Disaster Flashcards
Mass Casualty Incident
number of casualties exceeds the number of available resources
Terrorism
unlawful, systematic use of violence or threats against people in order to coerce
Outbreaks
occurrence of a disease within a population that exceeds normal expectations
ex. measles, water contamination
identify source of illness
Epidemics
widespread outbreak of specific disease within a community or population
Pandemic
Epidemic that spreads across multiple countries or continents
outbreak –> epidemic –> pandemic
Emergency Preparedness Plans
JCAHO requires hospitals to create an emergency plan and practice it twice a year
Nurse role in disaster response
- may vary and be asked to perform duties outside of expertise, i.e. intubation, inserting chest tubes, sutures
- may serve as triage officer
- maximize safety and be aware of state regulation
PPE
Level A, B, C, D
Level A: self-contained breathing apparatus (SCBA) + vapor-tight chemical resistant suit, gloves, boots
Level B: high level of resp protections (SCBA) but less skin and eye protection; chemical resistant suit
Level C: air-purified respirator, coverall with splash hood, chemical resistant gloves and boots
Level D: typical work uniform
C & D most often in hospitals
Triage for Disasters
Based on likelihood of survival
Red - Priority 1 - Immediate
Yellow - Priority 2 - Delayed
Green - Priority 3 - Minimal
Black - Priority 4 - Expectant
Triage: Red
Immediate; Priority 1
Life-threatening but survivable
Sucking chest wound, airway obstruction, shock, hemothorax, pneumothorax, chest/abdominal wounds, open fractures, 2nd/3rd degree burns of 15-40%
Triage: Yellow
Delayed; Priority 2
Significant but can wait hours without threat to life or limb
Stable wounds, soft tissue injuries, maxillofacial wounds w/o airway compromise, most eye and CNS injuries
Triage: Green
Minimal; Priority 3
Minor injuries, tx can be delayed hours to days
Minor burns, sprains, small lacerations, behavioral disorders or psychological disturbances
Triage: Black
Expectant; Priority 4
Extensive injuries, chances of survival unlikely; provide comfort measures
Penetrating head wounds unresponsive, high spinal cord injuries, 2nd/3rd degree burns over 60% of body, profound shock, pupils fixed and dilated
Blast Injury
Varies based on distance from blast, type of debris
Blast Lung - hemorrhage and tearing of lung, possible air emboli
Tympanic Membrane Rupture - most frequent injury after blast; most heal on their own
Abdominal and head injuries - abdominal hemorrhage; head injuries can occur without direct blow
Biologic weapons
weapons that spread disease among the general population; delivered in liquid or dry state and applied to foods, water, or vaporized for inhalation
Examples - anthrax, smallpox
Anthrax
Caused by replicating bacteria that release toxin
Incubation: 1-6 days
Spread by: skin contact, GI ingestion, inhalation
Skin contact: skin lesions
Ingestion: fever, n/v, abd pain, bloody diarrhea
Inhalation: mimics flu, can incubate up to 60 days; death results after 24-36 hrs after onset of severe resp distress
Tx: penicillin V, erythrocin
Smallpox
Classified as virus, extremely contagious, spread by direct contact, contact with clothing, droplets
S/S: high fever, malaise, HA, backache, prostration (lying face down); maculopapular rash after 1-2 days on face, mouth, pharynx, forearms
Tx: supportive care, abx for additional infection
Chemical Weapons
Industrial chemicals, gasoline, turpentine, kerosene, insecticides
Effects are more apparent and occur more quickly than with biologic weapons
Limit exposure essential; evacuate and decontaminate ASAP as close to scene as possible
Radiation exposure
May occur d/t nuclear weapon, nuclear reactor incidents, or exposure to radioactive samples
Affected by time and distance and shielding
Types of Radiation Injuries
External irradiation - all or part of body is exposed, decontamination not necessary, not medical emergency
Contamination - exposure to radioactive gases, liquids, solids; requires immediate medical management
Incorporation - uptake of radioactive material into the body
Radiation Decontamination
Done outside of hospital
Cover floors to prevent tracking; seal air ducts
Waste is double bagged and labeled
Staff must wear PPE + dosimetry devices
Pt’s surveyed for radiation
Decontaminate with shower - soap and water
Water should be contained
Resurvey and reshower as needed
Internal contamination: catharsis, gastric lavage, chelating agents
