Eh Flashcards
What is Force Health Protection
The conservation of the fighting potential of a force so that it is healthy and fully combat capable
Main categories Med Force Protection Hazards
Physical, chemical, biological
What is a Disease Non Battle Injury
Person who is not a casualty. But who is lost to the organisation by reason of disease or injury
Dnbi is split into two categories
External (flora/fauna, climate, disease, enviro/industrial hazards)
Internal (disease, food and water, waste, premises, processes)
1st line of Force Health Protection
CHA’s, CHD’s, unit medical staff
Two categories of disease
Communicable, non communicable
Communicable
Transmitted from an infected petson/animal/insect either directly or non directly to a susceptible host
Three roles of CHD
Op sanitation
Pest/vector control
Water quality/analysis
Roles of CMT in providing EH advice at 1st line
Policy and procedures
Advice and training
Monitoring and investigation
Principles of risk management
Prevention and control
JSP for FHP
950
Definition: HAZARD
Anything that may cause harm
Definition: RISK
Probability that someone could be harmed
3 methods of auditing and surveillance
Fmed 85
EHT audits
Local med intelligence
POPULATION AT RISK
list 4
Friendly forces
Local civ population
Locally employed civilians
P. o. W/ Detained personel
5 x steps Health Risk Management Process
Hazard identification Identify people at risk Risk assessment Risk management Monitoring activity
Definition: HEALTH
A state of complete physical, mental and social wellbeing and not merely the absence of disease
Definition: DISEASE
Any state that is a departure from positive health whether it be mental or physical
Chain of Infection
Source, route, target
Definition: FOMITE
inanimate object capable of spreading disease
Definition: DNBI
A person who is not a battle casualty but who is lost to the organisation by reason of disease or injury
Types of microorganism that can cause communicable disease
6
Bacteria Protozoa Helminths Virus Parasites Fungi
Defibition: PATHOGEN
Microorganism capable of causing disease
5 examples of source of disease
Case Carrier Convalescent Contact Corpse
Defintion: OUTBREAK
Two or more cases of a communicable disease which are/may be linked by time and/or space
Single point of contact for Fmed 85
So2 Health Protection, defence public health unit
When complete and Fmed 85?
Person with an infectious disease
What is a notifiable disease?
Any disease required by law to be reported to Gonvernment authorities
What form would you use for Notifiable Diseases
EpiNato
Roles and functions of EH
Communicable disease prevention and control
Water quality monitoring and analysis
Food hygiene and safety
Operation field sanitation and waste disposal
Vector and pest control
Environmental monitoring
Occupational health and safety
What does a risk assessment do?
Helps commander and their staff to prioritise and allocate resources for FHP
Impact of disease on military
Man power wastage
Unit mission failure
Wastes limited unit resources
Examples of Non communicable disease
Climatic injury
Physical Injury
Cancers
Dietary deficiencies/excesses
Organisms enter the body
Eyes Mouth Nose Injection Genitals Anus Open cuts sores
ROUTES of disease
Airborne
Contact/animal
Ingestion
Arthropod
Definition: TARGET
Healthy susceptible human
Who is ultimately responsible for Fmed 85
The MO
Outbreak investigations necessary for:
Assessing scale of outbreak Prevent further spread Investigate origin Learn lesson Assist in confirmation of outbreak Fulfil statutory requirement
An initial investigation consists
4
Preliminary phase
Communication
Confirm notification
Control measures
Short halt camp
Less then 24 hours. Cat sanitation
Temporary camp
24hrs-7days
Excavation and burial
Semi permanent
7 days - 6 months.
Improvised appliances
Permanent
6 months+
Permanent fixtures
Shallow trench urinal
1m x 3mx 150mm deep with further 150mm of loose earth.1 x STu for 250 men
Refuse/Ash pit
1m x 1m x 1m
Semi perm camp - US(SR)
Funnel urinal and soakage put.
