Tox Medic Flashcards
(125 cards)
1
Q
Any substance or material that has the ability to adversely affect a person’s health is a ____.
A
Hazardous material
2
Q
What is the most important factor in determining the level of hazmat suit needed?
A
Chemical or substance involved
3
Q
Name 3 places a hazmat incident could occur.
A
- Industrial facilities
- Residential structures
- Medical settings
4
Q
The lowest temperature at which a liquid will give off enough vapors to ignite but not sustain combustion is it’s ___.
A
Flash point
5
Q
Name the 3 strategic priorities when responding to a hazmat incident.
A
- Deny entry
- Isolate the area
- Identify the product
6
Q
Give 3 ways we can protect citizens during a hazmat incident.
A
- Prevent them from entering area
- Evacuate the area
- Protect in place
7
Q
A level A suit is ___.
A
Fully encapsulating
8
Q
What are two limits mandated by law?
A
Permissible exposure limit (PEL)
Short-term exposure limit (STEL)
9
Q
What are 3 factors that help the recognition of hazardous materials?
A
- Occupancy
- Placards, markings, labels
- Container size and shape
10
Q
The IDLH (immediately dangerous to life and health) indicates an exposure of ___.
A
30 minutes
11
Q
When does research begin?
A
En route to the emergency indicent
12
Q
Four areas that information should be obtained during research?
A
- Physical properties
- Toxicokinetics
- Toxicodynamics
- Treatment
13
Q
What is toxicokinetics?
A
What the body does to the poison
14
Q
List the 4 things that the body does to a hazardous material.
A
- Absorption
- Biotransformation
- Circulation/distribution
- Elimination
15
Q
What are the 4 ways a hazmat can enter the body?
A
- Inhalation
- Injection
- Ingestion
- Skin/eye absorption
16
Q
Contamination from a tool and/or a person that was contaminated is the definition of ___.
A
Secondary contamination
17
Q
What is toxicodynamics?
A
What the poison does to the body
18
Q
List 4 areas of decontamination.
A
- Skin decon
- Eye decon
- Respiratory decon
- GI decon
19
Q
What are the six steps of treating a hazmat and/or WMD victim following proper decon?
A
(ABCDEF)
- Airway
- Breathing
- Circulation
- Disability/neuro
- Exposure
- Field antidote
20
Q
What does respiratory decon consist of?
A
Removing the victim from the source of contamination and insuring adequate oxygenation and ventilation
21
Q
Entry of a substance into the body through the GI tract is:
A
Ingestion
22
Q
Which type of contamination occurs when a patient is directly exposed to hazmat and the contamination is limited to pt only?
A
Primary
23
Q
Which hazardous material is a high water soluble respiratory irritant gas?
A
Ammonia
24
Q
How do respiratory irritant gases damage the airway?
A
Production of a corrosive mixture producing local tissue damage
25
List 2 signs and symptoms of an exposure to respiratory irritant gases.
1. Coughing
| 2. Pale, cool, diaphoretic
26
What are the steps in proper treatment of a victim exposed to a respiratory irritant gas?
1. Should induce respiratory decon
2. O2
3. Ventilatory support
4. IV
5. Monitor
6. Albuterol/atrovent
27
What is a low water soluble respiratory irritant gas?
Phosgene
28
How should a victim of an exposure to a respiratory irritant gas be decontaminated?
Respiratory decon
29
Pulmonary irritant gases are classified according to their __.
Water solubility
30
A pulmonary irritant gas that is highly water soluble will usually limit the affects to the ___.
Upper airway
31
Pulmonary irritant gases form what type of mixture with the mucous of the respiratory tract?
Corrosive mixtures
32
Pulmonary irritant gases affect the nervous system in what way?
Hypoxia
33
A simple asphyxiate has what effect on the body?
Displaces oxygen
34
List two signs and symptoms of an exposure to a simple asphyxiate.
1. Cyanosis
| 2. Tachypnea
35
What does the proper treatment of a pt exposed to a simple asphyxiate consist of?
Respiratory decon
Oxygenation
Adequate ventilation
36
Carbon monoxide affects the body by creating ___.
Carboxyhemoglobin (this makes the red blood cells unable to transport O2)
37
Carbon monoxide is a type of ___.
Systemic asphyxiate
38
An example of a pt for whom hyperbaric oxygen therapy is indicated as a result of carbon monoxide exposure is ___.
4 month pregnant patient
39
How does cyanide affect the body?
It binds cytochrome oxidase at the cellular level and decreases ATP production.
40
What are 2 signs and symptoms of CO exposure?
Cherry red skin
| Tachypnea
41
List 2 signs and symptoms of an exposure to cyanide.
Tachypnea
| PVC's
42
Explain the proper treatment of a pt exposed to CO.
Respiratory decon
Oxygenation/ventilation
Tx in a hyperbaric chamber
43
Explain the proper treatment of a pt exposed to cyanide.
