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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

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2
Q

Types of natural disaster

A

Sudden or acute onset
Slow or chronic onset

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3
Q

Examples of man made disasters

A

Industrial
Transport accidents
Deforestation

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4
Q

Examples of complex humanitarian emergencies

A

Wars, civil strife

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5
Q

Define hazard

A

Damaging things that could occur

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6
Q

Define risk

A

The probability that an action or activity (including inaction) will lead to an undesirable outcome

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7
Q

What must a surveillance system be

A

Appropriate
Acceptable to those surveyed
Accurate
Timely
Defined
Compatible and collaborative

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8
Q

What must information be

A

Reliable
Relevant
Collected systematically
Standardised
Timely
Acceptable

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9
Q

Types of surveillance systems

A

Comprehensive
Sentinel
Clinical based
Laboratory based

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10
Q

What are the 11 priorities

A
  1. Initial assessment
  2. Measles immunisation
  3. WASH
  4. Food and nutrition
  5. Shelter and site planning
  6. Healthcare in the emergency phase
  7. Control of communicable diseases and epidemics
  8. Public health surveillance
  9. Human resource training
  10. Coordination
  11. Security
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11
Q

Daily caloric requirements

A

2100 kcal/ person/ day

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12
Q

Micronutrient requirements

A

Vitamin A, Zinc, Iron, Iodine

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13
Q

Describe kwashiorkor

A

Bloated appearance due to water accumulation (protein, antioxidant and micronutrient deficiency)

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14
Q

Describe Marasmus

A

Severe weight loss leaving “skin and bones” shortage of protein and calories

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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

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16
Q

Main causes of death (in malnutrition)

A

Hypoglycaemia
Hypothermia
Infection
Dehydration

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17
Q

Malnutrition assessment

A

Weight for height (z scores)
Weight for age
Mid Upper Arm Circumference (MUAC)

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18
Q

Management of malnutrition in populations - types

A

Selective
Therapeutic
Community based

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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

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20
Q

Anthropod vectors

A

Mosquitos, sandflies, ticks, lice

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21
Q

Rodent vectors

A

Rats, mice, bats

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22
Q

Important vector borne diseases

A

Malaria, yellow fever, dengue, typhus, leishmaniasis, plague, viral haemorrhagic fevers

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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

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24
Q

Chemo prophylaxis for vector borne diseases

A

Anti malarials

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25
Q

How can you prevent yellow fever and Ebola

A

Vaccination

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26
Q

Describe bite avoidance strategies

A

Protective clothing
Bednets impregnated with insecticide
Insect repellant

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27
Q

Important oral route diseases

A

Cholera, typhoid, dysentery, Hep A and E, polio, Shigella, salmonella etc

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28
Q

Toxins in food and water

A

Botulism
Staph aureus
Bacillus cereus

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29
Q

Prevention and control of oral route diseases

A

Clean water and safe food
Insect control
Waste control
Personal hygiene (handwashing)

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30
Q

Treatment of oral route diseases

A

Rehydration (oral, IV)
Oral zinc supplements
Appropriate use of antibiotics and antimotility

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31
Q

Important airborne disease

A

Colds, flus, influenza, pneumonia
Measles, meningitis, diphtheria, TV

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32
Q

Important blood borne diseases

A

Hepatitis B, C, HIV

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33
Q

Prevention and control of blood borne

A

Vaccination (hep b)
PPE
PEP
Barrier contraception

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34
Q

Describe the cold chain

A

Dedication refrigerators and freezers
Daily recording of temperatures
Cold boxes, cool packs, insulating material
Vaccine storage - correct temperature, protect from light

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35
Q

Types of heat illness/ injury

A

Sunburn
Prickly heat
Heat stress/ exhaustion
Heat stroke

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36
Q

How to diagnose heat illness

A

Core temperature reading

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37
Q

Preventative measures for heat illness

A

Acclimatisation
Monitoring of water intake
Appropriate clothing
Salt intake

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38
Q

Types of cold injury

A

Frost nip
Frost bite
Immersion foot
Hypothermia

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39
Q

Preventative measures for cold injury

A

Appropriate clothing
Diet
Fluid intake
Fitness

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40
Q

Describe the difference in poisonous and venomous organisms

A

Poisonous creatures use toxins for passive defence
Venomous creatures use poisons for active attack

