General Protocols Flashcards
(125 cards)
1
Q
HIV destroys what type of cells
A
CD4+ T cells
2
Q
After an Infectious disease exposure the worker should be transported to an ER within how long
A
2 hours after the exposure
3
Q
% of exposure through broken skin or abraded skin
A
3%
4
Q
In the rehab area what is considered an abnormal body temp
A
ORAL temp > 100.6F
5
Q
Mandatory rehab will occur after the following
A
- 30 min STRENUOUS activity or 2 SCBA bottles
- SCBA failure
- ANY medical complaint
- At the discretion of the IC, ISO, CISM coordinator, Company officer , or FF himself
6
Q
What percentage of Hep C infections account for sexual transmission and mothers passing the virus to their babies
A
both account for about 5%
7
Q
Patients being air lifted on a backboard must have how many straps securing them to the board
A
minimum 3 straps
8
Q
Minimum equipment for marshalling duties
A
- Helmet with strap secure
- Goggles or visor down
- FULL bunker gear with COLLAR UP
- Flashlights with wands for night ops
9
Q
What is the minimum amount of water recommended per hour
A
1 quart per hour
10
Q
What is the seroconversion percentage for a needlestick Hep B exposure
A
37-62%
11
Q
When transporting a female behavioral emergency, what must be documented with dispatch via radio communications
A
The beginning and ending mileage
12
Q
What other disease is covered by the presumptive law , but does not require a baseline screening
A
Meningitis
13
Q
This law allows for the treatment of patients not capable of informed consent
A
The Incapacitated Person Law F.S. 766.103
14
Q
Which disease carries the greatest risk of transmission from an exposure
A
Hep B
15
Q
This sheet is a quick reference that includes the sources of the most common occupational exposure.
A
Infectious Exposure Reference Sheet (aka. Disease Matrix)
16
Q
True/False
If a blood sample is available an ER may test the blood without consent as long as the exposed employee has the same test done to him
A
TRUE
17
Q
PEP worker should be monitored for drug toxicity for how long
A
2 weeks
18
Q
Does a voluntary Baker Act require a police escort
A
Yes.. even voluntary Baker Acts
19
Q
Florida Statute 401
A
The emergency examination and treatment of incapacitated persons
20
Q
After breathing ambient air for 5 min. if CO readings are still > 8% . what is the next course of action
A
Provide O2 via mask until levels drop below 5%
21
Q
How long do Hep B symptoms take to appear
A
60-90 days of (2-3 months)infection, but it can sometimes take as long as 6 months
22
Q
Degree of leg elevation when lying supine for RACE test
A
30 degrees for 10 seconds. Although 5 seconds is used to score mild/moderate/severe
23
Q
After completion of the HIV PEP, how long after should one use condoms
A
at least 30 days after completion
24
Q
What is the percentage of workers showing clinical Hep B signs after needlestick exposure
A
22-31%
25
A medical rehab area will be set up at the discretion of who
The IC
26
The mnemonic used to initiate the START triage
RPM
Respirations
Perfusion
Mental Status
27
Automatic transport to a comprehensive stroke center if actively pregnant or completed within
30 days
28
No worker should leave the rehab area if CO levels are not < ?
CO < 8%
29
What is the minimum rest time for personnel in rehab
15 minutes
30
Comprehensive stroke facility if HX of GI/GU bleed within
The last 21 days
31
In the rehab area what % is considered Moderate CO inhalation
> 12% CO
32
Treatment for heat stress in the rehab area should be initiated if the members oral temp exceeds
100.6 F
| The member should not be allowed to don PPE. Monitor for signs of heat exhaustion and heat stroke
33
An RPR test after exposure is testing for what disease
Syphilis
34
What does Tdap stand for
Tetanus Toxiod
Diphtheria toxiod
Acellular Pertussis
35
A medical condition that can cause a behavioral emergency which must be considered.
Excited Agitated Delirium
36
What is the recommended water intake while in the rehab area for 15 min?
1-2 quarts of water
37
Hep C transmission rate % for percutaneous exposure
1.8% with large newer studies showing only 0.5% transmission rate
38
How long is a Pt to hold their arm up at 90 degrees if seated and 45 degrees if lying supiine
at least 10 sec
39
What % of disease exposures were through mucous membrane
14%
40
Post exposure follow up timline for HIV
6 weeks
3 months
6 months
41
What is the purpose of CISM
Provide education, support , assessment, and intervention for emergency personnel.
