Ch. 20 EMS & Disaster Med Flashcards
Which act authorized the dept of transportation to develop prehospital services?
Highway Safety Act (1966)
Which Act provided government funding and training to encourage development
of regional, county, and local EMS systems and identified essential components of an EMS system?
Emergency Medical Services System Act (1973)
Which act requires a medical screening
examination and stabilization of any emergent medical condition (including active labor) for any patient who presents to a hospital with an emergency department?
Emergency Medical Treatment and Active Labor Act (EMTALA) 1985
Which act authorized government funds to states for development of trauma
systems?
Trauma Care Systems Planning and Development Act (1990)
In medical terms, how is a “disaster” defined?
any event where the needs exceed
the available resources
How is a “mass gathering” defined?
an event of over 1000 people gathered at a specific location for a specific amount of time (eg, sporting event, music festival)
Per JCAHO, How often must all hospitals perform disaster preparedness drills?
twice yearly
What are the four phases of disaster preparedness?
mitigation, preparedness, response (activation, implementation), and recovery
What are the Simple Triage and Rapid Treatment (START) four color designations?
■ Red (immediate): Critical or immediate life-threatening illness or injury (eg, tension pneumothorax, hypovolemic shock)
■ Yellow (delayed): Serious but not immediately life-threatening illness or
injury (eg, most long bone fractures)
■ Green (minor): The walking wounded (eg, anxiety attack after witnessing event, minor burns)
■ Black (dead/dying, or expectant): Dead or resource-intensive victims (eg, 100% TBSA burn)
How long is antibiotic therapy for anthrax?
60 days
What is the treatment for anthrax in toxic patients or with inhalational disease?
- Requires triple antibiotic therapy
with ciprofloxacin or doxycycline plus 2 additional antibiotics (eg, rifampin,
clindamycin, aminoglycoside, imipenem).
x60 days
PLUS - Vaccination - 3 doses (days 0, 14, and 28)
What is treatment for plague (y pestis)?
Antibiotics: Options include streptomycin, gentamycin, doxycycline, ciprofloxacin,
and chloramphenicol (do not use chloramphenicol or streptomycin in pregnant patients)
What organism causes smallpox?
Variola sp, a genus of large DNA viruses.
How is small pox spread?
via aerosol
How does rash of smallpox and chickenpox differ in their spread?
Smallpox starts in the face and forearms
and spreads inward (centrifugal), whereas
chickenpox starts in the trunk and spreads
outward (centripetal).
How long are people with smallpox contagious?
until all scabs fall off
What type of isolation is required for small pox?
airborne isolation
What type of isolation is required for tularemia?
isolation is NOT required
What is treatment for tularemia?
Antibiotic: Streptomycin is drug of choice. Gentamycin also effective.
What are names of four nerve agents (organophosphates)?
sarin, tabun, soman, and VX
What is the mechanism of action of organophosphates/nerve agents?
Nerve agents inhibit acetylcholinesterase,
producing a cholinergic toxidrome.
What are antidotes for organophosphates/nerve agents?
Atropine and pralidoxime, available in
Mark 1 autoinjector kit.
How does mustard injury occur?
induces blistering due to cellular damage – resembles second degree burns
What is treatment for mustard injury?
Supportive care, skin and mucous membrane decontamination with irrigation,
topical care for burns and eye injuries (do not require aggressive fluid resuscitation as not a typical burn), intubation for severe respiratory exposures