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41
Q

Describe Elapidae

A

Cobras, mambas, sea snakes
Tropical and subtropical (not Europe)
Mainly neurotoxic

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42
Q

Describe viperidae

A

Vipers, rattlesnakes
Neurotoxicity, haemotoxic and proteolytic
Americas, Africa, Eurasia

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43
Q

Describe colubridae

A

Sub Saharan Africa
Boomslangs
Haemotoxic

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44
Q

Initial signs and symptoms of bite (even if no bite or venom)

A

Agitation, shock

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45
Q

Envenomation: local symptoms and signs

A

Bite marks, pain, swelling, tissue damage

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46
Q

Systemic signs and symptoms of elapid bites

A

Neurological

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47
Q

Local signs and symptoms of evenomation

A

Bite marks
Pain
Swelling
Tissue damage

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48
Q

Systemic signs and symptoms of viper bites

A

Cardiovascular signs
Bleeding and clotting disorders
Tissue necrosis

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49
Q

Initial treatment of evenomation

A

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

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50
Q

Describe antivenom treatment

A

Monovalent or polyvalent
Cannot undo damage already caused by venom
Immediate or delayed hypersensitivity reactions

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51
Q

Arthropod examples

A

Spiders
Scorpions
Centipedes
Bees
Wasps

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52
Q

Treatment of poisoning

A

Antivenoms
Hot water/ vinegar for jellyfish stings
Antihistamines
Adrenaline for allergic reactions

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53
Q

Preparation for dealing with bites

A

Consider what dangers nearby
Locate treatment centres
Local availability of antivenoms
Brief team members
Health education

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54
Q

Role of aeromed

A

Deliver grand and equipment
Removal casualties
Access specialist care
Evacuate aid workers

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55
Q

Limitations of aeromed

A

Expensive
Availability
Time to organise
Site access
Capacity
Working environment
Physiological changes

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56
Q

Pros and cons of helicopter

A

Easy access but limited range and capacity, hostile working environment

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57
Q

Pros and cons of fixed wing

A

Need a landing strip and logistic support but increased capacity and range

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58
Q

Clinical considerations of aeromed

A

Basic physiology of hypoxia and pressure changes

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59
Q

Military roles and capabilities of aeromed

A

Aeromed essential to military ops to reduce medical footprint, achieve expected standards of care.
Capable of resuscitation, evacuation to intensive care

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60
Q

Disadvantages of aeromed

A

Limited asset
Expensive
Who do you evacuate
May make triage more complex
May splinter families

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61
Q

Definition of triage

A

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

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62
Q

Aim of triage

A

Address medical resources towards those that have the best chance of survival

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63
Q

Principle of triage

A

Triage is a dynamic process that can be performed at various stages in a mass casualty situation

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64
Q

4 things triage should be

A

Simple
Rapid
Reproducible
Safe

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65
Q

T1 meaning

A

Immediate treatment: require emergency life saving tests and or surgery that is not time consuming and leads to a good chance of survival

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66
Q

T2 meaning

A

Delayed treatment: require major surgery or medical treatment but can wait after receiving sustaining treatment

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67
Q

T3 meaning

A

Minimal treatment. Relatively minor injuries and longer delay is not life threatening. Can effectively take care of themselves or be helped by untrained people

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68
Q

T4 meaning

A

Expectant treatment. Multiple injuries need time/ material consuming treatment. Given supportive treatment

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69
Q

How does seive work

A

Assess mobility
Assess ABC

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70
Q

How does sort work

A

For evacuation
Based on physiological parameters and each given 0-4 score

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71
Q

Items to consider when triaging

A

Tactical situation
Is there a plan
Numbers of casualties
Number of staff and quality
Resources
Timelines
Clinical findings
Salvage ability
Safety of staff
Access

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72
Q

Trimodal death distribution

A

First peak: seconds to minutes
Second peak: minutes to hours
Third peak: days to weeks

