DMCC Flashcards
1
Q
Define disaster
A
A disruption of normal life and activities that requires the affected community to make extraordinary efforts to cope with it and usually requires outside help
2
Q
Types of natural disaster
A
Sudden or acute onset
Slow or chronic onset
3
Q
Examples of man made disasters
A
Industrial
Transport accidents
Deforestation
4
Q
Examples of complex humanitarian emergencies
A
Wars, civil strife
5
Q
Define hazard
A
Damaging things that could occur
6
Q
Define risk
A
The probability that an action or activity (including inaction) will lead to an undesirable outcome
7
Q
What must a surveillance system be
A
Appropriate
Acceptable to those surveyed
Accurate
Timely
Defined
Compatible and collaborative
8
Q
What must information be
A
Reliable
Relevant
Collected systematically
Standardised
Timely
Acceptable
9
Q
Types of surveillance systems
A
Comprehensive
Sentinel
Clinical based
Laboratory based
10
Q
What are the 11 priorities
A
- Initial assessment
- Measles immunisation
- WASH
- Food and nutrition
- Shelter and site planning
- Healthcare in the emergency phase
- Control of communicable diseases and epidemics
- Public health surveillance
- Human resource training
- Coordination
- Security
11
Q
Daily caloric requirements
A
2100 kcal/ person/ day
12
Q
Micronutrient requirements
A
Vitamin A, Zinc, Iron, Iodine
13
Q
Describe kwashiorkor
A
Bloated appearance due to water accumulation (protein, antioxidant and micronutrient deficiency)
14
Q
Describe Marasmus
A
Severe weight loss leaving “skin and bones” shortage of protein and calories
15
Q
Complications of malnutrition
A
Mild growth retardation and weight loss
Later stages
-apathy
-lack of facial expression
-loss of appetite
Damage to the immune system
-more severe disease episodes
-more complications
-longer duration of illness
16
Q
Main causes of death (in malnutrition)
A
Hypoglycaemia
Hypothermia
Infection
Dehydration
17
Q
Malnutrition assessment
A
Weight for height (z scores)
Weight for age
Mid Upper Arm Circumference (MUAC)
18
Q
Management of malnutrition in populations - types
A
Selective
Therapeutic
Community based
19
Q
Other activities to help malnutrition
A
Breast feeding
Extra rations for pregnant and lactating women
Support other vulnerable groups
Treat infectious diseases
Measles vaccination
Vitamin A
20
Q
Anthropod vectors
A
Mosquitos, sandflies, ticks, lice
21
Q
Rodent vectors
A
Rats, mice, bats
22
Q
Important vector borne diseases
A
Malaria, yellow fever, dengue, typhus, leishmaniasis, plague, viral haemorrhagic fevers
23
Q
Vector control measures
A
Hygiene
Site selection and maintenance
Sanitation
Insecticides, Rodenticides and traps
Waste disposal
Control of breeding sites
Limiting access to buildings and food
24
Q
Chemo prophylaxis for vector borne diseases
A
Anti malarials
25
How can you prevent yellow fever and Ebola
Vaccination
26
Describe bite avoidance strategies
Protective clothing
Bednets impregnated with insecticide
Insect repellant
27
Important oral route diseases
Cholera, typhoid, dysentery, Hep A and E, polio, Shigella, salmonella etc
28
Toxins in food and water
Botulism
Staph aureus
Bacillus cereus
29
Prevention and control of oral route diseases
Clean water and safe food
Insect control
Waste control
Personal hygiene (handwashing)
30
Treatment of oral route diseases
Rehydration (oral, IV)
Oral zinc supplements
Appropriate use of antibiotics and antimotility
31
Important airborne disease
Colds, flus, influenza, pneumonia
Measles, meningitis, diphtheria, TV
32
Important blood borne diseases
Hepatitis B, C, HIV
33
Prevention and control of blood borne
Vaccination (hep b)
PPE
PEP
Barrier contraception
34
Describe the cold chain
Dedication refrigerators and freezers
Daily recording of temperatures
Cold boxes, cool packs, insulating material
Vaccine storage - correct temperature, protect from light
35
Types of heat illness/ injury
Sunburn
Prickly heat
Heat stress/ exhaustion
Heat stroke
36
How to diagnose heat illness
Core temperature reading
37
Preventative measures for heat illness
Acclimatisation
Monitoring of water intake
Appropriate clothing
Salt intake
38
Types of cold injury
Frost nip
Frost bite
Immersion foot
Hypothermia
39
Preventative measures for cold injury
Appropriate clothing
Diet
Fluid intake
Fitness
40
Describe the difference in poisonous and venomous organisms
Poisonous creatures use toxins for passive defence
Venomous creatures use poisons for active attack
41
Describe Elapidae
Cobras, mambas, sea snakes
Tropical and subtropical (not Europe)
Mainly neurotoxic
42
Describe viperidae
Vipers, rattlesnakes
Neurotoxicity, haemotoxic and proteolytic
Americas, Africa, Eurasia
43
Describe colubridae
Sub Saharan Africa
Boomslangs
Haemotoxic
44
Initial signs and symptoms of bite (even if no bite or venom)
Agitation, shock
45
Envenomation: local symptoms and signs
