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Advanced Med/Surg > Disaster Management > Flashcards

Disaster Management Flashcards

1
Q

disaster that occurs inside a healthcare facility that could endanger workers and patients

A

Internal Disaster

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2
Q

disaster that occurs anywhere outside the healthcare facility requiring activation of a facility’s emergency response system

A

External Disaster

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3
Q

The Joint Commission requires how many disaster drills per year?

A

Two

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4
Q

the ability of a facility to rapidly expand during an emergency

A

surge capacity

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5
Q

What are the 4 phases of Emergency Management?

A

Mitigation, Preparedness, Response & Recovery

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6
Q

physician or administrator who assumes overall leadership for implementing the emergency plan

A

Hospital Incident Commander

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7
Q

physician who decided the number, acuity and resource needs of patients

A

Medical Command Physician

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8
Q

physician or nurse who rapidly evaluates each patient to determine priorities for treatment

A

Triage Officer

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9
Q

person who serves as a liaison between the health care facility and the media`

A

Community Relations/ Public Information Officer

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10
Q

triage category in which injuries are life-threatening but survivable with intervention ( EX: sucking chest wound, hemothorax, unstable chest/abdominal wounds, 2nd & 3rd degree burns over less than 50% TBSA)

A

Category Red/ Immediate/ Priority 1

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11
Q

triage category in which injuries are significant and require medical care but can wait 30 minutes- 2 hours without threat to life or limb (EX: stable abdominal wounds w/o significant hemorrhage, soft tissue injuries, maxillofacial wounds w/o airway compromise, fractures requiring ORIF)

A

Category Yellow/ Delayed/ Priority 2

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12
Q

triage category in which injuries are minor and treatment can be delayed hours or days… “walking wounded” (EX: extremity fractures, minor burns, sprains, behavioral disorders or psychological disturbances)

A

Category Green/ Minimal/ Priority 3

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13
Q

triage category in which injuries are extensive and chances of survival are unlikely even with definitive care (EX: unresponsive patients w/ penetrating head wounds, high spinal cord injuries, 2nd & 3rd degree burns in excess of 50% TBSA, patients exposed to large amounts of radiation)

A

Category Black/ Expectant/ Priority 4

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14
Q

level of PPE worn when the highest level of protection is needed with a self-contained breathing aparatus (SCBA), fully encapsulated, vapor-tight, chemical-resistant suit, and chemical-resistant boots & gloves

A

PPE Level A

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15
Q

level of PPE worn when the highest level of respiratory protection but a lesser level of skin/eye protectant is needed with SCBA and chemical resistant but not vapor-tight suits

A

PPE Level B

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16
Q

level of PPE containing air-purified respirator, chemical resistant coveralls w/ splash hood, chemical resistant gloves & boots

A

PPE Level C

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17
Q

level of PPE used most often in hospitals as a typical work uniform that is not adequate when caring for chemically, biologically or radiologically contaminated patients

A

PPE Level D

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18
Q

First Step of Decontamination Process

A

removal of clothing & jewelry and rinsing w/ water

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19
Q

Second Step of Decontamination Process

A

washing thoroughly with soap & water

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20
Q

injuries caused by pipe bombs, Molotov cocktails, fertilizer bombs and “dirty” bombs w/ nuclear material

A

Blast Injury

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21
Q

injury from over-pressurization force (blast wave)…pulmonary damage, tympanic membrance rupture, abdominal hollow organ preforation

A

primary blast injury

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22
Q

injury resulting from projectiles during a blast…penetrating traumas, fragmentation injuries, blunt trauma

A

secondary blast injury

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23
Q

injury resulting from the blast wind that causes a victim to be thrown resulting in traumatic injury…head injury, fractures, traumatic amputations

A

tertiary blast injury

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24
Q

all explosion-related injuries not due to primary, secondary or tertiary mechanisms including exacerbations of or complications r/t existing conditions…burns, crush injuries, head injuries, exacerbations of COPD, asthma, diabetes, cardiac conditions, hypertension

A

Quaternary blast injury

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25
Q

injury resulting from hyper-inflammatory state commonly seen in bystanders near a blast and due to toxic substances or uncommon explosives…hyperpyrexia (fever >106)

