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81
Q

How long is the Potable water log kept for?

A

2-year chronological record

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82
Q

WHat must the potable water log include?

A
  • time/date for each sample
  • location of ship
  • sample site
  • source
  • halogen residual
  • bacteriological test result
    • presence/absence
    • include +/- controls
    • purpose of test
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83
Q

What are the medical departments responsibilities with marine sanitation devices?

A

Conduct visual inspections as part of routine habitability and sanitation inspection

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84
Q

What is Medical’s responsibilities regarding prevention of waste water hazards during Indoc?

A
  • potential health hazards associated with human waste
  • proper personal hygiene necessary to reduce the risk associated with working with MSD systems
  • correct procedures for cleaning and disinfecting contaminated spaces
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85
Q

How often are personnel trained on prevention of waste water hazards?

A

Periodically

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86
Q

What cleanups or medical department representative is required to be at regarding waste water hazards?

A

Food service Spaces
living Spaces
medical Spaces

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87
Q

For collection hold and transfer system what are the three modes that it operates in?

A

Restricted waters
at sea
in Port

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88
Q

What is the most common collection hold and transfer system?

A

Tape II-B marine sanitation device

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89
Q

What are the functional elements of the CHT system?

A
  • Soil drains or sewage “from toilets and urinals“
  • Gray water drains “ from showers, laundry, and galleys“
    - diverter valves which direct the waste water over the side or to the holding tanks
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90
Q

How many hours are holding tanks constraints to?

A

12 hour holding period

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91
Q

For transfer elements regarding CHT, what are they?

A 
Sewage pumps, 
overboard/deck connection discharge, 
diverter valves/check valves,
- each tank has two sewage pumps connected to discharge sewage/gray water to receiving facility, 
ship waste offloading barge, 
directly overboard
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92
Q

What are the two different modes regarding CHT?

A

Manual mode - pumps actuated independent, deactivate when liquid reaches 10% of tank volume

Automatic mode - stops pump automatically at 10% capacity, activate signal at 30%, signal standby to activate at 60%, visual/audible high-level alarm activated at 80%

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93
Q

For health and safety inspections with CHT systems what is the greatest danger to ships and personnel?

A

Hydrogen sulfide (H2S)

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94
Q

What are health and safety inspection requirements for CHT systems?

A
  • always assume holding tanks contain toxic gases unless engineer says otherwise
  • never enter CHT pump room with odor and less supplied airline respirator with full face mask
  • Post safety watch, SCBA outside access
  • H2S is heavier than air
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95
Q

What are things pump rooms should have for CHT?

A

Two emergency escape breathing devices, EEBD, that are good for 10 minutes of air

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96
Q

Who needs to be reported to for all leaks spills or other sources of contamination observed during inspections or any time?

A

Engineering officer
executive officer
SMDR

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97
Q

What are the toxic or explosive gases associated with CHT?

A

Hydrogen sulfide
methane
ammonia
carbon dioxide

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98
Q

What are the basic immunizations that personnel to deal with CHT/waste water need to keep current?

A

Polio
tetanus
diphtheria

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99
Q

What are the required personal protective equipment for CHT workers?

A 
Coveralls 
rubber boots 
rubber gloves 
face shields 
SCBA, when necessary
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100
Q

What is the reference for sewage spill cleanup procedures?

A

NAVships technical manual, chapter 593 “pollution control“

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101
Q

What are the approved EPA disinfectants for Medical, food-service, and birthing Spaces?

A

Germicides:

  • phenolic type
  • iodine type
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102
Q

What is the process for contaminated bilges with sewage?

A

Must be pumped out
washed down with fire hose
pumped out again

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103
Q

What is the process if the potable water tanks formed the floor of the bilge and the ship has a sewage spill in it?

A
  • Daily bacterial logical monitoring of affected potable water tanks until assured potable water not contaminated
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104
Q

What are the color coding requirements for CHT systems interior of the ship?

A

All are gold including:

  • valve handles
  • operating levers
  • exterior deck discharge same color as external structure
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105
Q

What are the waste water disposal procedures within US waters and territorial seas?