42
When the IC has determined the need for a rehab area who will normally be assigned to manage and coordinate that area
Typical the first AVAILABLE "EMS" unit
43
Presumptive law requires baseline screening for which diseases
TB
| HEP A, B, C
44
Employers will make available vaccinations to employees who initially decline and then later decide to accept the vaccine within how many days
10 days
45
What percentage of street drug users are expected to have Hep c
80%
46
Emergency and public safety workers are considered what risk
At-risk workers for exposures to infectious diseases
47
Who has the Primary Marshalling duties
The officer in charge
48
How after infection do symptoms appear with Hep C
Typically 6-7 weeks after exposure, but can occur 2 WEEKS to 6 MONTHS after
49
How many people are reported to have Hep C in the US
4 million
50
Hep B may remain stable and infectious during desiccation for more than how long
1 week
51
CO reading > 8% but < 15% calls for ...
The worker to breath ambient air for at least 5 min.
52
Small group debriefing are done prior to demobilization from extended deployment within what time frame
12-72 hours after the critical
53
This form is intended as a "real time" documentation tool.
Infectious Disease Report Form
54
Florida Statute 394.463
The Baker Act
55
TB screening will be done at what intervals
Annually
56
What % of exposures are percutaneous (through the skin)
82%
57
PEP drug regimens are prescribed for how long
normally a 4 week cycle
58
The Florida Marchman Act is AKA
Florida's substance Abuse Impairment Act
59
If a members HR exceeds _?_ an oral temp should be taken
110 bpm
60
Normal pulse rates expected in the rehab area
less than 120 at a working incident.
61
When transporting a Baker Act or Behavioral Emergency who will decide if a police officer will ride in the rescue unit
The paramedic in charge.
62
Food will be provided to the rehab area for incidents that extend beyond how long
Soups, broth, stews will be made available for incidents 3 hours or longer
63
The source of the exposure may be mandated to submit to a blood testing after court order and sworn statement by the Doctor as this being a significant exposure.
TRUE
64
Who will contact the receiving facility when a pt is being transported via air rescue
The ground rescue unit
65
The HSLZ must not have any obstacles on approach or departure that are...
more 40 feet tall or within 100 feet of the HSLZ
66
In Dec. 2002 the FDA approved a new TB test known as
QuantiFERON- TB
67
The Broward Region CISM team is expected to respond within what time frame
Within 2 hours after a critical incident occurs and CISM services are requested.
68
What is the leading cause for liver transplantation.
Hep C
69
The Rapid HIV test can detect the HIV antibody as soon as how many weeks after exposure
2 weeks after. The test takes 30 min- 1hour
70
What is the % risk of contracting HIV after a mucous membrane exposure
0.09%
71
An intervention best delivered as soon as possible within the first 12 hours after an incident
Small group Defusing
72
Workers who have previously tested negative on a PPD test and now test positive will have what completed
a Baseline chest x-ray and one follow up a year later.
73
What are the 3 cortical Signs for automatic transport to comprehensive stroke center.
1. Positive Head gaze/eye gaze
2. Aphasia= difficulty following command (close your eyes, make a fist) = difficulty talking (name 2 objects, It is sunny today)
3. Agnosia= inability to recognize Pt own arm
74
Can the Rehab area be used to stage on scene personnel prior to an assignment
Yes
75
Perform baseline and follow up testing for anti-HCV how long after exposure
4-6 months
76
What are the 3 things needed to perform an Involuntary Baker Act
1. A person is mentally ill and because of the illness cannot has refused voluntary treatment 2. Is incapable of living alone due to possibility of self injury. 3. All less restrictive treatment alternatives are not appropriate.
77
What is the normal value SpCO for non-smoker/smoker
non-smoker 5%
| and < 8% for a smoker
78
The responsibility of the post exposure medical follow up lies on
The exposed worker
79
Heart rate > 120 for more than 15 min will constitute
Treatment and transport to the ER
80
The triage tag is constructed of what material
Synthetic Paper- making it 100% resistant to all commonly used decontamination solutions
81
The follow up test for TB after the intial baseline at 10 dyas is
10-12 WEEKS
82
The Disease Martix Sheet will be combined with what as a back/front copy
Employer Information Form
83
Hepatitis vaccine will be made available to new employees within what time frame
within 10 days of initial assignment
84
The Flu vaccine will be made available from what dates
October - February annually
85
This form will be combined with the Infectious disease exposure report form as a back/front copy
Exposure Information Form
86
This is a comprehensive, integrated, multi-component, systematic program of crisis intervention
CISM
87
Hep C accounts for how many deaths per year in the US
8,000-10,000
88
While SCBA cylinders are being changed , how much water will the member drink
Shall drink at least 8oz. of water.
