Disaster Planning Emergency Response Flashcards
Disaster
A catastrophic event that ends to major property damage , a large number of injuries , displaced individuals or major loss of life
Catastrophic human engineer failure
Bridge collapsing
Train coming off the tracks
Building collapse
What do we want to be informed about
City layout
Where am i in the belt of weather
No matter what happens i am still accountable for
My practice act , we wouldn’t be placing IV and stuff like that
Pre impact phase
Communication is critical
With EMS , city and hospitals
Impact phase
Protection for first responders
Don’t get in their way .. we are their helpers
Post impact phase
Evaluation
After actual disaster
May be as little as 2 hours or may last longer time..
( may take years to repair)
Longest of 3 phases
Scam artist prey on victims during this time
All things we have done as a city and community
Disaster phases
Pre impact
Impact phase
Post impact phase
External emergency
Tornado , flood, fire, bad storm
Internal emergency
Fire within building, active shooter, electricity outage, a tree fell into wall or window
What may a nurse help with during a disaster
Warm blankets
Waters
Directing traffic , helping EMS , , serving needs of others
It may be physically dangerous conditions
Act as if every down utility pole is in water
Keep in mind nursing practice act
Casualty
Does not just mean dead , it means injured, dead, dying
Important to know language
Involves large #s >1000 ( comes in all shapes and sizes)
Overwhelming for staff
Colored tags
Green , yellow , red. Black
Green
Walking wounded
Walkie talkie , least injured , require minimal or no treatment
Yellow tag
Hurting more than green but dont have to be treated right away - do not meet red criteria and can’t walk maybe
Red tag
We are more concerned about pt who needs help breathing or assistance with opening airway
Black tag
People who are expected to diet
Put aside and treated for comfort w families
60% burn pt not likely to survive and probably will be black tagged
Treated for pain management
You have a pt with a distended tender abdomen , sucking chest womb, and a pt can’t stop crying .. how would you tag these folks and a pt burned 60 %
Sucking chest womb- red
Distended tender abdomen - yellow
Pt can’t stop crying - green
Pt burned-black tags ( but give fluid)
K
How can we get a total # of casualties a hospital can expect
Doubling # of casualties that arrive in first hr
We a pt scared and crying, a pt with broken arm and no other injuries, pt killed in accident , sucking chest womb person and a scalp laceration.. who do we see first ?
Sucking chest womb
Scalp laceration
Pt scared and crying ( to avoid panic environment)
Pt with broken arm
And we would not see the person who got killed in the accident
What tag is an open fracture
Red
What tag is a closed fracture
Yellow
Anthrax - how is it treated
Ciprofloxacin (cipro)
( Haylee- ketorlorac and Levofloxacin )
Anthrax is from sheep
Plague
Alive and well
Tularemia
Blood born disease
Small pox treatment
Varicella or variola
( not iraticated)
Botulism
Paralyzes the respiratory system ( easy to obtain and spread- prone in a salad bar)
What is a hemorrhagic fever associated with?
Ebola
Treat the symptoms and hope for the best
Center of disease control has
Viruses locked up from a long time ago so we can keep vaccines
What does sarin effect?
Organophosphate
From pest control or fertilizer
Nerve component
Atropine
2pam ( pralidoxime) binds with the nerve gas and removed from the body
sarin is so toxic and cause death within minutes
Ethics.. if we never had an outbreak of disease in a country .. should we allow other works to go to another treatment to treat and they contract a disease .. do they come home and get treated
Can be bought home and treated
Chemical agents
Sarin
Phosgene
Hydrogen cyanide
Mustard gas
Phosgene
Colorless gas
Effects pulmonary system
Normally used in chemical manufacturing ( easy2obtain)
Hydrogen cyanide
Blood born
Mustard gas
Causes blister / vesicants
Organophosphate poisoning s/s
Slobbering , diarrhea, lose control of bowel and bladder
Give atropine &2pam
If a medic comes in with organophosphate poisoning .. what do we prepare to give
Atropine
2pam
National stockpile
Free for any hospital facility
Can be airdropped within 24* to 36 hours within notifying them
Do not send hospital personnel
Main danger from RDDs radiologic dispersal devices
Ionization radiation ( what happens to us)
Exploding bomb ( bomb damage is most important)
What is prioritized after ALS ( advanced life support)
Decontamination
If a ppl come and said we have been exposed to radioactive bomb
We are going to take the exposed pt and self and go around back where they can be decontaminated
What’s done after decontamination
Don’t let them be in waiting room , get isolated
After though vitals and whatever comes first
What does decontamination prevent
Secondary exposure
What does decontamination increase
Chances for survival
What do you use to decontaminate
Soap and water, and pat dry
What does an explosive device result in
Blast, crash or penetrating , crush injuries , burns , hearing loss
Effects hallow organs ( the closer you are the more damaged)
Shock wave done damage to internal organs ( jumbled everything up)
What do we do w pt involved with explosive devices
Comfort care
Usually black tagged
Who does all the tagging
EMS
Once you’ve been tagged yellow and pt comes in and we assess them we can up tag them to red.