A

prohibited within 3 nautical miles of sure

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106
Q

CHT systems are designed to operate in three modes, what are they?

A

At sea - sewage/gray waters, diverted or discharged overboard
in Port - sewage and gray water discharged into sanitary sewer through sewer risers/shipped waste off load barges
in restricted - waters sewage collected/stored in hold tanks, gray water discharged overboard via diverter valves

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107
Q

What is the NAV med instruction for a potable water in the field?

A

NAVmed P-5010-10, chapter 18, section 18-2

108
Q

What are the CO responsibilities for potable water in the field?

A
  • ensure safe water for drinking, cooking and bathing
  • water discipline
  • dangers of consuming untreated water
  • disinfection of personal drinking water
109
Q

What is the ENG O responsibilities for potable water in the field?

A
  • provides sufficient potable water quantities for population
110
Q

WHat is Medical Dept responsibilities for potable water in the field?

A
  • advise CO on water quality issues
  • assist engineers with:
    • selection of sources
    • surveying potable water system
  • bacteriological exam
  • Halogen levels
  • inform ENG of water quality/treatment required
  • Chemical analysis of field water supplues
110
Q

WHat is Medical Dept responsibilities for potable water in the field?

A
  • advise CO on water quality issues

- assist engineers with:

111
Q

What are influences on field water choices?

A
  • Quality
  • Quantity
  • Accessibility
112
Q

What are potential water sources in the field?

A
  • public water: easy/safe, already treated
  • unsafe until approved
  • evaluate/treat
113
Q

What are locations to get surface water and things to consider?

A
  • quality may be problem

- rivers, streams, lakes, ponds, seas, and oceans

114
Q

What are some ground water locations and possible issues?

A
  • wells/springs
  • usually less contaminated
  • located 30 yards upgradient
115
Q

What is the typical field water treatment process?

A
  • straining
  • chemical addition
  • coagulation
  • sedimentation
  • Various kinds of filtration
116
Q

What is the Military Reverse Osmosis Water Purification Unit (ROWPU)?

A
  • most common
  • can be used to produce water in:
    • fresh water
    • brackish water
    • sea water
  • removes:
    • microorganisms, parasites, bacteria, and viruses
117
Q

What is non-reverse osmosis?

A

Only used in treating fresh water

- 3000 gal/hr

118
Q

Specifics of the Lightweight water purifier (LWP)?

A
  • small military detachments

- 125gal/hr

119
Q

Specifics of the Tactical water purification system?

A
  • International Organization for Standardization, palletized load system trucks
  • produces 1500gal/hr
  • replacing RO unit
120
Q

For disinfection of water what is the most common method?

A

Chlorination

121
Q

How long after contact time should sufficient chlorine be achieved?

A

30 min

122
Q

What are the different types of disinfectants for field water?

A
  • Calcium Hypochlorite (HTH), 65-70%
  • Sodium Hypochlorite 5% or 10%
  • Chlorine dioxide
  • chlorine gas
  • bromine
  • chloramines ozone
  • UV radiation
123
Q

What are the required chlorine residuals?

A

2ppm FAC after 30 min contact time

124
Q

What are the chlorine residuals for secondary STORAGE/unit level STORAGE?

A

1ppm FAC

  • if between 02-1ppm - re-chlorinate
  • less than 0.2ppm FAC - re-chlorinate to 2ppm, at least 1ppm after 30 min
125
Q

What uses are natural surface/well water and what ppm’s for drinking water?

A
  • EMERGENCY ONLY

- 5ppm after 30min

126
Q

How many iodine tablets are used in a canteen?

A

2

127
Q

How many iodine tablets for a 5 gal jug?

A

40

128
Q

How many iodine tablets are for 70-72 ounce personal hydration system? 100-102 ounce reservoir?

A

4 for 70-72

6 for 100-102

129
Q

specifics of the 3000 gal tank?

A
  • onion tank
  • highly mobile
  • inflatable/collapsible fabric water tank
130
Q

Specifics of the Load Handling system water tank rack?

A
  • Hippo

- 2000 gal

131
Q

Specifics of the semitrailer-mounted fabric tank?

A

3000-5000 gal

132
Q

Tactical water distribution system?