89
What are the 3 MedCom priority levels
1. Critical
2. Serious
3. Stable
4. Admin. Traffic
90
While in the rehab area, transport to the local ER will occur if vital signs remain abnormal for >
15 mintues
91
After TB exposure within what time frame must you have a PPD test
within 10 days
92
What % is considered a severe CO inhalation
> 25% CO
| Pt must be treated and transported, preferably to a hyperbaric chamber
93
Considered an abnormal SpO2 reading for the rehab area
< 94%
94
CISM was formulated and standardized by whom
ICISF... International Critical Incident Stress Foundation.
95
This type of crisis intervention is considered best for large incidents with high media interest.
Crisis Management Briefing
96
Human bites exposure %
1%
97
Automatic transport to a comprehensive stroke facility if recent trauma, surgery, bleeding within
the last 14 days
98
Before what year were organ transplants a risk for contracting Hep c
prior to the early 1990's
99
What are the 3 PEP drugs of choice
1 Combivir
2. Truvada
3. Kaletra
100
What color is the "Contaminated " tear off strip on the triage tag.
Magenta- MUST be removed if the patient is NOT contaminated
101
Who can request a Florida Marchman Act
1. A spouse
2. Blood relative
3. or at least (3) people who have direct knowledge of a persons substance abuse problem
102
At no time should the pulse rate of personnel exceed
180 bpm
103
Minimum number of how many guards
Minimum 1 tail rotor guard
104
This type of Crisis Intervention is considered best for large groups
Crisis Management Briefing
105
Needlestick exposures were associated with what percent of the documented ACQUIRED INFECTIONS
89%
106
The Baker Act is also known as
The Florida Mental Health Act
107
While in the rehab area, vital signs should return to normal within how long
15 minutes
108
Rehab Examinations will occur at what intervals
10 min intervals
109
What is the other test for TB other than PPD
Quantiferon- TB
110
The agency requesting CISM must provide what info (4 things)
1. Agency name
2. Type of incident
3. Number of members involved
4. Call back contact number or pager.
111
Test for HBV antibody within
1-2 months after the last dose of the vaccine
112
Family Crisis intervention and One- on- One intervention are two services which are offered by CISM
TRUE
113
Broward Region CISM team members must have completed at least how many of the ICISF core courses
Minimum 3 of the core courses
114
What is the most common blood borne infection in the US
Hep C
115
Evaluate a worker taking PEP within how long
72 hours
116
Discussions held during the CISM intervention is protected by what Florida statute as "confidential and privileged info
F. S. 401.30
117
Medical follow up testing for the detection of seroconversion will be done when
Week 6
Week 12
Week 26
Testing after 1 year will be optional
118
What are the 4 categories that the the CISM Team leader uses to assemble for a defusing/debriefing
1. Rank
2. Proximity to the incident
3. involvement in the incident
4. As determined by the CISM team leader
119
What are the 3 things one must demonstrate when requesting a Marchman Act on someone
1. The person has lost control over the addiction and is at risk of causing harm to himself or others. 2. That the user lacks rational decision making. 3. must prov that they are unwilling to get help themselves.
120
The overall risk of transmission of HIV after percutaneous exposure to HIV infected material remains at
0.3%
121
The Marshaller should stand where in relation to the HSLZ
On the outer edge of the HSLZ on the windward side, with the wind to their BACK.
122
What are the 3 risk levels for workers
1. At risk
2. Low risk
3. Special Risk
123
For these workers, PEP rather than preexposure vaccination may be considered.
Low- risk workers
124
For a Well Person Check, if the vitals are ?? recommend transport to the ER.
Pulse >110 bpm
SBP >200
DBP >120
SaO2 <94%
125
A TB exposure test should not be conducted if the worker has had the test done within the last
12 weeks OR the worker has a reported history of positive skin reactions.