A

Quinary blast injury

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26
Q

bioterrorism category that is easily spread, results in high death rates, and requires special action for public health awareness

A

Bioterroism Category A

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27
Q

bioterrorism category that is moderately to easily spread resulting in moderate illness rates and low death rates

A

bioterrorism category B

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28
Q

bioterrorism category that is easily available, easy to produce & spread with a potential to cause high morbidity and major health impact

A

bioterrorism category C

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29
Q

the most potentially threatening biochemical weapon occurring seasonally in nature in two forms: variola major & variola minor

A

Smallpox

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30
Q

transmission route for smallpox

A

aerosol– oropharyngeal route

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31
Q

incubation period for smallpox

A

7-20 days

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32
Q

How soon after incubation period can symptoms of smallpox begin?

A

10-14 days

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33
Q

How long is smallpox stable in aerosol form?

A

48 hours

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34
Q

How far away can smallpox transmit in aerosol form?

A

30 feet

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35
Q

When is smallpox most contagious?

A

first 7-10 days of rash

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36
Q

What are the symptoms of the prodomal phase of smallpox?

A

flu-like symptoms: HA, fever, fatigue

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37
Q

What are the stages of smallpox rash?

A

macule—> vesicle –> papule –> pustule

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38
Q

What serious complications can the smallpox rash lead to?

A

corneal ulcers & blindness

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39
Q

What is the only treatment for smallpox?

A

supportive care and antibiotics for additional infections in skin lesions

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40
Q

What must laundry and biological waste from smallpox patient be washed in?

A

hot water and bleach

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41
Q

What kind of room must a smallpox patient be placed in?

A

Negative-Pressure Isolation Room

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42
Q

Who receives the smallpox vaccination?

A

military & outbreak first responders

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43
Q

If exposed to smallpox, when should the vaccine be administered?

A

within 3 days

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44
Q

What is the smallpox vaccine made from?

A

“Cow Pox”

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45
Q

mild case of cow pox in immunosuppressed patients caused by exposure to person who has received the smallpox vaccine

A

Vaccinia

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46
Q

most widely weaponized biological agent available…gram positive rods that release toxins causing hemorrhage, edema and necrosis

A

Anthrax

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47
Q

Why are cows vaccinated against anthrax?

A

because the spores can live in the ground for decades

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48
Q

What are the 4 routes that anthrax can be transmitted?

A

cutaneous, ingestion, inhalation, injection

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49
Q

transmission of anthrax that is the most common and causes edema, pruritis and necrosis

A

cutaneous

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50
Q

transmission of anthrax that causes fever, nausea, vomiting, abdominal pain, bloody diarrhea, and ascites

A

ingestion

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51
Q

transmission of anthrax that is odorless and invisible and causes flu-like symptoms of cough, headache, fever, chills, & vomiting

A

inhalation

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52
Q

What is the only difference between anthrax inhalation symptoms and flu symptoms?

A

no rhinorrhea or nasal congestion in anthrax

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53
Q

stage of anthrax infection disease w/ symptoms of fever, sever respiratory distress, stridor, hypoxia, cyanosis, diaphoresis, hypotension, shock, and hemorrhagic medistinitis

A

second stage of anthrax infection

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54
Q

bleeding within the chest wall

A

hemorrhagic medistinitis

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55
Q

What is the treatment for anthrax inhalation?

A

100% oxygenation- ventilation, correction of electrolyte imbalances and hemodynamic support, Cipro & Doxycycline

56
Q

How soon after exposure to anthrax does antibiotic therapy need to start to ensure survival?

A

60 hours

57
Q

Who receives the anthrax vaccine?

A

veterinarians and military

58
Q

Why is cremation recommended for anthrax victims?

A

because the spores can live for decades

59
Q

What precautions does the nurse use when caring for anthrax patient?

A

standard precautions (patient is not contagious–anthrax cannot be spread from person to person)

60
Q

biological agent caused by bacterium found in animals

A

Tularemia

61
Q

What are the symptoms of tularemia?

A

flu-like symptoms, life-threatening pneumonia, chest pain, bloody sputum, respiratory failure

62
Q

How is tularemia spread?