A

10 miles on level terrain

133
Q

What are the three modes of water distribution/waste management system?

A
  • water distribution set
  • hospital
  • deployable medical system
134
Q

What is the name of the 400-gal trailer?

A

Water Bull

135
Q

What is the nick-name of the 800 gal unit?

A

Camel

136
Q

What is DISINFECTION METHOD 1 of potable water containers?

A
  • chlorinate water to 100ppm FAC
  • run through valves/spigots
  • keep interior surfaces wet for 60min
  • drain at approved location
  • rinse container/spigots 2x
137
Q

What is DISINFECTION METHOD 2?

A
  • WATER/CHEMICAL in SHORT SUPPLY
  • prep 5 gal water w/100ppm chlorine solution
  • long handled brush/rod w/cloth, swab for 10 MIN
  • keep walls wet 60min
  • rinse through valves/spigots
  • rinse/drain 2x through valves/spigots
138
Q

Alternative procedure for disinfection of potable water container?

A
  • chlorine water to 10ppm
  • hold 24 hrs
  • drain
  • rinse spigots 2x
139
Q

What is accommodations?

A

number of personnel permanently supported by:

  • habitability spaces
  • systems
  • fixtures
  • equipment
140
Q

what is surge?

A

personnel embarked aboard ship for short durations of:

  • special operations
  • exercises
  • mobilizations
141
Q

what are transients?

A

personnel embarked who do not contribute to host ship capability

142
Q

Who are ships company?

A
  • all personnel assigned to a ship
143
Q

what is hot bunking?

A
  • more than one person to a single berth
144
Q

what are habitability factors?

A
  • floor area
  • ventilation
  • heating
  • sanitary fixtures
  • water supply
  • lighting
  • color
145
Q

Where are the intakes for ventilation/air conditioning located?

A
  • topside exhaust
  • stacks
  • water spray
146
Q

What max temp should berthing be?

A

80 degrees dry bulb

147
Q

For heating in berthing and messing what should the minimum temp be?

A

65 degrees dry bulb

148
Q

WHat is ventilation designed to do?

A 
minimize humidity/odors
Specific spaces:
- galley
- scullery
- laundry
- shower
- water closet
149
Q

Privacy standards in berthing?

A
  • full privacy partitions
  • individually controlled vent terminals
  • passageways shall not intersect
150
Q

What kind of pillows are prohibited?

A

polyurethane

151
Q

what are requirements for mattresses?

A
  • low smoke foam

- hot bunking is prohibited

152
Q

What are requirements for barbershops?

A
  • Crew <100 - portable barber facility
  • Crew 100-300 - barbershop with chair
  • Crew 300+ - barbershop, +1 chair for each 300+ people
153
Q

Ship’s store requirements?

A
  • required on all ships for hygiene/necessity
  • snack bar for 500+ personnel
  • vending machines in designated areas, secured to deck
154
Q

Laundry facility requirements for <100 people?

A
  • one 16lb washer/dryer

- three irons/boards

155
Q

Laundry facilities with 100+ personnel?

A
  • facility for 24lbs/week/person

- ironing board in every berthing

156
Q

Who makes routine sanitary inspections of toilets, lavatories, and berthing?

A
  • XO
  • MDR
  • OOD
  • JOOD
  • Chief MA
  • Div O
  • Div CPO
157
Q

How do we deal with sewage backflows?

A
  • secured immediately
  • corrected
  • space is cleaned/sanitized
158
Q

What reason would we submit an inspection report to the CO?

A
  • Identify discrepancies
  • recommend corrective actions
  • onsite training during inspection
159
Q

Barbershop terminology?

A
  • Disinfectant - agent that destroys/removes pathogenic organism
  • EPA - Environmental Protection Agency
  • FDA - Food and Drug Admin
160
Q

WHat are the barbershop health requirements?

A
  • medically screened/determined free of disease prior to assignment
  • screen deep enough to detect locality of diseases
  • NO ANNUAL EVAL
161
Q

Can barbers serve patrons with inflamed/infections conditions?

A

No, unless they have note from medical officer

162
Q

Barbershop requirements?

