Chapter 8

Question 1

who recognizes indicators of emergency situations

Answer 1

STSR

Question 2

who assess the emergency situation and provides instruction

Answer 2

surgeon/ anesthesia

Question 3

priorities in emergency situation

Answer 3

preserve life
prevent further deterioration of patient
try to get them higher care

Question 4

CABD

Answer 4

care priority

chest compression
airway
breathing
definitive treatment (OR/ER)

Question 5

how long with no air until your brain dies
(clinical death)

Answer 5

4-6 minutes (CPR)

Question 6

anesthesia role in CPR

Answer 6

in charge, airway management

Question 7

CN role in CPR

Answer 7

provide crash cart + support

Question 8

surgeon role in CPR

Answer 8

continue surgery to “safe” stopping point

Question 9

life threatening, acute pharmacogenic disorder.

Answer 9

malignant hyperthermia
developed during/ after anesthesia
50 events per year

Question 9

stsr role in CPR

Answer 9

protect the sterile field, if not aid in resuscitation

Question 10

what code is cardiac arrest

Answer 10

code blue

Question 11

malignant hyperthermia death rates

Answer 11

50% die without meds
5% die with meds started immediately

Question 12

what is malignant hyperthermia

Answer 12

fatal hypermotabolic state of muscles due to defect in calcium transport.
skeletal muscles can’t relax

Question 13

what triggers MH

Answer 13

genetic, mostly males
halogenated agents that ends in “ane”
perchance strenuous exercise

Question 14

MH signs

Answer 14

tachycardia
increase c02 levels
unstable BP
muscle contraction

high temp -107F

Question 15

MH emergency protocol for anesthesia

Answer 15

stops what they’re infusing
introduce chilled IV + ice pack
place Foley catheter

Question 16

what does the anesthesia administer during MH

Answer 16

dentrolene sodium

sodium bicarbonate
insulin
mannitol
heparin

Question 17

disseminated intravascular coagulation (DIC)

Answer 17

happens when blood begins to coagulate

uses up all coagulation factors and platelets, does blood EVERYWHERE

severe and life threatening

Question 17

what causes DIC

Answer 17

infection of blood
liver disease
cancer
severe trauma
post delivery complications

Question 18

DIC treatment

Answer 18

determine underlying cause
treat with transfusion
cryoprecipitate
heparin (prevent thrombosis)

Question 19

anaphylactic reaction # 1 fixer

Answer 19

epinephrine

Question 20

causes of anaphylaxis in the OR

Answer 20

anesthetics
codeine
antibiotic
insulin
latex

Question 21

where can you not put epinephrine

Answer 21

eyes ears fingers nose penis toes

Question 22

S+S of anaphylactic reactions

Answer 22

hives, bronchospasm, vascular collapse, cardiovascular failure

Question 23

anaphylactic treatments

Answer 23

supplement o2 - prevent resp arrest steroids - stabilize cells iv and plasma -restore fluid vol vasopressin agents - increase bp

Question 24

anaphylactic patient ID

Answer 24

identify chart patient ID band history noted on chart skin test performed to ID

Question 25

categories of Richter scale

Answer 25

1-5

Question 26

hot zone

Answer 26

central area where disaster occured

Question 27

warm zone

Answer 27

300 ft or more from hot zone

Question 28

cold zone

Answer 28

triage near the warm zone, patients evacuated for injuries

Question 29

best thing to do for radiological burn

Answer 29

take clothes off (90% of contamination)

Question 30

most variety of physical trauma requiring Surg from

Answer 30

factory explosion

Question 31

most likely bioterrorism risk

Answer 31

anthrax

Question 32

NIMS

Answer 32

national incident management system

Question 33

what does NIMS do

Answer 33

provides national response to emergency

Question 34

LEMA

Answer 34

local emergency management agency local coordination

Question 35

EOP

Answer 35

emergency operations plan predetermines location of emergency operations center

Question 36

ICS

Answer 36

incident command system ensures responders know their roles

Question 37

unified command groups

Answer 37

operations planning logistics finance + administration

Question 38

FEMA

Answer 38

federal emergency management agency requested via LEMA

Question 39

what is a Brach of FEMA

Answer 39

department of homeland security (DHS)

Question 40

NRF

Answer 40

national response framework pulls all the coordinating and communication together developed by homeland security

Question 41

NDMS

Answer 41

national disaster medical system over 100 med teams and 1000 hospitals rapidly deployed in case of national emergency

Question 42

three branches of NDMS

Answer 42

DMAT- disaster medical DMORT- disaster mortuary operation NPRT- pharmacy response teams

Question 43

Health care facility emergency response

Answer 43

develops action plan for hospital practice 2X a year

Question 44

four components of health care facility emergency response

Answer 44

mitigation - ID hazards preparedness - develop EAP response - all responsibilities recovery - plan for rebuilding

Question 45

HICS

Answer 45

hospital incident command center chain of commands written responsibilities

Question 46

evacuation plan

Answer 46

shelter in place transport of patients back up medical records

Question 47

first to arrive to scene

Answer 47

1st responders/ firefighters

Question 48

PPE levels

Answer 48

determined by incident command A,B,C,D A= spacesuit D=mask, eyewear and gloves

Question 49

decontamination areas

Answer 49

for anyone who's had contact with the scene clothes disposed of

Question 50

what is chemical contacted skin washed with

Answer 50

0.5% sodium hypochlorite- skin and wounds 1:9 ratio of household bleach ^

Question 51

decontamination area is for

Answer 51

radiological chemical blankets available

Question 52

triage of victims

Answer 52

sorting through victims according to injuries maximize medical resources

Question 53

goal of triage

Answer 53

provide treatment to as many patients as possible while spreading out + making most of medical resources

Question 54

triage personnel

Answer 54

EMT ER physicians- most experienced and best suited ST

Question 55

triage system DIME

Answer 55

delayed- (yellow), have a couple hours immediate- (red), need to prevent death asap minimal- (green), ambulatory, minor injuries expectant- (black)- survival unlikely, burns + head inj.

Question 56

triage of victims

Answer 56

tags patients without giving care 1 minute per person

Question 57

chemical nuclear disaster triage

Answer 57

separate into zones for contamination hot- level A PPE warm cold

Question 58

points of distribution POD

Answer 58

store people - mass prophylaxis

Question 59

SNS

Answer 59

strategic national stockpile stores medication and vaccines

Question 60

2 phases of strategic national stockpile

Answer 60

1- masses, get them antibiotics 2- individual needs, chronic illness

Question 61

who packages and distributes meds in a POD

Answer 61

NPRT, national pharmacy repsonse team

Question 62

distribution in POD:

Answer 62

"pull" patients come in "push" patients delivered to house

Question 63

PIO Risk Communications With Public

Answer 63

public information center where correct media is produced, eliminates rumors adress barriers

Question 64

volunteer health professions

Answer 64

ESAR- VHP: emergency system for the advanced registration of volunteer health professionals

Question 65

who is VHP deployed by (volunteered health professionals)

Answer 65

EMAC (emergency management assistance compact)

Question 66

CERT

Answer 66

community emergency response team community members completing training with fire/ police ie. search and rescue