Bite marks, pain, swelling, tissue damage
46
Systemic signs and symptoms of elapid bites
Neurological
47
Local signs and symptoms of evenomation
Bite marks
Pain
Swelling
Tissue damage
48
Systemic signs and symptoms of viper bites
Cardiovascular signs
Bleeding and clotting disorders
Tissue necrosis
49
Initial treatment of evenomation
Check person has been bitten
Reassure
Try to retard systemic absorption of venom
No food (especially no alcohol)
Do not apply tourniquet
Treat symptoms as they arise
Analgesia (not NSAIDs or aspirin)
Medical care facility
Try and identify snake
50
Describe antivenom treatment
Monovalent or polyvalent
Cannot undo damage already caused by venom
Immediate or delayed hypersensitivity reactions
51
Arthropod examples
Spiders
Scorpions
Centipedes
Bees
Wasps
52
Treatment of poisoning
Antivenoms
Hot water/ vinegar for jellyfish stings
Antihistamines
Adrenaline for allergic reactions
53
Preparation for dealing with bites
Consider what dangers nearby
Locate treatment centres
Local availability of antivenoms
Brief team members
Health education
54
Role of aeromed
Deliver grand and equipment
Removal casualties
Access specialist care
Evacuate aid workers
55
Limitations of aeromed
Expensive
Availability
Time to organise
Site access
Capacity
Working environment
Physiological changes
56
Pros and cons of helicopter
Easy access but limited range and capacity, hostile working environment
57
Pros and cons of fixed wing
Need a landing strip and logistic support but increased capacity and range
58
Clinical considerations of aeromed
Basic physiology of hypoxia and pressure changes
59
Military roles and capabilities of aeromed
Aeromed essential to military ops to reduce medical footprint, achieve expected standards of care.
Capable of resuscitation, evacuation to intensive care
60
Disadvantages of aeromed
Limited asset
Expensive
Who do you evacuate
May make triage more complex
May splinter families
61
Definition of triage
A system for sorting casualties, cascading down from the most urgent to the non urgent, in order to prioritise them for treatment (non treatment) or evacuation, and repeating this at each echelon of care
62
Aim of triage
Address medical resources towards those that have the best chance of survival
63
Principle of triage
Triage is a dynamic process that can be performed at various stages in a mass casualty situation
64
4 things triage should be
Simple
Rapid
Reproducible
Safe
65
T1 meaning
Immediate treatment: require emergency life saving tests and or surgery that is not time consuming and leads to a good chance of survival
66
T2 meaning
Delayed treatment: require major surgery or medical treatment but can wait after receiving sustaining treatment
67
T3 meaning
Minimal treatment. Relatively minor injuries and longer delay is not life threatening. Can effectively take care of themselves or be helped by untrained people
68
T4 meaning
Expectant treatment. Multiple injuries need time/ material consuming treatment. Given supportive treatment
69
How does seive work
Assess mobility
Assess ABC
70
How does sort work
For evacuation
Based on physiological parameters and each given 0-4 score
71
Items to consider when triaging
Tactical situation
Is there a plan
Numbers of casualties
Number of staff and quality
Resources
Timelines
Clinical findings
Salvage ability
Safety of staff
Access
72
Trimodal death distribution
First peak: seconds to minutes
Second peak: minutes to hours
Third peak: days to weeks
73
DCR aims to optimise outcome by
Maximising tissue oxygenation
Minimising blood loss
74
Advantages of prehospital fluids
Maintaining circulation and blood pressure
Important in head injuries and burns
75
Disadvantages of prehospital fluids
Not a blood replacement
Risk of clot disruption
Worsening haemorrhage
76
Define primary fragments
Fragments from the bomb
77
Describe secondary fragments
Fragments from the environment
78
The two elements of a blast
Shock wave
Blast wind (dynamic overpressure)
79
What does a shock wave do to the body
Accelerates the body wall
Pressure wave through body
Loses energy at different density interfaces
80
What does dynamic overpressure do to the body
Shears tissues
Displaces tissue
Avulse fractured limbs
81
Primary blast injuries
(Air and gas organs)
Blast lung
Bowel injury
Auditory
Some solid visceral injuries
82
Secondary blast injuries
Wounds from fragments
Penetrating
Visceral injury
83
Tertiary blast injuries
Trauma
Displacement of body
Amputation
84
Quaternary blast injuries
Crush injuries
Burns
Psychological
85
Quintinerary blast injuries
Immuno compromised
Neurological
86
The four underlying concepts of humanitarianism
Humanity
Independence
Impartiality
Neutrality
87
What are disasters
Serious disruptions to the functioning of a community that exceeds its capacity to cope using its own resources.
