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Flashcards in Disaster Management Deck (136):
1

disaster that occurs inside a healthcare facility that could endanger workers and patients

Internal Disaster

2

disaster that occurs anywhere outside the healthcare facility requiring activation of a facility's emergency response system

External Disaster

3

The Joint Commission requires how many disaster drills per year?

Two

4

the ability of a facility to rapidly expand during an emergency

surge capacity

5

What are the 4 phases of Emergency Management?

Mitigation, Preparedness, Response & Recovery

6

physician or administrator who assumes overall leadership for implementing the emergency plan

Hospital Incident Commander

7

physician who decided the number, acuity and resource needs of patients

Medical Command Physician

8

physician or nurse who rapidly evaluates each patient to determine priorities for treatment

Triage Officer

9

person who serves as a liaison between the health care facility and the media`

Community Relations/ Public Information Officer

10

triage category in which injuries are life-threatening but survivable with intervention ( EX: sucking chest wound, hemothorax, unstable chest/abdominal wounds, 2nd & 3rd degree burns over less than 50% TBSA)

Category Red/ Immediate/ Priority 1

11

triage category in which injuries are significant and require medical care but can wait 30 minutes- 2 hours without threat to life or limb (EX: stable abdominal wounds w/o significant hemorrhage, soft tissue injuries, maxillofacial wounds w/o airway compromise, fractures requiring ORIF)

Category Yellow/ Delayed/ Priority 2

12

triage category in which injuries are minor and treatment can be delayed hours or days... "walking wounded" (EX: extremity fractures, minor burns, sprains, behavioral disorders or psychological disturbances)

Category Green/ Minimal/ Priority 3

13

triage category in which injuries are extensive and chances of survival are unlikely even with definitive care (EX: unresponsive patients w/ penetrating head wounds, high spinal cord injuries, 2nd & 3rd degree burns in excess of 50% TBSA, patients exposed to large amounts of radiation)

Category Black/ Expectant/ Priority 4

14

level of PPE worn when the highest level of protection is needed with a self-contained breathing aparatus (SCBA), fully encapsulated, vapor-tight, chemical-resistant suit, and chemical-resistant boots & gloves

PPE Level A

15

level of PPE worn when the highest level of respiratory protection but a lesser level of skin/eye protectant is needed with SCBA and chemical resistant but not vapor-tight suits

PPE Level B

16

level of PPE containing air-purified respirator, chemical resistant coveralls w/ splash hood, chemical resistant gloves & boots

PPE Level C

17

level of PPE used most often in hospitals as a typical work uniform that is not adequate when caring for chemically, biologically or radiologically contaminated patients

PPE Level D

18

First Step of Decontamination Process

removal of clothing & jewelry and rinsing w/ water

19

Second Step of Decontamination Process

washing thoroughly with soap & water

20

injuries caused by pipe bombs, Molotov cocktails, fertilizer bombs and "dirty" bombs w/ nuclear material

Blast Injury

21

injury from over-pressurization force (blast wave)...pulmonary damage, tympanic membrance rupture, abdominal hollow organ preforation

primary blast injury

22

injury resulting from projectiles during a blast...penetrating traumas, fragmentation injuries, blunt trauma

secondary blast injury

23

injury resulting from the blast wind that causes a victim to be thrown resulting in traumatic injury...head injury, fractures, traumatic amputations

tertiary blast injury

24

all explosion-related injuries not due to primary, secondary or tertiary mechanisms including exacerbations of or complications r/t existing conditions...burns, crush injuries, head injuries, exacerbations of COPD, asthma, diabetes, cardiac conditions, hypertension

Quaternary blast injury

25

injury resulting from hyper-inflammatory state commonly seen in bystanders near a blast and due to toxic substances or uncommon explosives...hyperpyrexia (fever >106)

Quinary blast injury

26

bioterrorism category that is easily spread, results in high death rates, and requires special action for public health awareness

Bioterroism Category A

27

bioterrorism category that is moderately to easily spread resulting in moderate illness rates and low death rates

bioterrorism category B

28

bioterrorism category that is easily available, easy to produce & spread with a potential to cause high morbidity and major health impact

bioterrorism category C

29

the most potentially threatening biochemical weapon occurring seasonally in nature in two forms: variola major & variola minor

Smallpox

30

transmission route for smallpox

aerosol-- oropharyngeal route

31

incubation period for smallpox

7-20 days

32

How soon after incubation period can symptoms of smallpox begin?

10-14 days

33

How long is smallpox stable in aerosol form?

48 hours

34

How far away can smallpox transmit in aerosol form?

30 feet

35

When is smallpox most contagious?

first 7-10 days of rash

36

What are the symptoms of the prodomal phase of smallpox?

flu-like symptoms: HA, fever, fatigue

37

What are the stages of smallpox rash?

macule---> vesicle --> papule --> pustule

38

What serious complications can the smallpox rash lead to?

corneal ulcers & blindness

39

What is the only treatment for smallpox?

supportive care and antibiotics for additional infections in skin lesions

40

What must laundry and biological waste from smallpox patient be washed in?

hot water and bleach

41

What kind of room must a smallpox patient be placed in?