Skin/eye/respiratory decon
Oxygenation/ventilation
Cyanide antidote kit
44
Methemoglobin formers affect the body by:
Creating methemoglobin (which makes the hemoglobin unable to carry O2)
45
List 2 methemoglobin formers.
1. Nitrobenzene
| 2. Nitric acid
46
List 2 signs and symptoms of methemoglobin formers.
1. Tachypnea
| 2. PVC's
47
What is the proper treatment of a pt exposed to methemoglobin formers?
Skin/eye/respiratory decon
Oxygenation/ventilation
Methylene blue
48
The antidote for chemicals causing methemoglobinemia is?
Methylene blue
49
What 3 drugs does the cyanide antidote kit contain?
1. Amyl nitrite
2. Sodium nitrite
3. Sodium thiosulfate
50
Amyl nitrite and sodium nitrite have what effect on the body?
Convert the iron in the hemoglobin from ferrous iron (Fe +2) to ferric iron (Fe +3)
51
A common organophosphate is:
Diazinon
52
How do cholinesterase inhibitors affect the body?
Binds to acetylcholinesterase
53
List 2 signs and symptoms of an exposure to cholinesterase inhibitors.
Tachycardia
Weakness
Lacrimation
Salivation
54
Explain the proper treatment of a victim exposed to a cholinesterase inhibitor.
```
Skin/eye/respiratory decontamination
Oxygenation/ventilation
Cardiac monitoring
Valium
Atropine
2-PAM
```
55
Atropine is given for which signs and symptoms of organophosphate poisonings?
Bradycardia and bronchorhea
56
The antidote given for organophosphate poisonings to reactivate acetylcholinesterase is?
2-PAM
57
Your patient has been contaminated with organophosphates and the SLUDGE syndrome is apparent, your medical treatment for this patient is?
Atropine
58
Acids cause what type of skin damage?
Coagulum necrosis
59
Bases cause what type of skin damage?
Liquefactant necrosis
60
Explain how an acid and a base affect the body.
Acids cause coagulum necrosis
| Bases cause liquefactant necrosis
61
Hydrofluoric acid causes what?
Hypocalcemia
62
List 2 signs and symptoms of an exposure to an acid and a base.
Acids---Coagulative necrosis, hypoxia if airway involved, hypovolemia if large burn
Bases---Liquefactant necrosis, hypoxia if airway involved, hypovolemia if large burn
63
Decontamination of a patient that splashed acid into their eyes should last for at least ___ minutes.
15 minutes
64
In addition to local tissue damage, a patient that is a victim of acid burns must be monitored for?
Hypovolemia
65
List one example of a hydrocarbon.
Propane (and others)
66
Name the 3 ways hydrocarbons affect the body.
1. Defatting dermatitis
2. Opening the GABA receptors
3. Increased myocardial sensitivity to catecholamines
67
Hydrocarbons affect the skin by causing:
Defatting dermatitis
68
Hydrocarbons can cause bradycardia or tachycardia?
Tachycardia
69
Hydrocarbons affect what type of receptor?
GABA
70
CNS depression caused by hydrocarbon exposure is due to:
GABA affects (nartotic-like effects)
71
Explain the proper treatment of a victim exposed to hydrocarbons.
```
Skin/eye/respiratory decon
Oxygenation/ventilation
Monitor/IV
Propanolol
Diazepam
```
72
Fluorides are attracted to:
Calcium
73
List 2 signs and symptoms of an exposure to fluorides:
1. Runs of PVC's
| 2. Seizures
74
Explain the proper treatment of a patient exposed to fluorides:
```
Skin/eye/respiratory decon
Cardiac monitoring
ACLS algorithm
Calcium chloride
Diazepam
```
75
How does a decreased calcium level affect the nervous system?
Decreases the cell's resting potential
76
Hypocalcemia can be seen on the monitor by what 3 things?
1. Prolonged QT interval
2. PVC's
3. V-tach
77
Hydrazine can be classified as a:
Corrosive
78
GABA allows what to enter the CNS cell?
Chloride
79
Hydrazine does what to GABA?
Inhibits the production
80
Which medications would you administer to a seizing patient that was exposed to hydrazine?
Diazepam
81
The use of force or violence to intimidate or coerce a segment of the population is the definition of ___.
Terrorism
82
Name the 2 types of terrorist groups.
1. Foreign
| 2. Domestic
83
Name 3 foreign terrorist organizations.
1. Al Quaida
2. Hezbollah
3. Hamas
84
Name 3 domestic terrorist organizations.
1. KKK
2. Skinheads
3. Militias
85
Name 3 countries that sponsor terrorism.
1. Iran
2. Libya
3. North Korea
86
Name 3 reasons why a terrorist would use a weapon of mass destruction (WMD).
1. Cheap
2. Effective
3. Difficult to detect
87
What does BNICE stand for?