A
  • NOT IN GALLEY/FOOD SERVICE area
  • must have:
    • lavatory fixture
    • waste disposal
  • lighting/ventilation
  • FDA/EPA agents for cleaning/disinfecting
  • NO derm practices allowed
  • NO SHAVES
  • Change cover daily
  • clean shop
163
Q

WHat types of clippers are authorized? Compressed air limits?

A
  • vacuum equipped clippers

- Air less than 15 PSI

164
Q

How often must disinfecting solution be changed in a barbershop?

A

weekly

165
Q

What requirements are there for removable clipper heads?

A
  • remove
  • wipe or dust
  • wash/rinse
  • disinfected using EPA solution
  • rinse with water
166
Q

How often are barbershops inspected and by whom?

A
  • quarterly

- Conducted by MDR

167
Q

What things are required to be done for a Barber Shop inspection?

A
  • ensure sanitary regs posted
  • visual check for current physical cards
  • general cleanliness
  • no hair on floor
  • trash low or clean
  • countertops clean
  • check solutions for hair clipping buildup
  • personnel have clean smocks/well groomed
168
Q

At what distance at sea can a ship use seawater for laundry?

A

Outside the 50 fathom curve (25 miles from shore)

169
Q

What are the control measures for AIR DRY CHEMICAL CONCENTRATIONS when they exceed exposure levels?

A
  • engineering
  • administrative
  • personal protective equipment
170
Q

What noise hazardous levels require hearing protection?

A

84 decibels

171
Q

The eyewash stations in the laundry spaces need to be capable of providing ____ per minute for ____ minutes?

A

0.4 gal/min for 15 min

172
Q

What temperature is hygienically safe laundry?

A

120-140 degrees

173
Q

What is an required by OSHA for emergencies?

A

First Aid Kits

174
Q

When chlorine bleach is not included in formulation for laundry what us a necessary step?

A

Hot air dryers

175
Q

What must laundered articles be free of?

A
  • chemicals

- biological agents

176
Q

What is the instruction for laundry?

A

NAVMED P-5010-2

177
Q

What are the requirements for handling soiled/contaminated linens?

A
  • impervious laundry bag
  • washable carts, remove/replace liner
  • sorted in sorting room
  • personnel must wear: clean uniforms, masks, gloves
178
Q

How are laundry personnel to handle contaminated laundry?

A 
double sealed bag
outer bag must be:
- red
- biohazard label/symbol
hot water soluble inner bag
CONTAMINATED LINENS NOT SORTED
179
Q

What is the ships sanitation certificate program?

A

BUMEDINST 6210.4

180
Q

Quarantine regulations of the Navy?

A

OPNAVINST 6210.2

181
Q

What are quarantine regulations intended to do?

A

Prevent introduction/dissemination domestically/internationally of diseases affecting:

  • humans/plants/animals
  • prohibited/illegal wildlife
  • arthropod vectors
  • pests of health/agriculture importance
182
Q

What are the quarantinable diseases?

A
  • cholera
  • diptheria
  • infectious TB
  • plague
  • smallpox
  • yellow fever
  • viral hemorrhagic fever
  • SARS
  • influenza with potential to cause pandemic
183
Q

Facts about Cholera?

A

bacterium Vibrio Cholerae

  • 1/20 sever cases, profuse diarrhea, vomiting, leg cramps
  • inadequate Tx of sewage/drinking water
  • brackish/coastal drinking water
184
Q

Methods of control for Cholera?

A
  • oral vaccine
  • case report required by:
    • WHO/Medical Event Report
  • Concurrent disinfection of feces/vomitus of linens/clothes of Pt’s
185
Q

Facts about plague?

A

Bacterium, Yersinia pestis

- rodent flea on rats

186
Q

Clinical forms of plague?

A 
Bubonic
- Lymphadenitis in lymph nodes
- site of flea bite
Pneumonic 
- lungs with sputum loaded agent 
- respiratory droplets 
- leads to outbreaks/epidemics
187
Q

Methods of control of plague?

A
  • reduce contact with: flea areas, patients with disease
  • education
  • rat-proofing
  • storage/disposal of food/garbage
  • patient isolation
  • clothing repellant
  • case reports to WHO, MER
188
Q

Yellow fever facts?

