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Emergency Response to Hazardous Material and Terrorism > Chemical Agents and Treatment Protocols > Flashcards

Chemical Agents and Treatment Protocols Flashcards

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1
Q

what is a chemical attack

A

The purposeful use of chemical substance to harm people, cause economic or property damage or instill fear or panic.

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2
Q

severity of a chemical attack

A
  • toxicity + concentration
  • concentration variable
  • chemicals that vaporize are less toxic
  • wind
  • volatility
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3
Q

decontamination

A

-you must make sure the patient is decontaminated before treatment
-remove all chemicals and clothing
-

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4
Q

if you see something say something

A

-someone should investigate

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5
Q

personal protection

A
  • time- spend the least amount of time in the area -> less exposure
  • distance- put distance between you and incident or have PPE -> less exposure
  • shielding- wear the appropriate PPE
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6
Q

accidental exposure

A
  • blot- blot off the agent
  • strip- removing all clothing (80% of decontamination)
  • flush- flush the affected area with large amount of water
  • cover- cover the affected area- reduce exposure or infection
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7
Q

physiological effect of chemical warfare

A
  • overstimulation- seizures, twitching -> confusion
  • unaware of surroundings
  • dizzy
  • nervous system is affected
  • can last for 2-6 weeks
  • constriction of airways - you can get air in but no air out -> trouble breathing, high blood pressure
  • excessive mucus -> suction
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8
Q

affects on vagus nerve

A
  • simulates vagus nerve -> lowers heart rate
  • cardiac arrest
  • brain damage within 5 minutes
  • lowered blood pressure
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9
Q

choking agent

A

-chlorine gas
-prevent breathing
-pulmonary edema - fluid in lungs
-

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10
Q

herbicide

A
  • agent orange
  • used to damage vegetation
  • vietnam war- damage the foliage
  • no hiding
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11
Q

blister agents

A
  • causes blisters
  • can be in the airways too
  • eyes can be affected
  • can last 2 hours
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12
Q

riot control

A
  • law enforcement
  • irritates eyes
  • not meant to cause severe damage
  • pepper spray
  • if you spray someone with COPD or asthma it can be serious
  • tear gas
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13
Q

blood agents

A
  • cyanide- organ cells cant take up the oxygen
  • affects the way the body can use oxygen
  • affects the hemoglobin -> cant pick up oxygen
  • CO poisoning - hemoglobin cant pick up oxygen
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14
Q

nerve agents

A
  • chlorine gas
  • sarin gas
  • blisters
  • difficulty breathing
  • fluids coming out everywhere- SLUDGEM
  • tabun
  • soman
  • cyclosarin
  • seizures
  • paralysis
  • confusion
  • vomiting
  • pinpoint pupils **
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15
Q

SLUDGEM

A
  • salvation - fluids
  • lacrimation
  • urination
  • defecation
  • gastroenteritis
  • emesis- vomiting
  • miosis- pupil constriction
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16
Q

pathophysiology of nerve agents

A
  • agent binds with ACh
  • ex. sarin binds with ACh constantly
  • Acetylcholine releases constantly -> overstimulation -> Seizures, secretion of fluids
17
Q

tokyo subway attack

A
  • leader created his own religion
  • when you joined you sign off your wealth -> rich
  • experiments with nerve agents
  • used sarin gas in bags in the subway
  • use umbrellas to puncture the bags
  • 13 people died
  • this disrupts the economy, the public, in mass amounts
  • so easily available and yet instills fear, death, pain
18
Q

treatment: nerve agents

A
  • decontamination
  • ventilation
  • administration of antidotes
  • supportive therapy
19
Q

nasal cannula

A
  • 1-6 LPM (liters per minute)

- delivers 24-40% oxygen

20
Q

nonrebreather mask

A
  • 8-15 LPM
  • delivers 90% of oxygen
  • more difficulty of breathing-
21
Q

bag mask valve (BVM)