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73
Q

DCR aims to optimise outcome by

A

Maximising tissue oxygenation
Minimising blood loss

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74
Q

Advantages of prehospital fluids

A

Maintaining circulation and blood pressure
Important in head injuries and burns

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75
Q

Disadvantages of prehospital fluids

A

Not a blood replacement
Risk of clot disruption
Worsening haemorrhage

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76
Q

Define primary fragments

A

Fragments from the bomb

77
Q

Describe secondary fragments

A

Fragments from the environment

78
Q

The two elements of a blast

A

Shock wave
Blast wind (dynamic overpressure)

79
Q

What does a shock wave do to the body

A

Accelerates the body wall
Pressure wave through body
Loses energy at different density interfaces

80
Q

What does dynamic overpressure do to the body

A

Shears tissues
Displaces tissue
Avulse fractured limbs

81
Q

Primary blast injuries

A

(Air and gas organs)
Blast lung
Bowel injury
Auditory
Some solid visceral injuries

82
Q

Secondary blast injuries

A

Wounds from fragments
Penetrating
Visceral injury

83
Q

Tertiary blast injuries

A

Trauma
Displacement of body
Amputation

84
Q

Quaternary blast injuries

A

Crush injuries
Burns
Psychological

85
Q

Quintinerary blast injuries

A

Immuno compromised
Neurological

86
Q

The four underlying concepts of humanitarianism

A

Humanity
Independence
Impartiality
Neutrality

87
Q

What are disasters

A

Serious disruptions to the functioning of a community that exceeds its capacity to cope using its own resources.

88
Q

Three themes when considering a risk

A

Vulnerability - people, health systems, infrastructure
Capacity to cope- resilience, preparedness
Impact- localised, widespread, public sector

89
Q

Define a humanitarian emergency

A

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
Q

Define complex humanitarian emergency

A

Breakdown of authority caused by conflict which requires an international response that goes beyond the mandate or capacity of a single country

91
Q

Disaster Management Cycle

A

Response
Recovery
Mitigation
Preparedness

92
Q

Describe the response stage of the disaster management cycle

A

Search and rescue
Emergency relief
Initial needs assessment
Food, shelter, healthcare
10 priorities

93
Q

Describe the recovery phase of the disaster management cycle

A

Rehabilitation
Reconstruction
Rebuilding infrastructure

94
Q

Describe the mitigation stage of the disaster management cycle

A

Prevention
Engage wider stakeholders
Reduce risk and likelihood

95
Q

Describe the preparedness stage of the disaster management cycle

A

Think about early warning systems and ROC drills

96
Q

What framework can be used to guide work in the mitigation and preparedness phases

A

Sendai framework advises on actions that can be taken

97
Q

Which guidelines can be used for starting a response and describe them

A

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
Q

Describe the initial assessment

A

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
Q

4 phases of the initial assessment

A

1- 72hrs- initial
2 - 2 weeks - rapid
3 - 4 weeks - in depth
4- 5+weeks- indepth

100
Q

What is the most important indicator and indicated the severity of the problem

A

Crude mortality rate

101
Q

Define crude mortality rate

A

Number of deaths per 10,000 per day

102
Q

What is an acute emergency

A

> 1/10,000 dead per day (or >2 young children)

103
Q

Other epidemiology measures

A

Crude mortality rate
Maternal mortality rate
Cause specific death rates (Case fatality rates)

104
Q

10 priorities when responding to humanitarian emergencies

A

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
Q

Why is measles vaccination so important

A

R number of 20.
Much more infective than other organisms

106
Q

Why is early identification important

A

Means you can implement control measures
Prevent surging cases

107
Q

4 options for surveillance of crude mortality rate

A

Number of new graves
Go to community leader and ask for specific information
Health care workers recording
Syndromic diagnosis

108
Q

Define syndromic surveillance

A

Detection based on population health indicators/ group of symptoms before a firm diagnosis is made

109
Q

Which 4 diseases kill most often

A

Acute diarrhoea illness
Acute respiratory illness
Malaria
Measles

110
Q

Acronym for things to consider in a public health response

A

TEPID COIL

111
Q

What does TEPID COIL stand for

A

Training
Equipment
Personnel
Information
Doctrine
Clinical rationale
Organisation
Infrastructure
Logistics