A

airborne

63
Q

What is the treatment for tularemia?

A

streptomycin IM BID x 10 days and gentamycin IV QD x 10 days

64
Q

Is tularemia contagious?

A

No

65
Q

muscle-paralyzing disease caused by a toxin clostridium botulinum

A

botulism

66
Q

type of botulism that occurs when a person ingests pre-formed toxin that leads to illness w/in a few hours to days…public health emergency

A

foodborne botulism

67
Q

type of botulism that occurs in a small number of infants per year due to ingestion of honey

A

infantile botulism

68
Q

type of botulism that occurs when wounds a infected by the toxin

A

wound botulism

69
Q

How soon after eating toxin-containing food do botulism symptoms occur?

A

12-36 hours

70
Q

symptoms of double-vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, descending muscle weakness

A

foodborne botulism symptoms

71
Q

Is foodborne botulism contagious?

A

No

72
Q

What is the treatment for botulism?

A

botulism antitoxin must be administered early

73
Q

What bacterium causes plague?

A

Yersinia pestis

74
Q

most common type of plague that results from infected flea type and causes swollen, tender lymph nodes, fever, HA, chills

A

bubonic plague

75
Q

Is bubonic plague contagious?

A

No

76
Q

type of plague that is a complication of bubonic or pneumonic plague and leads to septic shock

A

septicemic shock

77
Q

What animals carry plague?

A

rodents and fleas that live on rodents

78
Q

most deadly type of plague that is contagious and can be aerosolized and used as biological weapon causing fever, HA, rapidly developing pneumonia, dyspnea, chest pain, cough, and hemoptysis

A

pneumonic plague

79
Q

How long does pneumonic plague progress leading to respiratory failure and death?

A

2-4 days

80
Q

How soon after symptoms of pneumonic plague are antibiotics administered?

A

24 hours

81
Q

What antibiotics are given for pneumonic plague?

A

streptomycin, gentamycin, and tetracyclines

82
Q

Ebola is a type of _____________?

A

viral hemorrhagic fever

83
Q

Where do viral hemorrhagic fevers naturally reside?

A

in rodents

84
Q

Are viral hemorrhagic fevers contagious?

A

Yes HIGHLY

85
Q

Is there treatment for viral hemorrhagic fevers?

A

No effective treatment

86
Q

What are the main symptoms of viral hemorrhagic fevers?

A

fevers and bleeding (leading to shock and death)

87
Q

How long after exposure to ebola do symptoms appear?

A

2-21 days

88
Q

How high is the fever in ebola?

A

greater than 101.5

89
Q

These are symptoms of what?…high fever, severe HA, muscle pain, constant diarrhea, constant vomiting, abdominal pain, bleeding/ bruising

A

Ebola

90
Q

How is ebola transmitted?

A

through contact w/ infected animal (primate), person-to-person spread through direct contact w/ blood or body fluids, or contaminated objects (needles)

91
Q

How is ebola diagnosed?

A

symptoms and bloodwork

92
Q

What are the lab tests for ebola?

A

ELISA, IgM ELISA, and virus isolation

93
Q

What are the palliative treatments for ebola?

A

IV fluids (electrolyte replacement), maintaining oxygenation and BP, treating super-infections, experimental treatments

94
Q

the tendency of chemical weapons to become a vapor

A

volatility

95
Q

the tendency of chemical weapons to be less likely to vaporize and disperse

A

persistence

96
Q

the potential of chemical weapons to cause injury

A

toxicity

97
Q

the time from absorption to the appearance of signs and symptoms in chemical weapons

A

latency

98
Q

the evacuation and decontamination of chemical weapons

A

limiting exposure

99
Q

type of chemical weapon that causes blistering and results in large number of injuries

A

vesicants (EX: lewisite, phosgene, nitrogen mustard, sulfur mustard)

100
Q

What type of chemical weapon would cause large burns in moist areas of the body, like the axilla or perineum?

A

vesicants

101
Q

What type of chemical weapon would cause purulent fibrinous psuedomembrane discharge that may cause obstruction of the airway?

A

vesicants

102
Q

What is the treatment for vesicant chemical weapon exposure?