A
  • rare cause of illness in travelers

- Transmitted by AEDES Egypti

189
Q

How long does the immunity last for Yellow fever vaccination?

A

10 years, live virus vaccine

190
Q

What are isolation procedures for Yellow fever?

A
  • blood/body fluid
  • clothing/bednet/repellant
  • CASE REPORT TO WHO/MER*
191
Q

What is Smallpox?

A

Variola Virus

  • last natural occurrence OCT 1977, SOMALIA
  • all stock held at CDC (Atlanta)/Centre of Virology/Biotechnology (Koltsovo, RUS)
  • spreads by droplet
192
Q

Methods of control for Smallpox?

A
  • immunization

- if suspected, contact local state/health authorities is OBLOGATORY

193
Q

OPNAVINST 6210.2?

A

Quarantine Regs of Navy

  • Navy’s responsibilities
  • liaisons
  • foreign quarantine
  • Public Health Service Req’s
194
Q

NAVMED P-5010-8

A

Navy Entomology and Pest Control Tech

195
Q

BUMEDINST 6210.4?

A

Shipboard Sanitation Cert Program

- identify PREMED techs IAW OPNAVINST 6210.2

196
Q

What are the three NAVMED 6210/ instructions?

A

NAVMED 6210/1 - Navy Ship sanitation control Exemption/Control Certificate

NAVMED 6210/2 - Notification of 30 day extension

NAVMED 6210/3 - Declaration of Health Cert

197
Q

In Foreign Ports, what are the limitations of foreign officials?

A

Cannot conduct inspections of Military vessels

198
Q

What are US port quarantine requirements?

A

15 days prior to port:

  • report crew w/Temp = 100+F
  • rash
  • glandular swelling
  • jaundice
  • SX +48 hours
  • DIARRHEA +24 HOURS W/3+ LOOSE STOOLS
199
Q

What are the CO timeline of responsibilities prior to port regarding quarantinable illnesses?

A

12-72 hours prior to port

  • copy to Military Quarantine inspector
  • PREVMED in port
200
Q

What are the elements of the TB Control program?

A
  • TB Screening
  • Prev Therapy
  • TB Case ID
  • TB Patient management
  • Contact investigation
201
Q

What is the name of the TB skin test?

A

Mantoux Method

202
Q

What is Tuberculin, PPD?

A
  • Purified Protein derivative
  • Tubersol - preferred
  • Aplisol - alternate
203
Q

What size needle is the TB skin test injected by?

A

Disposable 1ml tuberculin syringe

- fitted w/ 1/4-1/2 inch, 27 gauge short bevel needle

204
Q

What is the QuantiFERON-TB GOld (QFT) for?

A

used in place of, not in addition to, TST Test

205
Q

What is mycobacterium TB?

A
  • bacteria that cause latent TB/active TB disease
206
Q

What is active TB?

A
  • TB Bactria are multiplying/attacking body, usually lungs
207
Q

What is Latent TB?

A
  • Bacteria alive, inactive in the body
  • don’t feel sick, cant spread TB
  • usually positive skin test
208
Q

TB Skin test?

A
  • tests if you are infected with T Bacteria
209
Q

TB Blood test?

A
  • new test

- blood sample for TB

210
Q

What is the BCG test?

A
  • named after french scientists, Calmette/Guerin

- rarely used in US

211
Q

What is directly observed therapy for TB?

A
  • take TB Meds with help from medical

- meet w/healthcare worker daily/weekly

212
Q

What is LTBI Tx?

A
  • Isoniazid (INH)/Rifapentine (RPT) orally 15mg/week
213
Q

When a patient has past Hx of active TB/skin tests/Hx of INH they must provide:?

A
  • clinical eval
  • hospitalization
  • diagnosis
  • treatments
214
Q

What form do we document LTBI screenings?

A

NAVMED 6224/8

215
Q

What is Bacillus Calmette Guerin?

A

vaccine for TB given to INFANTS/Small CHildren where TB IS COMMON

216
Q

What are the Initial Isonazid (INH) prev therapy evaluations?

