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Med Surg 3 > Emergencies, Terrorism, and Disasters > Flashcards

Emergencies, Terrorism, and Disasters Flashcards

1
Q

emergent category (life threatening)

A

Patient has immediate threat to life or limb, and requires immediate treatment

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2
Q

Urgent category ( needs quick treatment, but not immediately life threatening)

A

Patient should be treated quickly but immediate threat to life does not exist at the moment

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3
Q

Non-urgent category (could wait several hours if needed without fear of deterioration

A

Patient can usually wait several hours for care without risk

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4
Q

respiratory distress is part of which tier of triage?

A

Emergent

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5
Q

Severe abdominal pain is part of which tier of triage?

A

urgent

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6
Q

chest pain with diaphoresis is part of which tier of triage?

A

emergent

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7
Q

a skin rash is part of which tier of triage?

A

non urgent

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8
Q

displaced multiple fractures are part of which tier of triage?

A

urgent

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9
Q

active hemorrhage is part of which tier of triage?

A

emergent

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10
Q

a stroke is part of which tier of triage?

A

emergent

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11
Q

complex multiple soft tissue injuries are part of which tier of triage?

A

urgent

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12
Q

colds are part of which tier of triage?

A

non urgent

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13
Q

renal colic is part of which tier of triage?

A

urgent

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14
Q

simple fracture is part of which tier of triage?

A

non urgent

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15
Q

new onset respiratory infection, especially pneumonia in older adults are part of which tier of triage?

A

urgent

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16
Q

strains and sprains are part of which tier of triage?

A

non urgent

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17
Q

Which one of the following patients would a nurse triage to be seen first?

65 year old man who fell on his right wrist with visible bone

35 year old female with vomiting, 9/10 pain from renal colic

45 year old female with blood pressure 80/55 , 128, 26 with reports of epigastric pain and diaphoresis

63 year old female with red, painful, raised rash across umbilicus.

A

45 year old female with blood pressure 80/55 , 128, 26 with reports of epigastric pain and diaphoresis

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18
Q

define trauma

A

bodily harm.

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19
Q

Level 1 Trauma center

A

Provides leadership and total collaborative care from prevention through rehabilitation. Occur in large teaching institutions.

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20
Q

Level 2 Trauma center

A

Can provide care to majority of injured patients. Located in small community hospitals.

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21
Q

Level 3 Trauma center

A

Focuses on initial injury stabilization and patient transfer.

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22
Q

Level 4 Trauma center

A

ACLS in rural or remote settings; transfers patient after stabilization.

23
Q

What are considered during a primary survey?

A 
Airway/Cervical spine 
Breathing 
Circulation
Disability
Exposure- cut clothes
24
Q

Airway/Cervical spine

A
  • highest priority is to establish an airway
  • non rebreather mas
  • Bag valve mask
  • may need an endotrach tube and or mechanical ventilator machine
25
Q

Breathing

A
  • assessing if ventilator efforts were successful
  • assess lung sounds
  • assess
26
Q

Circulation

A
  • The adequacy of the HR, BP, and perfusion are the overall concerns
  • large bore IV (16 gauge)
  • lactated ringers
  • NS
  • blood may also be needed…make sure they are warmed to prevent hypothermia
27
Q

Disability

A 
NEURO!
A (ALERT)
V  (RESPONSIVE TO VOICE)
P (RESPONSIVE TO PAIN)
U (UNRESPONSIVE)
  • ALSO, Glasgow COma Scaale
  • total unresponsiveness= 3
  • normal = 15
28
Q

Exposure-

A

cut clothes and prevent hypothermia
- clothes preservation inpatients involved in rape, elder abuse, suicide, homicide, domestic violence, drug overdose, and assault.

29
Q

what are included in the secondary survey

A

-Comprehensive head-to-toe assessment, VS- log roll

Identifies other injuries/issues that must be managed or may impact course of treatment

Gastric tubes

Urinary catheters

Diagnostic studies

Vitals

Family Presence

Comfort measures

Tetanus

30
Q

what is heat exhaustion

A
  • being out in the sun
  • dehydrated
  • over hours
    over days
31
Q

what does a person with heat exhaustion look like?

A
  • lethargic
  • fatigue
  • syncope
  • weak
  • nauseous
32
Q

who is at risk?

A
  • elderly- hypothalamus doesn’t work as well
  • anyone who works outside
  • athletes
  • postal service
  • gardeners
  • the homeless
  • mental health patients
  • military
33
Q

What do we do first?

A
  • **Remove them from the heat/ cool area
  • take of constrictive clothes
  • give electrolyte fluid (gatorade)
34
Q

where to put cold packs

A
  • armpits
  • groin
  • neck
35
Q

untreated heat exhaustion leads to

A

heat stroke

36
Q

With heat stroke the body temperature is above

A

104 degrees

37
Q

what are the 2 types of heat stroke

A

exertion heat stroke- sudden onset
- athletes

Classic heat stroke- over period of time
- homeless

38
Q

What does someone with heat stroke look like

A
  • tachycardia
  • low BP
  • difficulty breathy( fast then slow)
  • confused, bizarre
  • may have a seizure
  • dry, hot skin and perspiration
  • decreased perfusion….(slide 22)
39
Q

Interventions for Heat stroke

A

ABC’s

    • need to be cooled but not too fast (102 degrees)
  • – ice packs
  • – cold fluids
  • — moist towels, sheet
  • — continuos temp (foley)
40
Q

heat stroke nutrition

A

NPO

  • 2 IV
  • foley
41
Q

in a heat stroke you want to prevent shivering to prevent

A

increasing their temperature

* give benzodiazepines (muscle relaxants

42
Q

What is hypothermia

A

core body temperature below 95 degrees

43
Q

common causes of hypothermia

A
  • advanced age
  • hypothyroidism
  • cold weather
44
Q

mild hypothermia range

A

90-95 degrees F

45
Q

moderate hypothermia range

A

82.4- 90 degrees F

46
Q

Severe hypothermia range

A

below 82.4

47
Q

Intervention for mild hypothermia includes

A
  • rewarming the patient
    Passive: applying warm clothes blankets

Active - heating blankets, warm packs, warmers

48
Q

Interventions for moderate to severe hypothermia include

A
  • hospitalization
  • goal is to prevent heat loss and v fib
  • monitor for after drop
  • Monitor ABC’s
  • warm client with warm IV fluids and blankets
49
Q

casualties are classified as

A
  • direct victims
  • in direct victim
  • displaced person
  • refugee
50
Q

disaster preparedness in hospitals occur at least

A

twice a year

51
Q

Mass casualty triage categories

A
  • Emergent or Class 1 (RED)
  • Urgent or Class 2 (YELLOW)
  • Nonurgent or Class 3 (GREEN)
  • Expectant or Class 4 (BLACK)
52
Q

what does CISD stand for ?

A

Critical Incident Stress Debriefing

is a process intended to prevent or limit the development of post-traumatic stress in people exposed to critical incidents

53
Q

what is after drop?

A

after drop is when the cold blood from your peripheries recirculate into your core..it will re lower your core body temperature.

Med Surg 3 (5 decks)

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