Anthrax | Disaster Nursing Flashcards
Terrorism involves overt actions for the expressed purpose of causing harm. What are 4 ways this can be done?
Disease pathogens (ex. bioterrorism); chemical agents; radiologic/nuclear; explosive devices
How are anthrax, plague, and tularemia treated?
Antibiotics (assuming there are sufficient supplies)
_ can be prevented or ameliorated by vaccination even when first given after exposure
Smallpox
Botulism is treated with
antitoxin
Treatment for hemorrhagic fever
none known
Sarin is a toxic gas that can cause death within minutes of exposure. It enters the body through the es and skin and paralyzes respiratory muscles. Name 2 antidotes for this nerve agent
atropine, pralidoxime chloride
_ is a colorless gas normally used in chemical manufacturing
Phosgene
If phosgene is inhaled at high concentrations for long enough it causes (3)
respiratory distress, pulmonary edema, death
Yellow to brown in color with garlic like odor
Mustard gas
Mustard gas irritates eyes and causes skin
burns/blisters
Mix of explosives and radioactive material. When detonated, blast scatters radioactive dust resulting in radioactive contamination
radiologic dispersal devices (RRDs)/”Dirty bombs”
Main danger from RRDs
Explosion
Note: They do not usually generate enough radiation to cause immediate serious illness except to casualties who are close to the explosion
After RRD, measures to limit contamination should be initiated because radiation cannot be
seen, smelled, felt, or tasted
Ionizing radiation example
nuclear bomb or damage to a nuclear reactor
With ionizing radiation there is
serious threat to safety of people and environment
If external radioactive contaminants are present, _ procedures must be initiated immediately
decontamination
_ develops after a substantial exposure to ionizing radiation
Acute radiation syndrome
Note: follows a predictable pattern
Explosive devices result in one or more of the following types of injuries (3)
Blast, crush, or penetrating
Note: Damage to lungs, middle ear, GI tract can also occur
_ Injuries result from explosions that occur in confined spaces and result from structural collapse
Crush
_ injures result from explosive devices that contain materials that are projected during the explosion
Penetrating
Any extraordinary event that requires a rapid and skilled response and can be managed by a community’s existing resources
Emergency
Manmade or natural event or disaster that overwhelms the community’s ability to respond with existing resources
Mass causality incident (MCI)
MCIs usually involve large numbers of casualties (>_)m physical/emotional suffering, and permanent changes in the community
> 100
_ always require assistance from people/resources outside of the community (ex. FEMA, American Red Cross)
MCIs
When an emergency or MCI occurs first responders are dispatched. Triage of casualties is different from in the emergency department. The triage is conducted in
<15 seconds
System of colored tags designates both (2)
serious of injury and likelihood of survival
Green (minor injury) or yellow (non life threatening injury) tag indicates
non critical injury
Red tag indicates _ injury requiring immediate intervention
life threatening
Black tag identifies
The dead or those expected to die
Casualties who arrive at hospitals on their own without EMS
Walking wounded
If there is known or suspected contamination, decontaminate at the scene then
transport to hospital
How can a hospital predict the total number of casualties expected to come seek treatment?
Double the number of casualties that arrive in the 1st hour
Note: generally 30% need admission and half of these need surgery in 1st 8h
Partners in emergency preparedness, and training helps citizen to understand their personal responsibility in preparing for natural/manmade disaster
CERT- Community emergency response teams
Section within homeland security that is responsible for the coordination of the federal medical response to MCIs
National Disaster medical System (NDMS)
NDMS organizes and trains volunteer _
disaster medical assistance teams (DMATs)
- Can be deployed within 8 hours
- can remain self sufficient for 72 hours with enough food, water, shelter, and medical supplies to treat 250 patients per day
Level 1 DMAT
- Lacks enough equipment to be self sufficient but is used to replace a level 1 team
- Uses and supplements the equipment left on site
Level 2 DMAT
Arranges group discussions to allow participants to verbalize and validate their feelings and emotions about the experience to facilitate psychologic recovery
Critical incident stress management unit
Anthrax is caused by the spore forming bacterium _
bacillus anthracis
Human infection of anthrax typically follows contact with
anthrax infected animals or animal products
Note: can also be from intentional exposure
3 clinical forms of anthrax
cutaneous, inhalation, gastrointestinal
Intentional anthrax can be introduced with inhalation and cutaneous exposure through
US mail
farm workers can come into contact with anthrax from
infected animals
processors of wool, hair, hides, bones, or other _ can come into contact with anthrax
animal products
B. anthraces is one of the most important pathogens on the list of
bioterrorism threats
Be particularly aware of anthrax infection especially in
mail handlers
What is this concern of? previously healthy patient with rapidly progressive respiratory illness or cutaneous ulcer
anthrax
Report B. anthraces suspicion to
HCP and local/state public health staff
Exposed patients should continue treatment for _ days
60
Surface swabs and nasal swabs if person was potentially exposed to anthrax in the last
7 days
Potentially exposed to anthrax should get
antimicrobial prophylaxis
cutaneous anthrax begins as a _ and progresses through a vesicular stage to a depressed black necrotic ulcer (eschar)
papule
_ anthrax will resemble a viral like illness
inhalational
_ anthrax has abdominal distress usually accompanied by bloody vomiting or diarrhea, followed by fever and signs of septiecemia
GI
Note: develops after ingestion of contaminated poorly cooked meat
Chest XR for inhalation anthrax will show
widened mediastinum, pleural effusions, infiltrates, and pulmonary congestion
Meds used for anthrax
ciprofloxacin or doxycycline for 60 days