112
Q

Sources of public health information

A

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
Q

What is EWARN

A

Early warning system to allow early public health interventions. Used when resources are low, EWARS box has relevant kit

114
Q

7 perspectives on costs of disasters

A

Physical
Psychological
Sociocultural
Economic
Political
Biological

115
Q

Why are we getting more disasters

A

Better at recognising them
Global warming

116
Q

10 possible future disasters

A

Global pandemic
World war 3
A killer asteroid
Global economic collapse

117
Q

Control measures for pandemic

A

Social distancing
Masks
Handwashing

118
Q

Personal characteristics of respondents you should think about

A

Motivation
Availability
Psychology
Physical health
Teamwork

119
Q

3 phases in the health continuum

A

Prepare, sustain, recover

120
Q

Who should get cholera vaccine

A

Anyone going to potential cholera risk areas

121
Q

Things to consider when caring for the health of responders

A

Training
Communication
Welfare
Mental Health
Sexual Health

122
Q

What defines humanitarian actions

A

They are underpinned by benevelonce

123
Q

Which geneva convention is related to medical supplies

A

Article 23

124
Q

What are the 4 humanitarian principles

A

Humanity
Impartiality
Neutrality
Independence

125
Q

Define humanity

A

Suffering must be addressed wherever it is found

126
Q

Define impartiality

A

Humanitarian action must be provided without discrimination

127
Q

Define neutrality

A

Humanitarian action must not favour any side

128
Q

Define independence

A

Autonomy of humanitarian objectives from any political, economic, military or other aims

129
Q

What are the 9 core humanitarian standard commitments to a community

A
  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
Q

What are the two main actors involved with humanitarian action

A

ICRC
IFRC

131
Q

What is ICRC

A

Absolutely neutral guardian of international humanitarian law

132
Q

What is IFRC

A

Coordinator of humanitarian work from various national socities

133
Q

Who can request humanitarian action

A

Emergency Response Coordinator

134
Q

Who is the emergency response coordinator

A

Lives in country, assigned role at beginning of disaster and coordinates response

135
Q

Describe the cluster approach

A

Number of different clusters, spreads accountability and utilises expertise as there is a lead organisation for each cluster

136
Q

What are the oslo guidelines

A

Guidelines to improve the coordination of civil-military response to humanitarian situations

137
Q

What are the key things in the oslo guidelines

A

Request for aid must come from humanitarian coordinator
Military aid is a last resort
Should focus on supporting actions

138
Q

What is the approach to humanitarian aid involving refugees

A

Refugee coordination model

139
Q

What is the approach to humanitarian aid not involving refugees

A

Cluster approach

140
Q

Disaster consequences

A

Destruction
Loss of infrastructure
Death
Injuries
Pscyhological harm
Economic disruption
Loss of community cohesion
Disease
Environmental degradation

141
Q

Define complex humanitarian emergency

A

When conflict means a country is unable to cope using its existing resources

142
Q

What approach would you use to identify who is extremely malnourished

A

A systematic approach

143
Q

5 ways to support your team in country

A

Regular debriefing
Welfare support
Supervision
Rest schedules
Good nutrition
Security
Sanitation

144
Q

What is the all hazards approach

A

Do not prepare for individual hazards. Take a comprehensive emergency preparedness framework which considers the full scope of disasters

145
Q

How would you structure your CBRN response

A

Step-1-2-3-Plus approach

146
Q

Describe the step-1-2-3 plus approach

A

Step 1- standard SOPs
Step 2- 2 people- caution and SOP
Step 3- 3 people- caution and plus steps
Plus control measures

147
Q

What are the control measures as part of Step 1-2-3 plus

A

Plus
-Evacuate
-Communicate and advise
-Disrobe
-Decontaminate

148
Q

What are the principles of CBRN casualty care

A
  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
Q

Implications of CBRN

A

Weapons of mass destruction
Safety issues
Unusual casualty types
Decontamination, extends timelines and denies assets

150
Q

Examples of (C)BRN

A

Nerve agents
Cyanides
Blistering agents
Pulmonary agents
Incapacitating agents

151
Q

Examples of C(B)RN

A

Live threats
Toxins

152
Q

Examples of CB(R)N

A

Radiological damage
water
food

153
Q

Examples of CBR(N)