Negative-Pressure Isolation Room

42

Who receives the smallpox vaccination?

military & outbreak first responders

43

If exposed to smallpox, when should the vaccine be administered?

within 3 days

44

What is the smallpox vaccine made from?

"Cow Pox"

45

mild case of cow pox in immunosuppressed patients caused by exposure to person who has received the smallpox vaccine

Vaccinia

46

most widely weaponized biological agent available...gram positive rods that release toxins causing hemorrhage, edema and necrosis

Anthrax

47

Why are cows vaccinated against anthrax?

because the spores can live in the ground for decades

48

What are the 4 routes that anthrax can be transmitted?

cutaneous, ingestion, inhalation, injection

49

transmission of anthrax that is the most common and causes edema, pruritis and necrosis

cutaneous

50

transmission of anthrax that causes fever, nausea, vomiting, abdominal pain, bloody diarrhea, and ascites

ingestion

51

transmission of anthrax that is odorless and invisible and causes flu-like symptoms of cough, headache, fever, chills, & vomiting

inhalation

52

What is the only difference between anthrax inhalation symptoms and flu symptoms?

no rhinorrhea or nasal congestion in anthrax

53

stage of anthrax infection disease w/ symptoms of fever, sever respiratory distress, stridor, hypoxia, cyanosis, diaphoresis, hypotension, shock, and hemorrhagic medistinitis

second stage of anthrax infection

54

bleeding within the chest wall

hemorrhagic medistinitis

55

What is the treatment for anthrax inhalation?

100% oxygenation- ventilation, correction of electrolyte imbalances and hemodynamic support, Cipro & Doxycycline

56

How soon after exposure to anthrax does antibiotic therapy need to start to ensure survival?

60 hours

57

Who receives the anthrax vaccine?

veterinarians and military

58

Why is cremation recommended for anthrax victims?

because the spores can live for decades

59

What precautions does the nurse use when caring for anthrax patient?

standard precautions (patient is not contagious--anthrax cannot be spread from person to person)

60

biological agent caused by bacterium found in animals

Tularemia

61

What are the symptoms of tularemia?

flu-like symptoms, life-threatening pneumonia, chest pain, bloody sputum, respiratory failure

62

How is tularemia spread?

airborne

63

What is the treatment for tularemia?

streptomycin IM BID x 10 days and gentamycin IV QD x 10 days

64

Is tularemia contagious?

No

65

muscle-paralyzing disease caused by a toxin clostridium botulinum

botulism

66

type of botulism that occurs when a person ingests pre-formed toxin that leads to illness w/in a few hours to days...public health emergency

foodborne botulism

67

type of botulism that occurs in a small number of infants per year due to ingestion of honey

infantile botulism

68

type of botulism that occurs when wounds a infected by the toxin

wound botulism

69

How soon after eating toxin-containing food do botulism symptoms occur?

12-36 hours

70

symptoms of double-vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, descending muscle weakness

foodborne botulism symptoms

71

Is foodborne botulism contagious?

No

72

What is the treatment for botulism?

botulism antitoxin must be administered early

73

What bacterium causes plague?

Yersinia pestis

74

most common type of plague that results from infected flea type and causes swollen, tender lymph nodes, fever, HA, chills

bubonic plague

75

Is bubonic plague contagious?

No

76

type of plague that is a complication of bubonic or pneumonic plague and leads to septic shock

septicemic shock

77

What animals carry plague?

rodents and fleas that live on rodents

78

most deadly type of plague that is contagious and can be aerosolized and used as biological weapon causing fever, HA, rapidly developing pneumonia, dyspnea, chest pain, cough, and hemoptysis

pneumonic plague

79

How long does pneumonic plague progress leading to respiratory failure and death?

2-4 days

80

How soon after symptoms of pneumonic plague are antibiotics administered?

24 hours

81

What antibiotics are given for pneumonic plague?

streptomycin, gentamycin, and tetracyclines

82

Ebola is a type of _____________?

viral hemorrhagic fever

83

Where do viral hemorrhagic fevers naturally reside?

in rodents

84

Are viral hemorrhagic fevers contagious?

Yes HIGHLY

85

Is there treatment for viral hemorrhagic fevers?

No effective treatment

86

What are the main symptoms of viral hemorrhagic fevers?

fevers and bleeding (leading to shock and death)

87

How long after exposure to ebola do symptoms appear?