A
  • High Risk
  • Medium Risk
  • Low Risk
217
Q

INH eval therapy for HIGH RISK?

A
  • Induration 5mm+
  • recent close contact
  • fibrotic/other changes on radiograph
  • suspect of having TB
218
Q

INH eval therapy for MEDIUM RISK?

A
  • induration of 10mm+
  • recent immigrant (-5 years) from T region
  • Healthcare worker/at risk
  • clinical conditions that place person at risk
219
Q

INH Eval therapy for LOW RISK?

A
  • induration of 15mm+

- person with no risk factors

220
Q

Eval for TB must be done by and include?

A

MO, NP, PA, IDC

  • appropriate clinical Hx
  • physical exam
  • chest x-ray
  • sputum exam
  • liver function test
221
Q

What form are patients with INH Preventative therapy documented on?

A

NAVMED 6224/9

222
Q

What is directly observed INH treatment regarding NON-COMPLIANCE?

A
  • INH given 2X/Week

- difficulty with Tx adherence

223
Q

What is one of the problems with INH therapy regarding the liver?

A
  • Serum Glutamic Oxaloacetic Transaminase (SGOT)
  • Serum Glutamic-Pyruvic Transaminase (SGPT) blood levels
      • INH Therapy increases liver enzymes **
224
Q

What is the procedure when suspected/confirmed contact with TB?

A
  • MDR notify cognizant NEMPU
    NEPMU Conducts investigation
  • investigation done by CDC guidelines
225
Q

WHo is responsible for contact investigation of TB?

A

CO/OIC

226
Q

Who will TB investigation report be provided to?

A

cognizant FLEET/TYCOM surgeon

  • Navy Marine Corps Public Health Center (NMCPHC)
  • SUBMITTED WITHIN 24HRS
227
Q

WHat are the Characteristics of patients with Active TB?

A

Often Asymptomatic

  • cough, weight loss, fatigue, fever, loss of appetite, chills, night sweats
  • lungs:
    • pulmonary TB = bad cough, chest pain, dyspnes, coughing up blood
228
Q

Treatment for patients with active TB?

A 
Chemotherapy
- INH 300mg/day for 6-9 mo
- Children = 10-20mg/kg
Anti-TB drugs 
- Bactericidal
- bacteriostatic
229
Q

Adverse effects of secondary Tx for TB?

A
  • INH Associated Hepatitis
230
Q

what is medical surveillance and medical event reporting form?

A

NMCPHC-TM-PM 6220.12

231
Q

What does NMCPHD-TM-PM 6220.12 do?

A

Enables Navy public health experts to be aware of:

  • important med events
  • prevention/control actions already taken
  • impact/potential to affect large # of people
232
Q

What are the uses of Medical Event Reports?

A
  • any diagnosis/case/event that is classified by DON
  • findings reported to Navy Environmental and Preventative Medicine Unit (NEPMU)
    • primary consultant resource
233
Q

How can the MER be submitted?

A

Disease Reporting System internet
- official system for RME’s
- when internet unavailable use format on:
Appendix D of NMCPHC-TM-PM 6220.12

234
Q

Where are URGENT reports for MER made?

A
  • phone
  • priority Naval Message
  • encrypted email
235
Q

What are the timelines for MER submissions?

A
  • Urgent - 24hrs

- Routine - no later than 7 days after ID

236
Q

what kind of diseases are required to be reported within 24 hours?

A
  • Anthrax
  • botulism
  • diptheria
  • hemorrhagic
  • influenza a, novel
  • malaria
  • measles
  • meningococcal
  • outbreak or disease cluster
  • plague
  • poliomyelitis
  • rabies, human
  • severe acute respiratory syndrom
  • smallpox
  • TB, Pulmonary
  • tularemia
237
Q

what are the incidences REQUIRING submission of MER?

A
  • Any diagnosis listed on RME list

- outbreaks

238
Q

WHat marking should be marked outside of MER’s?

A

For Official Use Only

239
Q

What makes a COMMUNICABLE DISEASE diagnosis, case, or medical event REPORTABLE?

