Disaster Mgmt

Question 1

define “bioterrorism”

Answer 1

• use and dissemination of various kinds of microbes or toxins w/ the intent to intimidate or coerce a gov’t or civilian population to further political or social objectives

Question 2

define “human made disasters”

Answer 2

• destruction or devastation caused by humans

Question 3

define “mitigation”

Answer 3

• actions or measures to prevent a disaster from occurring or to reduce the severity of its effects
• ie sand bagging

Question 4

define “natural disasters”

Answer 4

• destruction or devastation caused by natural events

Question 5

when disasters occur:

Answer 5

• natural rxn for some persons to wish to leave the health care facility to be with loved onces
• nurses must be cognizant of the determination of compliance w/ the standard of confuct prohibiting patient abandonment of licensed nurse

Question 6

conventional terrorist weapons

Answer 6

• bombs
• guns

Question 7

non conventional terrorist weapons

Answer 7

• chemical
• biological
• nuclear

Question 8

5 stages of disasters

Answer 8

• 1st: non disaster–>occurs before threate of a disaster becomes real
  
  • time for planning, prep, and assessing community vulnerability
• 2nd: pre disaster stage–>time during which a disaster event is certain to occur but has not yet happened
  
  • warning or threat stage
• 3rd: comprehensive disaster plan–>mitigation, preparedness, responsive, response, recovery
• 4th: impact care–>time when disaster has occurred and community is experiencing its effects
• 5th: emergency stage–>community comes to aid of its members
  
  • late assistance is provided from outside the affected area
• 6th: reconstruction/recovery stage–>activities of restoration, reconsitution, mitigation
  
  • affected community begins cleanup and rebuilding and attempts to return to normalcy

Question 9

acute stress disorder

Answer 9

• an anxiety disorder that describes the acute stress reactions that occur in the first 4 weeks following trauma

Question 10

nurses role in disasters

Answer 10

• listen to victims tell and retell how they currently feel about the situation
• encourage victims to share their feelings w/ one another if it seems appropriate to do so
• help victims make decisions
• delegate tasks (reading, crafts, playing games) to teenagers and others to help combate boredom
• provide the basic necessities–food, clothing, rest
• try to recover or get needed items (prescription glasses, meds)
• provide basic compassiona and dignity when appropriate
• refer to a mental health counselor if situation warrants

Question 11

disaster levels by monetary cost

Answer 11

• level I: <$10,000
• level II: costs $10,000 or more, but less than $50,000
• level III: costs $50,000 or more, but less than $250,000
• level IV: costs $250,000 or more, but less than $2.5 mil
• level V: costs $2.5 mil or more

Question 12

single family disaster

Answer 12

• affects an individual or single family unit, occurs within the jurisdiction of a single Red Cross chapter, and may require the short term application of limited human and material resources

Question 13

local disaster

Answer 13

• affects more than one family
• occurs w/in the jurisdiction of a single Red Cross chapter
• generally requires application of limited human and material reources from Red Cross Chapters

Question 14

state disaster

Answer 14

• affect multiple families occurs w/in jurisdiction of one or more Red Cross Chapters w/in a single state

Question 15

major disaster

Answer 15

• has one or more of the following characteristics:
  
  • affects more than a single state
  • creates national news and media attention
  • expected to be a major disaster declaration by the President of US
  • requires international involvement
  • involves nuclear power plants, nuclear, chemical, or biological weapons

Question 16

presidentially declared disaster

Answer 16

• requires full or partial implementation of NRP
• exceeds capabilities of local and state gov’ts
• substantial or has potential to cause substantial health problems

Question 17

what vaccine does everyone get in a disaster?

Answer 17

tetanus

Question 18

triage

Answer 18

• method of quickly identifying victims who have immediately life threatening injuries AND who have the best chance of surviving

Question 19

triage tagging

Answer 19

• rapid identification of patients
• color coded system:
  
  • red–1–may survive if given immediate simple life saving measures
  • yellow–2–should survive if given care w/in a few hours
  • green–3–walking wounded: minor injuries that do not require rapid care
  • black–4–deceased or severely injured patients unlikely to survive

Question 20

layout for triage care

Answer 20

• dead on the left when you walk in
• red/immediate care are right behind the dead on the left
  
  • this is where we would utilize our surgeons
• walking wounded on the right when you walk in
  
  • you put these ppl to work
• delayed care right behind walking wounded on the right

Question 21

START system

Answer 21

• created in 1980s
• allows rapid assessment of victims
• should not take more than 15 sec/patient
• once victim is in tx area, more detailed assessment should be made

Question 22

classification of START system

Answer 22

• based on 3 things: RPM
  
  • respiratory–over or under 30, or absent
  • perfusion–radial pulse present or absent
  • mental status evaluation–follows simple commands or not
    
    • do all this in 15 sec

Question 23

START system steps

Answer 23

• first:
  
  • can patient walk?
    
    • yes–green (minor)
    • no–(evaluation ventilation w/ step 2)
• second:
  
  • ventilation present:
    
    • no–>open airway
      
      • if ventilation present?
        
        • no–>black
        • yes–>red/immediate
    • yes–>
      
      • >30/min–>red/immediate
      • <30/min–>eval circulation w/ step 3
• third:
  
  • circulation:
    
    • absent radial pulse OR cap refill >2 sec–>control hemorrhage–>red/immediate
    • present radial pulse OR cap refill <2sec–>eval LOC w/ step 4
• fourth:
  
  • LOC:
    
    • can’t follow simple commands–>red/immediate
    • can follow simple commands–>yellow/delayed

Question 24

contaminated patient

Answer 24

• patients with exposure (potential or real) to contaminants should be tagged as BLUE
  
  • will continue to stay this category until patient is adequately decontaminated, then begin START system
• some recommend “double tagging” w/ blue and standard START color

Question 25

reverse triage

Answer 25

• used in mass casualty lightning injuries
• dead are treated first
• high potential for respiratory arrest
• potential for resuscitative success