A
  • 15 LPM
  • delivers up to 100% oxygen
  • when someone cannot ventilate themselves
  • lung size depends on height
  • issue comes in when you start over inflating -> pneumothorax
  • meant to be used by two people- bc cramping
  • add a filter to decrease spread of germs
  • put on mask then attach bag
22
Q

peep valve

A
  • red cap on a BVM
  • increases pressure so when you squeeze the bag it keeps pressure within the system (if you have a good seal)
  • when you have built up fluid the alveoli will open up and STAY open*
  • helps with bringing oxygen in when fluid is present
  • o2 doesn’t move easily in fluid but CO2 does
23
Q

continuous positive airway passage mask (CPAP)

A
  • asthma attack
  • opens the airways
  • used on someone is exposed to a chemical
  • maintains the pressure
  • opens alveoli
24
Q

Bilevel positive airway pressure (BiPAP)

A
  • for people that are tired

- tired of breathing

25
Q

endotracheal tube

A

-gold standard of airway management

26
Q

Igels

A

-you dont need to look into the airway to be intubate

-

27
Q

auto-injector

A
  • atropine/pralidoxime combination- injects at same time
    1. atropine- inject first
    1. pralidoxime- inject second
28
Q

atropine

A
  • anticholinergic -> blocks acetylcholine receptors
  • chemicals have nothing to bind to
  • initial dose- 2 mg
  • muscle relaxer
  • mydriasis
  • for people with hypersalivation or large amount of fluids
  • comes from atropa belladonna (Nightshade)
  • onset: Minutes after
  • IV administration
  • Duration: 3-5 minutes
29
Q

pralidoxime

A
  • 600 mg dosage
  • attaches to nerve agent receptor
  • doesnt allow it to bind to ACh
  • nerve agent has nothing to attach to
  • less effective if aging present (bond between ACh and nerve agent is strong and hardened)
30
Q

diazepam

A
  • valium
  • benzodiazepine
  • 10mg IV/IM- dosage
  • seizure history
  • anticonvulsant, hypnotic
  • motor cortex- planning, control and voluntary movement
  • onset- (IV 1-5min)
  • onset- IM 15-30 min
  • (PR) Varied
  • Duration: (IV) 15 min-1 hour; (IM) 15 min-1 hour; (PR) Peak concentration 1.5 hour
31
Q

midazolam

A
  • aka Versed- before a procedure or anesthesia to cause drowsiness, decrease anxiety, and cause forgetfulness of the surgery or procedure.
  • Class: Benzodiazepine
  • Initial dose: 1-2 mg IVP or 5 mg IM/IN
  • Anticonvulsant
32
Q

supportive care

A

-

33
Q

benzodiazepine

A
  • lowers respiration rate

- must be careful

34
Q

suffolk county protocol

A
  • adult patients- > 15 years
  • for patients who exhibit signs or symptoms of organophosphate or nerve agent exposure
  • ensure scene is safe and you have correct PPE
  • triage after gross decontamination
  • contact emergency department - number of patients, nature of exposure
  • start triage
  • provide airway support
  • for asymptomatic patients- decontaminate, monitor
  • for mild / moderate exposure- give antidote
  • for severe exposure- administer all antidotes(duos)
  • monitor and reassess
  • repeat until patient is not secreting
35
Q

suffolk county protocol: CHEMPACK Program

A
  • hospitals listed below are referred to as SPOKE HOSPITALS -> they do not have chempack stored at the facility but are fed by a specific pre-determine HUB HOSPITAL
  • chempack assets are for treatment of NERVE AGENT/ORANGOPHOSPHATE EXPOSURE and include:
  • mark 1 auto-injectors
  • atropine for IV use
  • pralidoxime for IV use
  • diazepam autoinjectors
  • diazepam for IV use
  • atropen auto-injector
  • sterile water
36
Q

cyanokits

A
  • cyanide poisoning
  • block ability to use oxygen
  • form a vitamin B12
  • binds to cyanide to create cyanocobalamin -> not toxic to the body
  • 5g max of 10 g over 15 min IV
37
Q

cyanokits

A
  • cyanide poisoning
  • block ability to use oxygen
  • form of vitamin B12
  • binds to cyanide to create cyanocobalamin - which is not harmful to the body

Emergency Response to Hazardous Material and Terrorism (18 decks)

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