A
  • suspected
  • probable
  • confirmed
  • ALL DIAGNOSIS’S NEED TO BE CONFIRMED IN MER
240
Q

Describe the Adenovirus Type 4/7 vaccination.

A

admin: Basic Training
dose: 2 tabs (white/peach)
route: oral

241
Q

Anthrax Vaccine

A

dose: 5 - 0.5ml shots over 18mo
route: IM
booster: annually as needed/required

242
Q

Haemophilus Influenzae Type B

A

admin: immunocompromised, sickle cell, no spleen function
dose: 1 - 0.5ml
route: IM

243
Q

Hepatitis A

A

admin: unless seroimmune, give at boot camp
dose 6-18yo: one 720EL.U/(0.5mL)
dose 19yo+: one 1440EL.U/(1.0mL)
interval: 0, 6mo

244
Q

Hepatitis B

A

Energix-B
dose: 0-19 y/o, 0.5ml, 3 doses

Recombivax HB
dose: 0-19y/o, 0.5mL, 3 doses

route for both: IM

245
Q

Hep A/B (Twinrix)

A

dose: 3 doses, 1.0mL

246
Q

Influenza

A

admin: Annually
dose: 1 0.5ml
route: IM

CONTRAINDICATIONS: serious systemic/anaphylactic reaction

247
Q

Measles, Mumps and Rubella

A

live virus, pregnant women 28 weeks advisory

dose: 0.5ml
route: SQ

248
Q

Meningococcal

A

All AD Military
Dose: 1 0.5ml
Route: IM
booster: persistent risk, 5 years

249
Q

Pneumococcal

A

Admin: High risk for ACIP

dose: 0.5mL
route: IM

250
Q

Poliomyelitis

A

All AD military booster at basic
dose: 0.5ml
Route: SQ, IM

251
Q

Rabies

A

Considerations: Animal bite, type of bite, non-bite, saliva exposure

dose: 4 1.0mL HDCV, within 14 days, + 1 dose HRIG (20IU/kg
* **immunocompromised 5th dose at 28 days

251
Q

Rabies

A

Considerations: Animal bite, type of bite, non-bite, saliva exposure

dose: 4 1.0mL HDCV, within 14 days, + 1 dose HRIG (20IU/kg
* **immunocompromised 5th dose at 28 days

252
Q

Smallpox

A

dose: 15 jabs of bifurcated needle
***Assess 6-8 days “Major reaction”
route: Percutaneous (scarification)
booster q/10years

253
Q

TDAP

A

dose: 0.5mL
route: IM
booster every 10 years

254
Q

Typhoid

A

before overseas dep/assignment to typhoid endemic area
dose: 0.5mL
route: IM
booster 2 years

255
Q

Varicella

A

given at basic training

dose: 2 of 0.5mL
route: SQ

256
Q

Yellow Fever

A

Dose: 0.5mL
route: SQ
booster 10 years

257
Q

Yellow fever storage

A

36-46F

- discarded after 1 hour of reconstitution

258
Q

MMR storage

A
  • 58Deg +/- 5 degrees
  • STORE IN DARK PLACE
  • discard 8 hours after reconstitution
259
Q

Varicella storage

A

Ref: 35-46F
Freezer: -58F +/-5
Discard after 30 minutes of reconstitution

260
Q

WHat is a requirement prior to immunizing patients?

A

ALLERGIES

Pregnancy

261
Q

What is the equipment necessary for anaphylactic shock Tx?

A
  • ACLS qualified IDC, Dentist, PA, Nurse

Crash cart contents:

  • O2
  • Admin apparatus
  • airways
  • IV fluid
  • meds for ACLS
  • AED/Defibrillator/cardiac monitor
262
Q

Advisory committee on Immunization Practices (ACIP) for Navy IMMS program?

A

develops recommendations on administration that include:

  • age of vaccine admin
  • number of doses/interval
  • precautions/contraindications

ACIP is only entity in fed gov that makes these recommendations

263
Q

WHat immunizations can be given while underway?

A

Everything but YELLOW FEVER

264
Q

What are the forms for documenting immunizations?

A
  • NAVMED 6230-4 - adult health record imms rec
  • CDC 731 - Intl. Cert of Vaccination
  • DD Form 2766

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