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Nursing 202 - Midterm > Terrrorism, Mass Casuality > Flashcards

Terrrorism, Mass Casuality Flashcards

(51 cards)

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1
Q

How many times per yr is req by Joint Commission to create plan for emergency preparedness?

A

Twice

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2
Q

Essential components of emergency plan

A
  • Activation response
  • Internal/external communication plan
  • Plan for coordinated pt care
  • Security plans
  • ID of external resources
  • Plan for people management & traffic flow
  • Data management strategy
  • Demobilization response
  • After-action reporter corrective plan
  • Plan for practice drills
  • Anticipated resources
  • Mass causality incident (MCI) planning
  • Education for above
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3
Q

Triage in disaster

Immediate

A

Priority: 1
Color: Red
Conditions: sucking chest wound, airway obstruction due to mechanical cause, shock, hemothorax, tension pneumo, asphyxia, unstable chest/abd wound, incomplete amputation, open FX, 2nd/3rd degree burns of 15-40% BSA

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4
Q

Triage in disaster

Delayed

A

Priority: 2
Color: yellow
Conditions: stable abd wounds w/o evidence of hemorrhage, soft tissue injury, maxillofacial wounds w/o airway compromise, vascular injuries w/adequate collateral circulation, GU disruption, FX needing SX repair, eye/CNS injuries

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5
Q

Triage in disaster

Minimal

A

Priority: 3
Color: green
Conditions: UE FX, minor burns, sprains, small lacerations w/o significant bleeding, behavioral D/O or psychological disturbance

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6
Q

Triage in disaster

Expectant

A

Priority: 4
Color: black
Conditions: unresponsive patients w/penetrating head wounds, high spinal cord injuries, wounds involving multiple sites/organs, 2nd-3rd degree burns over 60% BSA, SZ/vomiting w/in 24 hrs radiation exposure, profound shock, agonal respirations, no pulse/BP, fixed & dilated pupils

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7
Q

Level A PPE

A

Self-contained breathing apparatus (SCBA), vapor-tight chemical resistant suit, gloves, boots

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8
Q

Level B PPE

A

High level of respiratory protection (SCBA) but lesser skin & eye protection, chemical resistant suit

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9
Q

Level C PPE

A

Air-purified respirator, coverall w/splash hood, chemical resistant gloves & boots

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10
Q

Level D PPE

A

Typical work uniform

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11
Q

Primary blast injury

Mechanism

A

Results from pressure wave

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12
Q

Primary blast injury

Injuries

A
  • Pulmonary barotrauma, contusion
  • Head injuries
  • Tympanic membrane rupture, middle ear injury
  • Abdominal hollow organ perforation, hemorrhage
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13
Q

Secondary blast injury

Mechanism

A

Results from debris from the scene or shrapnel from the bomb

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14
Q

Secondary blast injury

Injuries

A
  • Penetrating trunk, skin, soft tissue injuries

- FX, traumatic amputation

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15
Q

Tertiary blast injury

Mechanism

A

Results from pressure wave that causes the victim to be thrown

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16
Q

Tertiary blast injury

Injuries

A
  • Head injuries

- FX (including skull)

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17
Q

Quaternary blast injury

Mechanism

A

Results from pre-existing conditions exacerbated by the force of the bast of by post blast injury complications

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18
Q

Quaternary blast injury

Injuries

A
  • Severe injuries w/complex injury patterns - burns, crush, head
  • Common pre-existing conditions = COPD, asthma, cardiac conditions, diabetes, HTN
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19
Q

Anthrax

Incubation

A

1-6 days

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20
Q

Anthrax

Spread

A

Skin contact, GI ingestion, inhalation

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21
Q

Anthrax

S/S

Study These Flashcards
A

Skin lesions, fever, N/V, abdominal pain, diarrhea

Respiratory S/S mimic flu

22
Q

Anthrax

Treatment

Study These Flashcards
A

Penicillin V, erythromycin

23
Q

Smallpox

Incubation

Study These Flashcards
A

Virus, 12 days

24
Q

Smallpox

Spread

Study These Flashcards
A
  • Extremely contagious

- Spread by direct contact, contact w/clothing or linens, droplet person-person

25
Smallpox | S/S
High fever, malaise, HA, backache, prostration After 1-2 days, maculopapular rash forms on face, mouth, pharynx, forearms
26
Smallpox | Treatment
Supportive care w/ABX for additional infection
27
Vesicants | Type
Lewisite, sulfur mustard, nitrogen mustard, phosgene
28
Vesicants | S/S
Blistering, burning | Respiratory effects can be serious —> death
29
Vesicants | Decontamination
Soap & water, do not scrub or use hypochlorite solutions Eye exposure requires copious irrigation
30
Vesicants | Treatment
Lewisite: dimercaprol IV or topically
31
Nerve agents | Types
Sarin, soman, tabun, organophosphates, VX
32
Nerve agents | MOA
Inhibit cholinesterase, causing cholinergic crisis
33
Nerve agents | S/S
Cholinergic S/S progressing to loss of consciousness, SZ, copious secretions, apnea, death
34
Nerve agents | Decontamination
Copious amts of soap and water or saline for at least 20 min Blot, do not wipe off **Plastic equipment will absorb sarin gas
35
Nerve agents | Treatment
Supportive care, atropine, Benzos, pralisoxime
36
Blood agents | Types
Hydrogen chained, cyanogen chloride
37
Blood agents | MOA
Direct effect on cellular metabolism, resulting in asphyxiation through alterations in hgb
38
Blood agents | Spread
Inhalation, ingestion, absorbed in the skin & mucus membranes
39
Blood agents | S/S
Leads to respiratory muscle failure, respiratory arrest, cardiac arrest, death
40
Blood agents | Treatment
Rapid admin of amyl nitration, sodium nitrite, and sodium thiosulfate after patient is incubated and placed on vent
41
Pulmonary agents | Types
Phosgene and chlorine
42
Pulmonary agents | MOA
Destroy the pulmonary membrane that separates the alveolus from the capillary bed, disrupting alveolar-capillary oxygen transport mechanisms. Capillary leakage results in fluid-filled alveoli
43
Pulmonary agents | S/S
Pulmonary edema w/SOB, especially on exertion | Initial hacking cough followed by frothy sputum production
44
Radiation exposure | External
All or part of the body is exposed to radiation Decontamination not necessary Not emergency
45
Radiation exposure | Contamination
Exposure to radioactive gases, liquids, or solids | Immediate medical management to prevent incorporation
46
Radiation exposure | Incorporation
Uptake of radioactive material into body
47
Radiation decontamination
- Triage OUTSIDE of hospital - Cover floor & use strict isolation precautions to prevent the tracking of contaminants - Air ducts and vent sealed - Waste double bagged and labeled “radiation waste” - Decontaminate each patient outside ED w/shower - Internal contamination: catharsis, gastric lavage w/chelating agents
48
Radiation decontamination | Staff protection
- Water-resistant gowns, two pairs of gloves, caps, goggles, masks, booties - Dosimetry devices
49
Acute radiation syndrome | Probable survivors
No initial symptoms or only minimal s/s
50
ARS | Possible survivors
Present w/ N/V that persist for 24-48 hrs
51
ARS | Improbable survivors
Acutely ill w/ N/V/D, shock Neuro S/S suggest a lethal dose

Nursing 202 - Midterm (12 decks)

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