4 funnels per soakage pit
1 x funnel = 25 men
Deep trench latrine
3.6m x 750mm wide x 2.5m depth
Deep trench Latrine
3.6m x 750mm wide x 2.5m dept
4th Line EH support
DMS whittington
RAF Centre for aviation medicine
Institute of Naval Medicine
Environmental Monitoring Teams
2nd Line of EH support
Theatre EH teams
3rd Line EH support
REGIONAL command EH Teams
Arthropod modes of spread
Biological and mechanical
Definition: INFESTATION
Presence of an unusually large number of insects or animals in a place, typically so as to cause damage or disease
Definiteion: ECTOPARASITE
Organisms that live on the skin of the host from which they derive their sustenance
Two modes of spread contact/animal
Direct and indirect
Defibition: DIRECT
Diseases that are contracted following direct contact with an infected person or animal
Definition: indirect
Transmitted on fomites
Diseases military significance:.
DIRECT
Sti
Scabies
Rabies
Q fever
Diseases military significance:.
INDIRECT
Gingivitis
Impetigo
Verucca/warts
Fungal skin infection
Zoonotic disease
Scabies, rabies, q fever
Signs symptoms of Q Fever
Flu like symptoms Headache Nausea Weightloss Sever cases pneumonia
Control of contact/animal disease
SOURCE
Treatment of cases Dispose of corpses/carcasses correctly Health education Contact tracing Disinfection
Control of contact/animal
ROUTE
Direct: abstinence, monogmomy, don’t touch animals
Indirevt: disinfection, launder, keep personal items personal
Control of contact/animal
TARGET
Health education
Immunisation
Personal hygeine
How to eliminate blood borne diseases
Incorrect use of PPE
Not enough adequate PPE
Needlestick injuries
Mode of spread of ingestion disease
Consumption of contaminated food and water
Types of contamination of ingestion diseases
Chemical (lead, Mercury, disinfectants, insecticides)
Physical (glass, paint, masonry, dust)
Biological (pathogenic microorganisms)
How does contamination occur
Flies and cockraoches Rodents Poor personal hygiene Poor waste disposal Poor food hygiene Poor food prep Untreated water
4 ingestion borne diseases you can be vaccinated against
Polio and infective hepatitis, cholera, typhoid
Biological mode of spread
Pathogens multiply inside the arthropod
Mechanical mode of spread
Arthropod carries pathogens on outside of body
Benefits of CHD personnel
7
Self sufficient Proactive pest control Improvised sanitation Water safety Lower DNBI Maintain Op efficiency Intelligent tasking of EH team
Constraints of EH personnel
4
Lack of space
Proximity to sleeping/eating areas
Logistics
High tempo of activities
Functional areas of CHA
Completion of T1 EIH
Management of CHD personnel
Medical force protection using risk management
Involvement in overseas training
CHA specific tasks
Identify hazards in AOR
Threat and hazard assessment and recognition
Implement FHP measures
Advise CoC in management measures
Short halt camp USSR
Cat sanitation
Temporary camp USSR disposal
Shallow trench urinal (1x250x24hrs)
Shallow trench latrine (5 x 100x 3days)
Grease strainer and soakage pit
Refuse/Ash pit (1m2 x 100 x 24hrs)
Semi perm USSR removal
Funnel/female urinal and soakage pit: (1 x25)ax 4 x funnel per pit. 6 months usage
Trough urinal (1 x 100 x 6 months)
Deep trench latrine (5seats x 100 men x 6 months)
Types of incinerator
Oil drum incin
Incline plane incin
Semi enclosed incin
Military impacts of climatic injuries
61
Climatic injuries can kill Morbidity/downgrading Medical discharge Loss of effectiveness Waste of limited resources MISSION failure
Climate doctrine
JSP 375
Minor heat illness/injuries
Faibting
Heat cramp
Prickly heat
Sunburn
Two types of major heat illness
Heat exhaustion
Heat stroke
Two type of heat climates
Hot wet
Hot dry
What environmental factors can effect risk of heat illness
Radiant heat
Humidity
Wind speed
Ambient air temperature
Two doctrines for clinical info and advice for commander and cold and heat injurjes
JSP 950 (clin) JSP 375 (advic commander and climate)
How long does it take to acclimatise
10-14 days or longer
Individual risk factors that increase the chance of heat illness
Health - nutritional Work - activity Lifestyle - smoker Sunburn Age
EpiNato2, what is it?
