Ch 40, 41, 42, 43, & 44 Flashcards
The NHTSA has six core elements for advancing a culture of safety, what are they?
-Just culture
-Coordinated support and resources
-EMS safety data system
-EMS education initiatives
-EMS safety standards
-Requirements for reporting and investigation
______ (CRM) is defined as the process of effectively using all resources available, to reduce errors, increase safety, and improve performance
crew resource management
What are the 5 factors of CRM that are essential?
-communication
-situational awareness
-decision making
-teamwork
-barriers
— access is access in which tools are not required
Simple
— access require the use of tools and specialized equipment
Complex
A —— can be defined as a chemical, compound, materials or substance that in any quantity poses a threat or unreasonable risk to life, health, or property if not properly controlled during manufacture, processing, packaging, handling, storage, transportation, use, and disposal
Hazardous material
What does TRACEM stand for determining types of damage from hazardous materials:
-thermal
-radiological
-asphyxiation
-chemical
-etiological
-mechanical
What does the white section of the emergency response guidebook contain?
-instructions on how to use the guidebook
-shipping documents
-basic info
-placards
What does the yellow section of the emergency response guidebook contain?
-4 digit UN number and the name of the chemical matching it
-guide for specific actions to take
What does the blue section of the emergency response guidebook contain?
-hazardous materials by name is alphabetical order with UN number
-appropriate guide number for each material
What does the orange section of the emergency response guidebook contain?
-blue and yellow sections reference orange section
-all hazardous materials are grouped into 1 of 63 guide numbers
-provides initial action to be taken
-PPE, spill control, fire control, first aid
What does the green section of the emergency response guidebook contain?
-denotes that the chemical presents a specific hazard as a toxic industrial hazard when spilled.
-a hazardous material listed in the green section has specific initial isolation distances and other info
— (chemical transportation emergency center) is a public service division of the chemical manufacturers association and another important resource
CHEMTREC
— provides essential info on substance identification, physical and chemical properties of a hazardous material, toxicology info, and further hazardous materials response guidance
WISER
The regulations identify four levels of training of hazardous waste operations and emergency response standards, what are they?
-first responder awareness
-first responder operations
-hazardous materials technician
-hazardous materials specialist
What does RAIN stand for in awareness level responsibilities at a hazardous materials incident?
-recognize that a hazardous materials incident has occurred
-avoid contact with the hazardous materials
-isolate the area
-notify the appropriate authorities or response agencies
— is defined by OSHA as the removal of hazardous substances from exposed individuals to the extent necessary to prevent the occurrence of foreseeable adverse harm
Decontamination
As an early priority at the scene of any hazardous materials emergency, —— are established in which rescue operations and a specific sequence of decontaminations procedures take place
Safety zones
The — zone is also known as the exclusion zone, is where contamination can be present. Is immediately near the accident sight, you should never eat or drink in this site. This spot should be restricted and only allow access to specific individuals
Hot
The — zone, is also known as the contamination reduction zone, is immediately adjacent to the hot zone, might still be contaminated, all people in this zone must wear protective gear, in this zone ems can give lifesaving care, for airway management or spine motion restriction
Warm
The — zone is also known as the support zone, or outer perimeter, before entering this zone from the warm zone, one must shed all contaminated gear and patients should be fully decontaminated. This zone should not contain any contamination but it is possible it can. By the time patients enter this zone, life threatening problems should have initially been managed
Cold
— decontamination always involves the use of copious amounts of water and might also include the use of a simple soap
Initial
A — assessment is to be performed in the warm zone
Primary
After the primary assessment in the warm zone, a complete — should be performed
Decontamination
Following thorough decontamination in the warm zone, a — assessment should be performed where you treat any major injuries and provide spine motion restriction
Physical
In the — zone, you should take a set of vitals and history, and prepare the patient for transport
Cold
— occurs when the patient is in the presence of radioactive material without any of the radioactive material touching his body
Exposure
— occurs when the patient has come into direct contact with the source of the radioactivity or radioactive gases, liquids, or particles
Contamination
What are two major principles to remember in radiation related accidents?
-protect yourself and others from contamination
-no emt should ever attempt to decontaminate a radiation patient
If you suspect a patient is contaminated by radiation, you have two choices, what are they?
-wait for a radiation safety officer
-if an RSO cannot come to the site, transport the patient to the hospital for decontamination experts there
— is the critical factor in managing radiation emergencies
Time
Alpha rays can be stopped by —
Clothing
Beta rays can be stopped by —
Aluminum like materials
Gamma rays can be stopped by —
Lead shielding
Protecting yourself from exposure to radiation includes consideration of what factors?