88
Three themes when considering a risk
Vulnerability - people, health systems, infrastructure
Capacity to cope- resilience, preparedness
Impact- localised, widespread, public sector
89
Define a humanitarian emergency
An event or series of events that represent a critical threat to the health, safety, security or well being of a community or other large groups of people, usually over a wide area
90
Define complex humanitarian emergency
Breakdown of authority caused by conflict which requires an international response that goes beyond the mandate or capacity of a single country
91
Disaster Management Cycle
Response
Recovery
Mitigation
Preparedness
92
Describe the response stage of the disaster management cycle
Search and rescue
Emergency relief
Initial needs assessment
Food, shelter, healthcare
10 priorities
93
Describe the recovery phase of the disaster management cycle
Rehabilitation
Reconstruction
Rebuilding infrastructure
94
Describe the mitigation stage of the disaster management cycle
Prevention
Engage wider stakeholders
Reduce risk and likelihood
95
Describe the preparedness stage of the disaster management cycle
Think about early warning systems and ROC drills
96
What framework can be used to guide work in the mitigation and preparedness phases
Sendai framework advises on actions that can be taken
97
Which guidelines can be used for starting a response and describe them
The SPHERE guidelines- outline universal and minimal standards.
There are also reasons why these minimum standards might not be met, such as no cold chain, cultural beliefs, access, security
98
Describe the initial assessment
The priority of the needs of the disaster affected population are identified through a systematic assessment of the context, risks to life, with dignity and the capacity of the affected people and relevant authorities to respond
99
4 phases of the initial assessment
1- 72hrs- initial
2 - 2 weeks - rapid
3 - 4 weeks - in depth
4- 5+weeks- indepth
100
What is the most important indicator and indicated the severity of the problem
Crude mortality rate
101
Define crude mortality rate
Number of deaths per 10,000 per day
102
What is an acute emergency
>1/10,000 dead per day (or >2 young children)
103
Other epidemiology measures
Crude mortality rate
Maternal mortality rate
Cause specific death rates (Case fatality rates)
104
10 priorities when responding to humanitarian emergencies
Initial Assessment
Measles Vaccination
Water, Hygeine and Sanitation
Food and Nutrition
Shelter, site planning
Health care in the emergency phase
Control of communicable diseases and epidemics
Public health surveillance
Human Resources
Coordination
Security
105
Why is measles vaccination so important
R number of 20.