We can’t tag down pt.. they are what EMS said
What can a pt have that causes us to vent them
ARDS
What do you do when you receive Bomb threat
Ask questions
Listen for back ground sounds
The callers voice
Remain calm
Questions to ask during a bomb threat
Where is the bomb
What does it look like
What will cause it to explode
What building is it in
What floor is it on
What is your name and address
Did you place the bomb and why
Do not hang up , extend the call as long as possible, listen to the callers voice
Do you hear a stutter , an accent , nervous speech impediment
Questions to ask during a bomb threat
Where is the bomb
What does it look like
What will cause it to explode
What building is it in
What floor is it on
What is your name and address
Did you place the bomb and why
Do not hang up , extend the call as long as possible, listen to the callers voice
Do you hear a stutter , an accent , nervous speech impediment
After bomb threat call is complete
Immediately call IUPD on a landline phone to relay the information to the dispatcher
Do not move suspicious objects
Do not use radios , pagers, or cell phones as they can trigger an explosive device
What should you never tell a bomber
We’re going to find you
Don’t use threatening language or hang up .. even if they hang up first .. dont hang up
The general population may want to be helpful but what can we do
Initiate CERT training to make sure they are certified CPR , have first aide class to put on dressing
Teach them danger of disaster and what roles they may play for us.. they may direct traffic , or pass out blankets or sandwiches
Willl be in the way if not properly trained
national disaster medical system organizes and trains who
DMAT ( disaster medical assistance teams )
Trained to treat lots of people (level 1 800 ppl )
The hospital has to support the team , put on special pay, special supplies and equipment
Must show up to the area within 8 hours
Critical incident stress management
Site must be secured before anyone can go to site -FIRST
Group discussion so people can verbalize and validate feelings and emotions about the experience
What they saw, what they heard, and how they feel..to keep people working and to avoid breakdowns
Available in the hospital as well
Who all has disaster plans
Hospital plans , city plans
Surge capacity
The total # of ppl you can have in a hospital
No such thing in a disaster
Team has to have plans and know what’s going on becuase we have to take them
Lockdown plan
The hospital alone has a lot of outside doors and we can get overwhelmed in a matter of moments
So have 1 door in and 1 door out
Staffing plan
Call down list in an emergency if staff is short
They are expected to go in
What happens if plant exploded and 150 people are on the way to the hospital
Activate disaster plan
Everyone has a job, discharge pt, move pt
If pt hasn’t had anything invasive they will be discharged somewhere else with a cot ( nurses will be there)
Activate hospitals emergency response plan- take to the chain of command
How do we increase surge capacity
Reverse triage
- see who needs to be discharged but not out into chaos but have a place with cots and lounge chairs they will stay with nurses
Who gets discharged at hospital when the activated disaster plan is going
Pt who got their tonsils removed
Elective cataract surgery goes home
Who can’t get discharged when disaster plan is activated
Person with active chest pain
What can a nurse delegate to the student nurse
Wheel the discharge pt out , can’t do anything invasive without another nurse
First rule in an emergency
Keep yourself and staff safe
( they can make sure that family is safe so that they will and can work)
Arrangements must be made for a place to rest or have a meal and a place for families to be close and present
Make plan for pets
Watch for contaminated water
What can we do when it comes to intruder safety
Prepare ourselves and kids both physically and mentally
What fact can’t we dismiss when it comes to radiologic /nucear explosions
Acute radiation syndrome after substantial exposure to ionizing radiation
Emergency management team/disaster task force
Incident command
Disaster plans
Surge capacity
Lockdown plan
Staffing plan
As a triage nurse - activate the hospitals emergency response plan- what does that mean for me?
I took the call - take call to Supervisor or up chain of command