2-21 days

88

How high is the fever in ebola?

greater than 101.5

89

These are symptoms of what?...high fever, severe HA, muscle pain, constant diarrhea, constant vomiting, abdominal pain, bleeding/ bruising

Ebola

90

How is ebola transmitted?

through contact w/ infected animal (primate), person-to-person spread through direct contact w/ blood or body fluids, or contaminated objects (needles)

91

How is ebola diagnosed?

symptoms and bloodwork

92

What are the lab tests for ebola?

ELISA, IgM ELISA, and virus isolation

93

What are the palliative treatments for ebola?

IV fluids (electrolyte replacement), maintaining oxygenation and BP, treating super-infections, experimental treatments

94

the tendency of chemical weapons to become a vapor

volatility

95

the tendency of chemical weapons to be less likely to vaporize and disperse

persistence

96

the potential of chemical weapons to cause injury

toxicity

97

the time from absorption to the appearance of signs and symptoms in chemical weapons

latency

98

the evacuation and decontamination of chemical weapons

limiting exposure

99

type of chemical weapon that causes blistering and results in large number of injuries

vesicants (EX: lewisite, phosgene, nitrogen mustard, sulfur mustard)

100

What type of chemical weapon would cause large burns in moist areas of the body, like the axilla or perineum?

vesicants

101

What type of chemical weapon would cause purulent fibrinous psuedomembrane discharge that may cause obstruction of the airway?

vesicants

102

What is the treatment for vesicant chemical weapon exposure?

decontamination w/ soap and water, copious irrigation of the eyes, intubation, and bronchoscopy

103

type of chemical weapon that is the most toxic in existence (widespread death), inexpensive, effective and easily dispersed

nerve agents

104

What does nerve agent exposure cause?

cholinergic crisis

105

What are the symptoms of a cholinergic crisis?

bilateral miosis, visual disturbances, increased GI motility, bradycardia, AV block

106

What will a lethal dose of a nerve agent cause?

loss of consciousness, seizures, fasisculations (twitching), seizures, and apnea

107

What is the treatment for nerve agent chemical weapon exposure?

decontamination w/ soap and water or saline for 20 minutes, maintain the airway (NO PLASTIC AIRWAYS), Atropine IV, Protopam

108

The military carry auto-injectors of what medication for chemical weapon exposure?

Protopam

109

the type of chemical weapon that directly effects cellular metabolism resulting in asphyxiation through alterations in hemoglobin

blood agents

110

What is the most common blood agent used?

Hydrogen cyanide

111

What does cyanide smell like?

bitter almonds

112

What should you do if you are exposed to a chemical agent?

Evacuate, Stay upright, carry children, stay upwind, remove clothing, and wash with soap and water

113

What should you do with clothing after chemical exposure?

seal in 2 bags and turn it over to the local health workers

114

How can cyanide be put into the body?

ingested, inhaled or absorbed

115

What does cyanide exposure cause?

respiratory muscle failure, respiratory arrest, cardiac arrest and death

116

What is the first-line treatment for cyanide exposure?

intubation w/ mechanical ventilation

117

What is the second-line treatment for cyanide exposure?

rapid administration of amyl nitrate pearls, sodium nitrate, and sodium thiosulfate

118

What is the third-line treatment for cyanide exposure?

give IV Vit. B12

119

What do amyl nitrate pearls do in a patient exposed to cyanide?

it causes methemoglobinemia which binds to cyanide

120

What does sodium nitrate and sodium thiosulfate do in a patient exposed to cyanide?

it excretes methemaglobin via the kidneys

121

How can radiation be put into the body?

inhaled, ingested, injected or absorbed

122

How can most radiation patients be treated with to recover?

decontamination with soap and water

123

condition that arises with a large amount of radiation exposure

Acute Radiation Syndrome

124

phase of acute radiation syndrome that occurs 48 to 72 hours after exposure

prodomal phase

125

phase of acute radiation syndrome that occurs after resolution of prodomal phase and last up to 3 weeks

latent phase

126

phase of acute radiation syndrome that occurs after the latent phase

manifest illness phase

127

last phase of acute radiation syndrome that can take weeks to months

recovery phase

128

What is the first sign of impending death due to acute radiation syndrome?

increased intracranial pressure (change in LOC)

129

What is triage based on for of acute radiation syndrome?

whether or not the patient will survive

130

Who is at risk for severe and longer lasting reactions to trauma?

people proximal to the event, people w/ multiple stressors, people w/ history of prior traumas, people w/ chronic medical illness or psychological disorders

131

What are the immediate effects of trauma?

severe panic and anxiety

132

What is a long-lasting effect of trauma?

PTSD

133

the impact of event scale used to determine psychosocial response to trauma

Likert Scale

134

With disabled adults, what are the concerns during a disaster?

mobility, medications, access to healthcare/ evacuations/ shelters,

135

With older adults, what are the concerns during a disaster?

aging changes, co-morbidities, lack of physiological reserves to recover, drug metabolism/ excretion

136

With pediatric patients, what are the concerns in a disaster?

short stature, BSA for antidote dosage, psychological trauma, respiratory problems