Much more infective than other organisms
106
Why is early identification important
Means you can implement control measures
Prevent surging cases
107
4 options for surveillance of crude mortality rate
Number of new graves
Go to community leader and ask for specific information
Health care workers recording
Syndromic diagnosis
108
Define syndromic surveillance
Detection based on population health indicators/ group of symptoms before a firm diagnosis is made
109
Which 4 diseases kill most often
Acute diarrhoea illness
Acute respiratory illness
Malaria
Measles
110
Acronym for things to consider in a public health response
TEPID COIL
111
What does TEPID COIL stand for
Training
Equipment
Personnel
Information
Doctrine
Clinical rationale
Organisation
Infrastructure
Logistics
112
Sources of public health information
Aerial photography
Satellite imaging
Information from people on the ground
Information from people who have been to the area
Recce/ site survey
Needs assessment
Comms from deployed personnel
Internet search
Social media
113
What is EWARN
Early warning system to allow early public health interventions. Used when resources are low, EWARS box has relevant kit
114
7 perspectives on costs of disasters
Physical
Psychological
Sociocultural
Economic
Political
Biological
115
Why are we getting more disasters
Better at recognising them
Global warming
116
10 possible future disasters
Global pandemic
World war 3
A killer asteroid
Global economic collapse
117
Control measures for pandemic
Social distancing
Masks
Handwashing
118
Personal characteristics of respondents you should think about
Motivation
Availability
Psychology
Physical health
Teamwork
119
3 phases in the health continuum
Prepare, sustain, recover
120
Who should get cholera vaccine
Anyone going to potential cholera risk areas
121
Things to consider when caring for the health of responders
Training
Communication
Welfare
Mental Health
Sexual Health
122
What defines humanitarian actions
They are underpinned by benevelonce
123
Which geneva convention is related to medical supplies
Article 23
124
What are the 4 humanitarian principles
Humanity
Impartiality
Neutrality
Independence
125
Define humanity
Suffering must be addressed wherever it is found
126
Define impartiality
Humanitarian action must be provided without discrimination
127
Define neutrality
Humanitarian action must not favour any side
128
Define independence
Autonomy of humanitarian objectives from any political, economic, military or other aims
129
What are the 9 core humanitarian standard commitments to a community
1. Participate in decisions
2. Access timely and effective support
3. Are better prepared and more resilient
4. Support does not harm people or the environment
5. Can safely report complaints
6. Access coordinated and complimentary support
7. Support adapted based on feedback
8. Staff are respectful
9. Ethical management of resources
130
What are the two main actors involved with humanitarian action
ICRC
IFRC
131
What is ICRC
Absolutely neutral guardian of international humanitarian law
132
What is IFRC
Coordinator of humanitarian work from various national socities
133
Who can request humanitarian action
Emergency Response Coordinator
134
Who is the emergency response coordinator
Lives in country, assigned role at beginning of disaster and coordinates response
135
Describe the cluster approach
Number of different clusters, spreads accountability and utilises expertise as there is a lead organisation for each cluster
136
What are the oslo guidelines
Guidelines to improve the coordination of civil-military response to humanitarian situations
137
What are the key things in the oslo guidelines
Request for aid must come from humanitarian coordinator
Military aid is a last resort
Should focus on supporting actions
138
What is the approach to humanitarian aid involving refugees
Refugee coordination model
139
What is the approach to humanitarian aid not involving refugees
Cluster approach
140
Disaster consequences
Destruction
Loss of infrastructure
Death
Injuries
Pscyhological harm
Economic disruption
Loss of community cohesion
Disease
Environmental degradation
141
Define complex humanitarian emergency
When conflict means a country is unable to cope using its existing resources
142
What approach would you use to identify who is extremely malnourished
A systematic approach
143
5 ways to support your team in country
Regular debriefing
Welfare support
Supervision
Rest schedules
Good nutrition
Security
Sanitation
144
What is the all hazards approach
Do not prepare for individual hazards. Take a comprehensive emergency preparedness framework which considers the full scope of disasters
145
How would you structure your CBRN response
Step-1-2-3-Plus approach
146
Describe the step-1-2-3 plus approach
Step 1- standard SOPs
Step 2- 2 people- caution and SOP
Step 3- 3 people- caution and plus steps
Plus control measures
147
What are the control measures as part of Step 1-2-3 plus
Plus
-Evacuate
-Communicate and advise
-Disrobe
-Decontaminate
148
