Concepts of Preparedness: Disaster & Mass Casualty Flashcards
Disaster Overview
☆ Disaster events defined by 3 characteristics
- Event of destructive magnitude
- Kills, injures, or causes human suffering to a significant # of ppl or the environment
- Requires the need for external assistance
Mass Casualty Incidents
- All mass casualty events are disasters, but not all disasters are MCIs
☆ Mass casualty
- Local medical capabilities overwhelmed
- May require collaboration of multiple agencies & healthcare facilities to handle crisis
☆ GOAL is to do the greatest good for the greatest # of ppl; accomplished through DISASTER TRIAGE
Preparedness
- TJC
- CMS
- CDC
- WHO
Terrorism
- Involves overt actions for the expressed purpose of causing harm
- Terrorists use threats
- Create fear among the public
- Try to convince citizens that their government is powerless to prevent terrorism
- Get immediate publicity for their causes
> Often motivated by religious, political, or other ideological beliefs
Weapons of mass destruction/effect
> A toxin or poisonous chemical or their precursors
> A disease organism
> Radiation or radioactivity
> An explosive device
Disaster: Bioterrorism
☆ Anthrax, plague, & tularemia: treated w/abx assuming sufficient supplies & nonresistant organisms
☆ Smallpox can be prevented or ameliorated by vaccination even when 1st given >exposure
Anthrax
- Oldest recorded disease of grazing animals thought to be the “sixth plague”
> Aerosol, cutaneous, ingested (rare); bacterial w/spores
- Incubation period 1-6 days; inhalation up to 42 days
> Preferred treatment - Cipro, Levofloxacin, Doxycycline, & PCN
Small Pox
- Viral: Variola major & Variola minor
- Highly contagious (direct or indirect contact); usually droplets
- Smallpox localizes in small blood vessels of the skin & in the mouth & throat, forming fluid-filled, raised blisters (skin)
- Incubation period about 12 days
Treatment is supportive, w/use of antivirals
Disaster: Chemical
Characterized by target organ or effect
> Inactivates enzyme acetylcholinesterase, preventing the breakdown of the neurotransmitter acetylcholine in the victim’s synapses
?
- Toxic nerve gas that can cause death within min of exposure
- Enters body through eyes & skin
- Acts by paralyzing resp muscles
- Antidotes for nerve agents: atropine, pralidoxime chloride (aka Protopam) [2PAM]
Sarin
?
Colorless gas normally used in chemical manufacturing
- If inhaled @ high conc for long enough period, causes severe resp distress, pulm edema, & death
Phosgene
Mustard gas
- Yellow to brown in color w/garlic-like odor
- Irritates eyes & causes skin burns/blisters
Blood - causes intravascular hemolysis that may lead to RF
Cyanide - cherry red skin - immediate onset
Pulmonary - similar mechanism to blister agents in that the compounds are acids or acid-forming, but action is more pronounced in resp system flooding it & resulting in suffocation; survivors often suffer chronic breathing problems
Biological: Plague
A spec disease c/b Yersinia pestis; are 3 major manifestations (Gram negative)
- Bubonic plague
- Septicemic plague
- Pneumonic plague (! most lethal)
> Can cause a pandemic
> Treatment w/abx: gentamycin, Cipro
Biological: Others
Tularemia
- C/b the bacterium Francisella tularensis found in animals (esp rodents, rabbits)
- s/s flu-like w/cough
- sx’s within 3 days
- Treatment - abx
Disasters: Radiation
- Nuclear/radiological events
- Exposures to radiation may be accidents or deliberate in origin
Radiation
- Ionizing radiation
- Alpha radiation
- Beta radiation
- Gamma radiation
Means of exposure
- Irradiation
- Contamination
- Radiation effects
- Adverse health effects of exposure may not be apparent for many yrs
- 2 types of radiation injury
> Local radiation inj & acute radiation synd
Ionizing radiation
Can damage our DNA & cause health effects when humans are exposed to sufficiently high doses
Alpha radiation
Is a stream of positively charged particles that travel only about an inch in air
Beta radiation
Is a stream of electrons that can be stopped by a few millimeters of aluminum but can penetrate up to a centimeter into human tissue
Gamma radiation
Is similar to x-rays as it can penetrate the whole body but unlike x-rays they are more radioactive & can kill cells
A person is externally contaminated when material that contains radioactive atoms is deposited on the skin, clothing, or anywhere it is not desired
A person is internally contaminated if radioactive material is breathed in, swallowed, or absorbed through wounds
Most radiation injuries are “local” injuries frequently involving only the hands
Acute radiation syndrome (ARS) is an acute illness c/b irradiation of the whole body (or a significant portion of it)
Disaster Triage
★ Goal: Do the most good for the greatest amt of ppl
Gives highest priority to those who have a serious inj/illness, BUT also have a good probability of survival, & do not req extraordinary resources
