Emergencies, Terrorism, and Disasters

Question 1

emergent category (life threatening)

Answer 1

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

Question 2

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

Answer 2

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

Question 3

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

Answer 3

Patient can usually wait several hours for care without risk

Question 4

respiratory distress is part of which tier of triage?

Answer 4

Emergent

Question 5

Severe abdominal pain is part of which tier of triage?

Answer 5

urgent

Question 6

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

Answer 6

emergent

Question 7

a skin rash is part of which tier of triage?

Answer 7

non urgent

Question 8

displaced multiple fractures are part of which tier of triage?

Answer 8

urgent

Question 9

active hemorrhage is part of which tier of triage?

Answer 9

emergent

Question 10

a stroke is part of which tier of triage?

Answer 10

emergent

Question 11

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

Answer 11

urgent

Question 12

colds are part of which tier of triage?

Answer 12

non urgent

Question 13

renal colic is part of which tier of triage?

Answer 13

urgent

Question 14

simple fracture is part of which tier of triage?

Answer 14

non urgent

Question 15

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

Answer 15

urgent

Question 16

strains and sprains are part of which tier of triage?

Answer 16

non urgent

Question 17

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.

Answer 17

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

Question 18

define trauma

Answer 18

bodily harm.

Question 19

Level 1 Trauma center

Answer 19

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

Question 20

Level 2 Trauma center

Answer 20

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

Question 21

Level 3 Trauma center

Answer 21

Focuses on initial injury stabilization and patient transfer.

Question 22

Level 4 Trauma center

Answer 22

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

Question 23

What are considered during a primary survey?

Answer 23

Airway/Cervical spine 
Breathing 
Circulation
Disability
Exposure- cut clothes

Question 24

Airway/Cervical spine

Answer 24

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

Question 25

Breathing

Answer 25

- assessing if ventilator efforts were successful - assess lung sounds - assess

Question 26

Circulation

Answer 26

- 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

Question 27

Disability

Answer 27

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

Question 28

Exposure-

Answer 28

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

Question 29

what are included in the secondary survey

Answer 29

-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

Question 30

what is heat exhaustion

Answer 30

- being out in the sun - dehydrated - over hours over days

Question 31

what does a person with heat exhaustion look like?

Answer 31

- lethargic - fatigue - syncope - weak - nauseous

Question 32

who is at risk?

Answer 32

- elderly- hypothalamus doesn't work as well - anyone who works outside - athletes - postal service - gardeners - the homeless - mental health patients - military

Question 33

What do we do first?

Answer 33

* **Remove them from the heat/ cool area - take of constrictive clothes - give electrolyte fluid (gatorade)

Question 34

where to put cold packs

Answer 34

- armpits - groin - neck

Question 35

untreated heat exhaustion leads to

Answer 35

heat stroke

Question 36

With heat stroke the body temperature is above

Answer 36

104 degrees

Question 37

what are the 2 types of heat stroke

Answer 37

exertion heat stroke- sudden onset - athletes Classic heat stroke- over period of time - homeless

Question 38

What does someone with heat stroke look like

Answer 38

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

Question 39

Interventions for Heat stroke

Answer 39

ABC's - * need to be cooled but not too fast (102 degrees) - -- ice packs - -- cold fluids - --- moist towels, sheet - --- continuos temp (foley)

Question 40

heat stroke nutrition

Answer 40

NPO - 2 IV - foley

Question 41

in a heat stroke you want to prevent shivering to prevent

Answer 41

increasing their temperature | * give benzodiazepines (muscle relaxants

Question 42

What is hypothermia

Answer 42

core body temperature below 95 degrees

Question 43

common causes of hypothermia

Answer 43

- advanced age - hypothyroidism - cold weather

Question 44

mild hypothermia range

Answer 44

90-95 degrees F

Question 45

moderate hypothermia range

Answer 45

82.4- 90 degrees F

Question 46

Severe hypothermia range

Answer 46

below 82.4

Question 47

Intervention for mild hypothermia includes

Answer 47

- rewarming the patient Passive: applying warm clothes blankets Active - heating blankets, warm packs, warmers

Question 48

Interventions for moderate to severe hypothermia include

Answer 48

- 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

Question 49

casualties are classified as

Answer 49

- direct victims - in direct victim - displaced person - refugee

Question 50

disaster preparedness in hospitals occur at least

Answer 50

twice a year

Question 51

Mass casualty triage categories

Answer 51

- Emergent or Class 1 (RED) - Urgent or Class 2 (YELLOW) - Nonurgent or Class 3 (GREEN) - Expectant or Class 4 (BLACK)

Question 52

what does CISD stand for ?

Answer 52

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

Question 53

what is after drop?

Answer 53

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