What are the principles of CBRN casualty care
1. CBRN first aid
-recognition, safety, self aid
2. Emergeny medical treatment
-Triage, T1 treatment, hazard management
3. Advanced medical care inc crit care
-Supportive and definitive management
149
Implications of CBRN
Weapons of mass destruction
Safety issues
Unusual casualty types
Decontamination, extends timelines and denies assets
150
Examples of (C)BRN
Nerve agents
Cyanides
Blistering agents
Pulmonary agents
Incapacitating agents
151
Examples of C(B)RN
Live threats
Toxins
152
Examples of CB(R)N
Radiological damage
water
food
153
Examples of CBR(N)
Nuclear waste
Nuclear weapons
154
Examples of hazardous materials
Asbestos
Excrement
Fertilisers
Pesticides
Fuel
Gas leaks
Water
155
How would you manage a mascal incident
C SCATTER
Command and control
Safety
Communication
Triage
Treatment
Transport
Evacuate
Recover
156
How would you treat CBRN
CABCDE
Inform specialists
Screen other exposed individuals
157
Who are the most vulnerable groups
Pregnant women, elderly, children and disabled
158
Define reproductive health
State of complete psychological, physical, mental wellbeing and not merely disease in relation to sexual and reproductive health systems
159
Define state fragility
When state structures lack the legitimacy or effectiveness to provide for basic development, security and human rights for their populations
160
Define conflict
Prolonged armed struggle
161
Contributing factors to state fragility
Weak governance
Extreme poverty
Persistent inequality
Lack of territorial control
Frequent conflict
External shock
Inability to provide basic services
162
Issues for poor
Poverty
Education
Child labor
Violence and exploitation
Orphans
Child soldiers
163
Consequences of conflict
Death
Disability
Rape, torture
Separation
Break up of community
164
Calorie cut offs for fall in energy supply, adults and children
1500kcal/ day in adults
<100kcal/kg/day in infants and small children
165
Define wasting
<15% of normal body weight
166
Signs of a fall in energy supply
<1500kcal/day
Reduced Z score or MUAC in 10% children under 5
Wasting
167
What can you assess the needs for vaccination campaigns based on
National vaccination records
Questioning mothers
Vaccination histories
168
How to assess the effectiveness of vaccination programmes
Recording % of children vaccinated
Track rates of disease
169
How much is standard requirement for water
15-20l
170
How much water should a feeding centre aim to provide
20-30l/ person/ day
171
How much water should a healthcare centre aim to provide
40-60l
172
Outline nutrition care
Involve specialist NGOs
Dry ration provision
Wet ration provision
Support to families
Supplementary feeding programmes
Therapeutic feeding programmes
173
How to decide supplementary or therapeutic feeding programme
Supplementary if below 85% wt/ht
Therapeutic if below 75% wt/ht
174
NATO principle of universal emergency care
Treat any person with life/ limb/ sight threatening injury
175
UN Charter for rights of the child
Children must be treated by competent trained professionals
176
Define force health protection
The conservation of the fighting potential of a force so that it is, healthy, fully combat capable and can be applied at the decisive time and place
177
Chain of infection
Causative agent
Reservoir/ source
Means of exit
Mode of transmission
Portal of entry
178
Examples of control measures
Hand hygeine
PPE
Controls of aerosols and splatter
Food safety
Personal hygeine
Health education
Chemoprophylaxis
Physical fitness
Cleaning bedding
Trace carriers/ contracts
Contact tracing
Immunisation
179
Actions of med centre following outbreak
Isolation/ segregation
Identifying separate accomodation
Collect details
Locate
FMed85
Estimate PAR
Consult SMO
180
Themes by which disasters in the urban environment are different
Population
Economic
Social
Infrastructure
181
Issues with disasters in urban environment
Nature of infrastructure
Higher density population
Congestion
Overwhelmed emergency services
182
Which organisation is an example of how the UK supports oversease
UKMed
183
Which three things affect disaster's effects
Vulnerability
Capacity to cope
Impact
184
5 factors to consider when dealing with the dead
Preparedness
Legal
Socio-cultural
Psychological
Health
185
Storage of dead bodies (above ground)
Cold storage
12-48hrs in hot climates
2-4 degrees celsius
Can use wet or dry ice
Identification of bodies is important
186
Stats for graves
1.5m deep
200m from drinking water
0.4m apart
187
Security threats for humanitarians
Work accidents
Road traffic collisions
Danger from indiscriminate weapons of war
Criminal acts
Violent acts
Acts of terror
Staff disappearance
Psychological intimidation
Sexual violence
188
Principles for military medical practicioners in humanitarian assistance
Last resort
Do no harm
Based on need
Clinically appropriate
Culturally sensitive
Sustainable
Civilian primacy
189
What to do before engaging with media
Gain permission from relevant teams
Establish official line
Follow organisation procedures
Focus on objective facts