-time
-distance
-shielding
-quantity
—— is caused by exposure to large amounts of radiation, symptoms start a few hours to days following exposure, can last up to 8 weeks. can cause nausea, vomiting, diarrhea, hemorrhage, weight loss, appetite loss, fever, and sores in the throat and mouth, can also lower the immune system
Radiation sickness
—— is a local injury that is generally caused by exposure to large amounts of less penetrating particles such as beta particles. Can cause hair loss, skin burns and generalized skin lesions
Radiation injury
—— occurs when the patient has been exposed to dangerous amounts of internal radiation. This result is a host of serious diseases, including cancer and anemia
Radiation poisoning
——— is a collection of signs and symptoms that patients exposed to high levels of radiation will present with. The CDC defined this as an acute illness caused by irradiation of the entire body by a high dose of penetrating radiation in a very short period of time
Acute radiation syndrome
A ——— is any event that places excessive demands on personnel and equipment, involved three or more patients
Multiple casualty incident
The ———— ( NIMS) provides for a consistent approach to managing disasters by all responders to the incident that might include emergency response personnel and local, state, and federal government agencies and employees
National incident management system
What are the three main components NIMS provides?
-flexibility
-standardization
-scalability
The ——— is an incident management concept that has become the standard for on scene management of disasters and MCI’s
Incident command system
The —— is responsible for coordinating all aspects of the incident
Incident commander
The — unit of EMS sorts patients by criticality and assigns priorities for emergency care and transport
Triage
The — unit in ems gives emergency care to patients, this is done based on the priority assigned to the patient by the triage unit
Treatment
The — unit in ems is where patients are mice to ambulances or helicopters for transportation to a medical facility, and communications are organized to notify the receiving medical facilities
Transportation
In the — unit in ems, the ambulances, helicopters and additional equipment are held in this area until they are assigned to a specific task
Staging
In the — unit in ems, the deceased casualties are moved to this unit where they are held and processed
Morgue
— is a system used for sorting patients to determine the order in which they receive medical care or transportation to definitive care
Triage
— triage occurs immediately upon the arrival of the first ems crew, this triage is usually conducted at the actual site of the incident
Primary
What does a red triage tag indicate?
Immediate care and transport necessary
Priority 1
What does a yellow triage tag indicate?
Delayed mercenary care and transport
Priority 2
What does a green triage tag indicate?
Minor injuries and ambulatory patients
Priority 3
What does a black triage tag indicate?
Deceased or fatal injuries
Priority 4
After the patients are moved from the scene to the ——, the secondary triage occurs
Triage unit
The —— is designed to reevaluate the patient categorization, during which the patient might be upgraded to a higher priority, downgraded to a lower priority, or kept at the same priority status
Secondary triage
What do the letters in START mean?
Simple triage and rapid transport
The — system is an easy triage system to use and allows for rapid categorization of patients into the priority categories for further assessment, treatment, and transport
START
What are the 3 basic categories assessed in START?
-respiratory status
-perfusion status
-mental status
Any patient who can walk, despite the injuries he has suffered is a lower priority initially and is tagged —
Green
If the patient is breathing but the respiratory rate is over 30 RPM, tag —
Red
If the capillary refill in a triage patient is greater then 2 seconds and the pulse is absent, tag them —
Red
What do the letters in SALT stand for in triage?
-sort
-assess
-lifesaving interventions
-treatment/transport
A —— or area should be designated close to the area where ambulances arrive
Treatment unit
A — is a sudden catastrophic event that overwhelms the natural order and causes great loss of property or life
Disaster
——— are intended to cause widespread and indiscriminate death and destruction
Weapons of mass destruction
What does the CBRNE mnemonic stand for when remembering WMD’s?
-chemical
-biological
-radiological
-nuclear
-explosive
What does the B-NICE mnemonic stand for when remembering WMD’s?
-biological
-nuclear/radiological
-incendiary
-chemical
-explosive
— means bringing the agent into contact with its intended target population
Dissemination
With chemical weapons, patients often complain of what symptoms?
-respiratory distress
-dyspnea
-cough
-burning chest
-burning eyes
Explosives work by using chemicals whose primary characteristic is to burn extremely rapidly when exposed to certain stimuli, causing hot gases to displace air in a violent fashion, creating a shock wave or blast. this is referred to as —
Detonation or deflagration
An ——— is defined as an explosive device constructed from homemade or readily available materials that is used to kill, incapacitate, distract, or harass a specific target
Improvised explosive device
The blast of an explosion is the — effect. The — effects result from flying debris, shrapnel, and other projectiles
-primary effect
-secondary effect
The — effects are the injuries produced by the propulsion of the persons body
Tertiary
— effects include burn, crush, and inhalation injuries that may worsen existing conditions like asthma and COPD
Quaternary
— effects result from environmental exposures to bacteria, chemicals, radiation, fuels, and metals
Quinary
— devices create different injury patterns from conventional explosives, these include napalms, thermite, magnesium and white phosphorus, causes a primary injury of burns
Incendiary
The tendency of the chemical agent to evaporate is called —
Volatility
A characteristic of agents that do not evaporate and tend to remain as a puddle for long periods of time is referred to as —
Persistence
What are 6 major types of chemical agents?