```
B - Biological
N - Nuclear
I - Incendiary
C - Chemical
E - Etiological (always thought this was "explosive," but the book says etiological)
```
88
Give 5 high profile places or events a terrorist may target.
1. Large crowds
2. Materials in transit
3. Government offices
4. Family planning clinics
5. High profile events
89
Why are explosives the most used tool of a terrorist?
Easy to make
High number of casualties
Inspires fear in populace
90
Name 3 bacterial agents that may be used as a weapon.
1. Anthrax
2. Bubonic plague
3. Cholera
91
Name 2 viruses that may be used as a weapon.
1. Small pox
| 2. Viral hemorrhagic fever
92
Name 2 toxins that may be used as a weapon.
1. Botulinum
| 2. Ricin
93
How were biological weapons used in the 1760 French Indian Wars?
French gave blankets from smallpox victims to Indians, introducting smallpox into the population
94
How were biological weapons used in World War I?
Targeting of livestock with Anthrax
95
How were biological weapons used in 1979 Sverdlovsk Russia?
Accidental release of Anthrax
96
How were biological weapons used in 2001 New York and Washington D.C.?
Anthrax mailed in letters
97
Name 3 biological agents that are not transmissible.
1. Venezuelan Equine Encephalitis (VEE)
2. Botulinum
3. Ricin
98
What is the difference between biological and chemical agents?
Biological - natural, delayed onset, can be contagious, may replicate
Chemical - manmade, volatile, do not replicate
99
What is the difference between a primary aerosol and a secondary aerosol?
```
Primary = released directly into the air
Secondary = released onto the ground, and stirred up
```
100
A biological agent is weaponized when it has what 3 things:
1. Milled down to 1-4 microns
2. Hydrophobic
3. Silicate added to keep it airborne
101
What is an overt attack?
People are exposed and responsibility is claimed right away
102
What is a covert attack?
People are exposed and no claims of responsibility are made
103
Why is field detection of a biological agent harder than that of chemical agents?
Biological agents have no smell or taste and have a delayed onset
104
Name 4 common signs and symptoms of most biological agents
1. Fever
2. Nausea
3. Vomiting
4. Headache
105
What kind of PPE should be worn when dealing with patients exposed by biological weapon?
Gloves, gown, sleeves, eye protection, HEPA mask
106
What kind of decontamination should be used when dealing with a patient exposed to a biological weapon?
Soap and water
107
What are the 2 types of treatments for patients that have been exposed to biological weapons?
1. Antibiotic therapy
| 2. Supportive care
108
Name 3 parts of an atom:
1. Protons
2. Neutrons
3. Electrons
109
The process of unstable atoms trying to become stable by emitting ionizing radiation is the definition of ___.
Radioactivity
110
Name the 4 types of radiation.
1. Alpha
2. Beta
3. Gamma
4. Neutron
111
Alpha radiation:
- How far does it travel?
- How do you protect yourself from its effects?
1-2 inches
| Paper, cloth, dead layer of skin
112
Beta radiation:
- How far does it travel?
- How do you protect yourself from its effects?
10 feet
| Thick clothing, 1/4 inch aluminum, 1/4 inch plastic
113
Gamma radiation:
- How far does it travel?
- How do you protect yourself from its effects?
Hundreds of feet
| 1 in of lead, 3 in of steel, 6 in of concrete, 1 foot of dirt
114
Neutron radiation:
- How far does it travel?
- How do you protect yourself from its effects?
Hundreds of feet
| 10 in of plastic, 1 foot of concrete, 3 feet of dirt, 3 feet of water
115
What is the difference between radiological material and radiological contamination?
Radiological material = material containing unstable (radioactive) atoms
Radiological contamination = radioactive material in an unwanted place
116
What is the difference between radiological and nuclear?
```
Radiological = deals with radiation or material that emits radiation
Nuclear = the process that involves splitting a nucleus (fission) or combining nuclei of atoms
```
117
What does ALARA stand for?
```
As
Low
As
Reasonably
Achievable
```
118
Name 3 sources of natural radiation.
1. Cosmic radiation
2. Terrestrial radiation
3. Radon gas
119
Name 3 sources of manmade radiation.
1. Medical radiation
2. Building materials
3. Domestic water supply
120
On average, how many MREMS a year are you exposed to?
~360 MREMS/year (approx. 1 per day)
121
What cells are more sensitive to radiation? Why?
Blood, sperm, intestinal tract, hair follicles
| Why: they are fast-dividing
122
What kind of physical effects could be expected with a dose rate of 50-100 rems?
Low WBC count (temporary)
123
What kind of physical effects could be expected with a dose rate of 100-200 rems?
Nausea, vomiting, diarrhea, no permanent disability
124
What kind of physical effects could be expected with a dose rate of 200-450 rems?
Vomiting, diarrhea, hair loss
125
What kind of physical effects could be expected with a dose rate of 450-600 rems?
Death
