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Flashcards in Disaster Detect Deck (29)
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What are some chemical agent clues?

Rapid symptom onset, multiple victims, EMTs effected, disseminated device used, animal or insect die off


Describe the choking agent Phosgene.

Smells like newly cut hair
Coughing, choking, vomiting


Describe the choking agent Chlorine.

Swelling like swimming pools
Coughing, choking, vomiting


Describe blistering agent of Mustard.

Smells like garlic, symptom onset delayed
Tearing, eye itching, running nose, cough, blistering


Describe the blister agent of Lewisite.

Smells like geraniums, immediate onset
Tearing, eye itching, running nose, cough, painful blisters


Describe blood agent of Cyanide gas.

Smells like bitter almonds, rapid onset
Normal skin color, gasping for air, shock


What are the nerve agents?

Tabun, sarin, soman, VX


What are the symptoms of nerve agents?

Rapid to 48 hr onset, pinpoint pupils, salivation, runny nose, shortness of breath, chest tightness, nausea, muscle twitch, seizures, coma, death


What are the characteristics of a biological agent?

May not have an scene, hard to detect, beware of multiple people with similar complaints in "healthy" population


Describe bacillus anthracis as a biological agent.

Spore forming, sheeps and cattle, 2-60 day incubation
Inhalation, cutaneous, GI


What is the presentation and prognosis of cutaneous anthrax ?

Local edema, itchy bump to blister, painless, depressed eschar
Untreated = 20% dead
Treated = 0% dead


What is the presentation for inhalation anthrax?

Non-specific "flu-like" symptoms to abrupt respiratory failure
Widened mediastinum and/or pleural effusions on chest rad


How is anthrax diagnosed?

Cutaneous - clinical, culture beneath eschar
Inhalation - blood culture, chest rad


What are the features of yersina pestis (plague)?

10 natural cases a year
Usually lymph node/blood infection
Pneumonic plague for bioterrorists


What is the clinical presentation for the plague?

Flea bite - bubonic
Inhalation - pneumonic
Incubates for 2-3 days, high fever, chills, headache, coughing blood, toxic look


How is the plague diagnosed?

Staining of sputum (gram neg), culutres


What is the route of infection for tularemia (Francisella tularensis) and the presentation?

Tick and fly bites, infected animals and inhale
Incubation 1 - 21 days, acute febrile illness, pneumonia, conjunctivitis or skin ulcers, swollen lymph nodes


How is tularemia diagnosed?

Culture of blood and sputum (neg coccobaccillus)


What are the features of small pox?

7-17 day incubation, prodrome, 2-3 day rash, 8-10 rash with pustules then scabs


Describe Viral hemorrhagic fever?

Variants (Ebola, Marbug, Lassa, Dengue)
Naturally occurring - mircovascular damage
Incubation 2-21 days, non-specific prodrome, flushing in face and chest, petechiae
Shock and generalized mucous membrane hemorrhage


How is viral hemorrhagic fever diagnosed?

Clinical presentation, high level index of suspicion
If pt thought to present with VHF report before results


Describe SARS (severe acute respiratory syndrome)?

Coronavirus, world-wide in 2003
Incubation 2-7 days (up to 10), presents flu-like prodrome, diarrhea, respiratory symptoms on day 3-7
Development of pneumonia


Describe Ricin.

Castor beans, exposed bu injection, inhalation ingestion
Inhalation - fever, cough, chest pain, pulmonary edema
Ingestion, nausea, vomit, diarrhea, GI hemorrhage


What are the features of boutlinum toxin?

Clostridium botulinum, neurotoxin, inhale or ingestion
Presents 24-36 hrs after ingestion
Blurred and double vision, slurred speech, swallow issues, descending paralysis, respiratory failure


How is botulism diagnosed?

Based on presentation, toxin assay of blood



Skin rash with fever (smallpox)
Acute pulmonary syndrome (anthrax/plague)
Flue like syndrome (Tularemia/SARS)
Excessive bleeding (Viral hemorrhagic fever)
Toxin effect (Botulism)
Your personal/community safety


What is step one of surveillance?

Ongoing monitoring of your environment and your patient population for unusual events


What is step two of surveillance?

Communication of any worrisome observation to a 911 operator or appropriate health department contact


Describe the signs and symptoms of a radiological event.

Delayed onset, early symptoms predicts worse outcome, nausea, vomit, burns