-nerve agents
-vesicants
-cyanide
-pulmonary agents
-riot control agents
-toxic industrial chemicals
— agents are among the deadliest known chemicals, these are extremely potent and easy to make, becomes both a vapor and liquid hazard
Nerve
What are some nerve agents?
-tabun (GA)
-sarin (GB)
-soman (GD)
-GF
-methylphosphonothioic acid (VX)
-novichok agents ( Russian nerve agents)
Nerve agents block the action of an enzyme called — which is plasma of the blood, red blood cells, and nervous tissue. It’s function is to stop the action of —, a neurotransmitter
-acetylcholinesterase (AChE)
-acetylcholine (ACh)
What are the two drugs used to counteract the effects of a nerve agent?
Atropine and pralidoxime (protopam)
— are another group of chemical agents that result in damage to exposed skin, lungs, and eyes. These can cause general illness, blistering, burning and tissue damage on contact
Vesicants
It can take — hours for mustard exposure to produce signs and symptoms but eye damage can occur within — hours within exposure
-2-24
-1-2
The most important emergency care to be given to a patient with a vesicant exposure is:
Irrigation
— is a rapid acting agent that disrupts the capability of the cell to use oxygen, leading to severe cellular hypoxia and eventually death. Has a bitter almond smell, if a person comes into contact with this, the patient can lose consciousness within 1 minute and die within 6-8 mins
Cyanide
What is the best emergency care for cyanide incidents?
Manage airway and provide PPV if needed
Can be treated with antidote nitrite by medical direction
— agents include phosgene (CG), other halogen compounds, and nitrogen oxygen compounds. Primarily cause lung injury and is also known as choking agents.
Pulmonary
A pulmonary agent can cause ——
Pulmonary edema
What is the best emergency care in a pulmonary agent situation?
Manage the airway and ensure the patient breathes adequately
—— agents are solids that become an aerosol when deployed. Also known as “tear gas”
Riot control
Riot control agents can cause?
Extreme irritation of the eyes, nose, mouth, skin, and respiratory tract
What is the best emergency medical care for a riot control agent incident ?
Removing the patient from the area, irrigating the eyes, managing breathing
— agents are made up of living organisms or the toxins produced by the living organisms and cause diseases in a target population
Biological
The — tract is the most common and efficient portal of entry for most biological agents
Respiratory
What biological agents pose a serious threat?
-pneumonia like agents (present with fever and rapidly progressing dyspnea)
-encephalitis like agents (present with fever and altered mental status)
-biological toxins
-other agents
Which pneumonia like agent has an incubation period of 1-6 days, fever, malaise, fatigue, nonproductive cough, mild chest discomfort with worsening dyspnea, diaphoresis, shock, strider, cyanosis and death can occur within 24-36 hours?
Anthrax
Which pneumonia like agent has an incubation period of 2-3 days, headache, coughing up blood (hemoptysis) severe dyspnea, high fever, stridor, cyanosis, and death from respiratory failure, circulatory collapse, and bleeding disorder?
Plague
Which pneumonia like agent has chest pain that worsens with breathing, headache, malaise, nonproductive cough, and weight loss?
Tularemia
Which encephalitis like agent presents with a sudden onset of malaise, fever, headache, vomiting, and backache vesicular rash in same stage of development appears in 2-3 days?
Smallpox
Which encephalitis like agent produces a sudden onset of of malaise, fever, severe headache, rigor, nausea, vomiting, cough, sore throat, and diarrhea, with recovery within 1-2 weeks?
Venezuelan equine encephalitis
When an unstable radioactive atom breaks apart, it releases energy in the form of rays and particles that travel at high speeds creating ——
Nuclear radiation
— radiation and — radiation are the same type although they are created by different processes, this is the most penetrating type of radiation and can travel long distances, occurs from nuclear power plants and nuclear bombs
X ray radiation
Gamma radiation
— radiation is a powerful and damaging particle that penetrates several hundred meters of air and easily passes through the body. It is blocked by water and other hydrogen containing materials
Neutron
— radiation is a low speed, low energy particle that is easily stopped by 6-10 feet of air, clothing, or the first few millimeters of skin. Is a common product of fallout decay, can be contaminated in foods and airborne particles
Beta
— radiation is a heavy and slow moving particle that travels only inches in air and is stopped by clothing or the outer layer of the skin, can be ingested or inhaled
Alpha
— exposure is the primary radiation injury that occurs during or shortly after the detonation
Primary
— is the second form of radiation exposure. This is radioactive dust and particles that can be life threatening to people far from the epicenter of the detonation
Fallout
— is defined by the FBI as the use of computer network tools to shut down critical national infrastructure or to coerce or intimidate or hold for ransom a government or civilian population
Cyberterrorism