A

decontamination w/ soap and water, copious irrigation of the eyes, intubation, and bronchoscopy

103
Q

type of chemical weapon that is the most toxic in existence (widespread death), inexpensive, effective and easily dispersed

A

nerve agents

104
Q

What does nerve agent exposure cause?

A

cholinergic crisis

105
Q

What are the symptoms of a cholinergic crisis?

A

bilateral miosis, visual disturbances, increased GI motility, bradycardia, AV block

106
Q

What will a lethal dose of a nerve agent cause?

A

loss of consciousness, seizures, fasisculations (twitching), seizures, and apnea

107
Q

What is the treatment for nerve agent chemical weapon exposure?

A

decontamination w/ soap and water or saline for 20 minutes, maintain the airway (NO PLASTIC AIRWAYS), Atropine IV, Protopam

108
Q

The military carry auto-injectors of what medication for chemical weapon exposure?

A

Protopam

109
Q

the type of chemical weapon that directly effects cellular metabolism resulting in asphyxiation through alterations in hemoglobin

A

blood agents

110
Q

What is the most common blood agent used?

A

Hydrogen cyanide

111
Q

What does cyanide smell like?

A

bitter almonds

112
Q

What should you do if you are exposed to a chemical agent?

A

Evacuate, Stay upright, carry children, stay upwind, remove clothing, and wash with soap and water

113
Q

What should you do with clothing after chemical exposure?

A

seal in 2 bags and turn it over to the local health workers

114
Q

How can cyanide be put into the body?

A

ingested, inhaled or absorbed

115
Q

What does cyanide exposure cause?

A

respiratory muscle failure, respiratory arrest, cardiac arrest and death

116
Q

What is the first-line treatment for cyanide exposure?

A

intubation w/ mechanical ventilation

117
Q

What is the second-line treatment for cyanide exposure?

A

rapid administration of amyl nitrate pearls, sodium nitrate, and sodium thiosulfate

118
Q

What is the third-line treatment for cyanide exposure?

A

give IV Vit. B12

119
Q

What do amyl nitrate pearls do in a patient exposed to cyanide?

A

it causes methemoglobinemia which binds to cyanide

120
Q

What does sodium nitrate and sodium thiosulfate do in a patient exposed to cyanide?

A

it excretes methemaglobin via the kidneys

121
Q

How can radiation be put into the body?

A

inhaled, ingested, injected or absorbed

122
Q

How can most radiation patients be treated with to recover?

A

decontamination with soap and water

123
Q

condition that arises with a large amount of radiation exposure

A

Acute Radiation Syndrome

124
Q

phase of acute radiation syndrome that occurs 48 to 72 hours after exposure

A

prodomal phase

125
Q

phase of acute radiation syndrome that occurs after resolution of prodomal phase and last up to 3 weeks

A

latent phase

126
Q

phase of acute radiation syndrome that occurs after the latent phase

A

manifest illness phase

127
Q

last phase of acute radiation syndrome that can take weeks to months

A

recovery phase

128
Q

What is the first sign of impending death due to acute radiation syndrome?

A

increased intracranial pressure (change in LOC)

129
Q

What is triage based on for of acute radiation syndrome?

A

whether or not the patient will survive

130
Q

Who is at risk for severe and longer lasting reactions to trauma?

A

people proximal to the event, people w/ multiple stressors, people w/ history of prior traumas, people w/ chronic medical illness or psychological disorders

131
Q

What are the immediate effects of trauma?

A

severe panic and anxiety

132
Q

What is a long-lasting effect of trauma?

A

PTSD

133
Q

the impact of event scale used to determine psychosocial response to trauma

A

Likert Scale

134
Q

With disabled adults, what are the concerns during a disaster?

A

mobility, medications, access to healthcare/ evacuations/ shelters,

135
Q

With older adults, what are the concerns during a disaster?

A

aging changes, co-morbidities, lack of physiological reserves to recover, drug metabolism/ excretion

136
Q

With pediatric patients, what are the concerns in a disaster?

A

short stature, BSA for antidote dosage, psychological trauma, respiratory problems

Advanced Med/Surg (10 decks)

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