A

Nuclear waste
Nuclear weapons

154
Q

Examples of hazardous materials

A

Asbestos
Excrement
Fertilisers
Pesticides
Fuel
Gas leaks
Water

155
Q

How would you manage a mascal incident

A

C SCATTER
Command and control
Safety
Communication
Triage
Treatment
Transport
Evacuate
Recover

156
Q

How would you treat CBRN

A

CABCDE
Inform specialists
Screen other exposed individuals

157
Q

Who are the most vulnerable groups

A

Pregnant women, elderly, children and disabled

158
Q

Define reproductive health

A

State of complete psychological, physical, mental wellbeing and not merely disease in relation to sexual and reproductive health systems

159
Q

Define state fragility

A

When state structures lack the legitimacy or effectiveness to provide for basic development, security and human rights for their populations

160
Q

Define conflict

A

Prolonged armed struggle

161
Q

Contributing factors to state fragility

A

Weak governance
Extreme poverty
Persistent inequality
Lack of territorial control
Frequent conflict
External shock
Inability to provide basic services

162
Q

Issues for poor

A

Poverty
Education
Child labor
Violence and exploitation
Orphans
Child soldiers

163
Q

Consequences of conflict

A

Death
Disability
Rape, torture
Separation
Break up of community

164
Q

Calorie cut offs for fall in energy supply, adults and children

A

1500kcal/ day in adults
<100kcal/kg/day in infants and small children

165
Q

Define wasting

A

<15% of normal body weight

166
Q

Signs of a fall in energy supply

A

<1500kcal/day
Reduced Z score or MUAC in 10% children under 5
Wasting

167
Q

What can you assess the needs for vaccination campaigns based on

A

National vaccination records
Questioning mothers
Vaccination histories

168
Q

How to assess the effectiveness of vaccination programmes

A

Recording % of children vaccinated
Track rates of disease

169
Q

How much is standard requirement for water

A

15-20l

170
Q

How much water should a feeding centre aim to provide

A

20-30l/ person/ day

171
Q

How much water should a healthcare centre aim to provide

A

40-60l

172
Q

Outline nutrition care

A

Involve specialist NGOs
Dry ration provision
Wet ration provision
Support to families
Supplementary feeding programmes
Therapeutic feeding programmes

173
Q

How to decide supplementary or therapeutic feeding programme

A

Supplementary if below 85% wt/ht
Therapeutic if below 75% wt/ht

174
Q

NATO principle of universal emergency care

A

Treat any person with life/ limb/ sight threatening injury

175
Q

UN Charter for rights of the child

A

Children must be treated by competent trained professionals

176
Q

Define force health protection

A

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
Q

Chain of infection

A

Causative agent
Reservoir/ source
Means of exit
Mode of transmission
Portal of entry

178
Q

Examples of control measures

A

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
Q

Actions of med centre following outbreak

A

Isolation/ segregation
Identifying separate accomodation
Collect details
Locate
FMed85
Estimate PAR
Consult SMO

180
Q

Themes by which disasters in the urban environment are different

A

Population
Economic
Social
Infrastructure

181
Q

Issues with disasters in urban environment

A

Nature of infrastructure
Higher density population
Congestion
Overwhelmed emergency services

182
Q

Which organisation is an example of how the UK supports oversease

A

UKMed

183
Q

Which three things affect disaster’s effects

A

Vulnerability
Capacity to cope
Impact

184
Q

5 factors to consider when dealing with the dead

A

Preparedness
Legal
Socio-cultural
Psychological
Health

185
Q

Storage of dead bodies (above ground)

A

Cold storage
12-48hrs in hot climates
2-4 degrees celsius
Can use wet or dry ice
Identification of bodies is important

186
Q

Stats for graves

A

1.5m deep
200m from drinking water
0.4m apart

187
Q

Security threats for humanitarians

A

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
Q

Principles for military medical practicioners in humanitarian assistance

A

Last resort
Do no harm
Based on need
Clinically appropriate
Culturally sensitive
Sustainable
Civilian primacy

189
Q

What to do before engaging with media

A

Gain permission from relevant teams
Establish official line
Follow organisation procedures
Focus on objective facts

DMCC (1 decks)

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