A disease surveillance program used by Nato on overseas operations
What do you do with an EpiNato2?
Fill it in correctly. Send up CoC/HQ, do own analysis.
Daily data collection and weekly declaration/ return
Water samples must be:
In a suitable aseptic container
Correctly labelled- DTG, location, source, samples
Supporting information
Flight information
Sampling frequency
Daily - chlorine
Weekly - bacterialogical testing
Quarterly - chemical testing
What should be done in the event of water contamination?
Switch to bottled water reserve
Hard regimes.
Collect sample for quicksilver
Inform EH immediately
What chemical is added to de taste water. When is it added
Sodium thiosulfate to neutralize it. Added just before consumption.
Contact period of water is normally 15 mins. When would you leave it 30 mins.
If schistosomiasis is present
If there is no test kit present
If the water is below 5 degrees
Two methods of clarifying water
Filtration and sedimentation
Two methods of disinfecting water
Chemical (chlorine)
Physical (boiling)
Two methods of clarifying water
Filtration (sand or man made porous filter)
Sedimentation (allowing gravity to remove suspended particles from water)
Basic considerations relating to water quality
2km recce Flowing Turbidity Livestock Live fish Vegetation
Basic considerations relating to water quantity
25L pp/per day 10L minimum (drinking and hygiene)
6 stages/ principles of water purification
and explain
Selection of source Clarification Disinfection Contact period Test De taste
Diseases associated with water
WILDCATSGP
Who does water testing
ROYAL ENGINEERS
EHP’S (CHA AND CHD can assist)
Two types of water contaminants and examples
Suspended (grit, sand, disease, sewage, organisms, sediment)
Dissolved (heavy metals, chemicak/toxic waste, pesticides, war agents, salts, detergents)
Purpose of water purification within the Army
To prevent disease by removing all disease causing organisms, therefore maintaining force effectiveness
Impact of contaminated water
Loss of manpower
Increase in DNBI
Unit mission faikure
Limited resources wastage (time/money)
Purposes of good waste management
Minimise risk of disease
Prevention water/food contamination
Discourage pest/vectors
Maintain comfort and morale
Considerations to camp siting
Access
Location
Terrain
Basic principles when siting camp
Front of camp facing wind
Accommodation at front
Sanitary facilities down wind of accom
Latrines away from kitchens and water sources
Hypothermia mechanisms of injury
Immersion
Exposure
Urban
3 categorise of of cold injuries
Generalised cold ibjuries
Localised freezing cold ibjury
Non freezing cold injury
Signs and symptoms of generalised cold injury
Say they feel cold Loss of dexterity Blue lips Uncontrolled shivering (or stopped shivering) Irritability and confusion Slurred speech Reduced consciousness Say they feel ok
What is localised cold injury
Individual body part Exposed to cold which may become damaged.
Two common localised cold injury
Freezing cold injury
Non freezing cold injury
Two common freezing cold injuries
Frost nip (tingling followed by numbness, white and pink, mottled)
Frost bite (no feeling, waxy looking, white/black, clear line between white and pink)
Non freezing cold injuries
Trench foot
Wind burn
Snow blindness
Signs symptoms of trench foot
Numbness in area
Pain
Pins and needles
Commanders assessment of risk should consider following
Activity/ duration Environmental condition Preparation/ education Water/food intake Alcohol Dress/equipment Predisposing factors
What environmental factors can affect the risk of heat illness
Radiant heat
Ambient air temperature
Hunidity
Windspeed
Individual risk factors for getting heat injury
Health Work Lifestyle Age Sunburn
Climatic injury reporting
Dmicp climatic injury template
JSP 375 climatic injury template
Prevention of cold injury
Individual prep
Enviro temp
Wind chull
Work intensity
Commanders risk assessment should consider:
Predisposing factors Environments condition Food/water intake Acitivity/duration Prepeation/ education Alcohol Dress/equipment
5 individual risk factors that increase chance of heat illness
Lifestyle - smoking
Health - previous heat injury, recent vaccination, sunburn, dehydration
Work - lack of sleep
