Final Exam - Class 7

Question 1

What is a disaster?

Answer 1

A public emergency needing assistance from outside the community

Question 2

What 3 things do all disasters have in common?

Answer 2

1. little or no warning
2. overwhelmed emergency personnel
3. serious threat to life, public health, or environment

Question 3

Mitigation phase of emergency management

Answer 3

Occurs either before or after the event - used to PREVENT a disaster

Goal is to identify potential hazards, risks, and resources

Use the lessons learned to reanalyze after the disaster

Ex.: purchasing flood insurance, warning system for tornados

Question 4

Preparedness Phase of emergency management

Answer 4

Occurs before an event - plans FOR a disaster

Assess risks

develop a plan to save lives and assist 1st responders & rescue team

national, state, local, community levels of involvement

Question 5

Response Phase of emergency management

Answer 5

Implementation of disaster plan

The disaster has taken place

Must establish greatest good for the greatest number of casulties.

Question 6

Recovery Phase of emergency management

Answer 6

occurs after an event

restores the community to normal

communicable disease may be present as a result

Sanitation control

Counseling for PTSD

update the plan - includes rebuilding, reemployment, and repair of essential infostructure.

Question 7

Hot disaster zone

Answer 7

most dangerous

at the site of the disaster

goal is to locate victims

basic life saving measures are performed

Use appropriate PPE

Question 8

Warm disaster zone

Answer 8

At least 300 ft from hot zone

goal is decontamination

Use appropriate PPE

Question 9

Cold disaster zone

Answer 9

Victims are triaged and treated

medical services and transport

Use appropriate PPE

Question 10

Non-mass casulity triage

Answer 10

conditions of highest acuity are treated and evaluated first

Question 11

Mass casualty triage

Answer 11

unable to treat everyone - greatest good for greatest number of people

red
yellow
green
black

Question 12

Internal disaster

Answer 12

occurs within a facility

greatest good for greatest number of people

Evacuate the easiest to move first

Question 13

Black Triage Marker

Answer 13

Unlikely to survive

No spontaneous breathing, no pulse

Palliative care provided

Question 14

Red Triage Marker

Answer 14

Need immediate medical attention within minutes or up to 60 minutes to survive

airway, breathing, or circulation is compromised

RR >30

radial pulse absent

capillary refill > 2

do NOT obey commands

Question 15

Yellow Triage Marker

Answer 15

Non-ambulatory but stable

transport can be delayed, not expected to decline over several hours

Question 16

Green Triage Marker

Answer 16

Ambulatory

Minor injuries not likely to decline over several days

can help in own care

Question 17

Anthrax forms

Answer 17

cutaneous
inhalation
GI
injection

Question 18

Cutaneous anthrax

Answer 18

Painless lesion with black/eschar center

diagnosed with physical assessment

small blisters/bumps - itchy!

edema around sore

mostly on face, neck, arms, and hands

most common form, least dangerous

occur 1-7 days post exposure

get from contact with spores from infected animals

Question 19

Inhalation anthrax

Answer 19

result of untreated cutaneous or biological weapon

diagnosed with chest XR, CT, sputum culture

similar to pneumonia, but with widened mediastinum on chest XR & lymph node involvement

fever, chills, malaise, body aches

chest pain, SOB

confusion, dizziness, headache

N/V

severe diaphoresis

most deadly

7-60 days post exposure

Question 20

GI Anthrax

Answer 20

get from undercooked meat or dairy from infected animals

diagnosed with blood culture

fever, chills, headache

edema of neck, sore throat, painful swallowing, hoarseness

N/V (bloody)

diarrhea (bloody)

abdominal pain, swelling

1-7 days post exposure

Question 21

Injection Anthrax

Answer 21

Get from IV drug use

diagnosed with blood culture

similar to cutaneous

abscess occur deep under the skin

harder to treat

1-7 days post exposure

Question 22

Anthrax treatment

Answer 22

antibiotics (Ciproflxacin, doxycycline)

anti-toxin

standard precautions

contact precautions if uncontrolled drainage (vomit, diarrhea)

goal is to minimize transmission and manage symptoms

Question 23

Botulism Types

Answer 23

Foodborne
Wound
Infant
adult intestinal
iatrogenic

Question 24

Botulism symptoms

Answer 24

Full body paralysis that works its way down the body

displopia (double vision)

blurred vision

ptosis

slurred speech

dysphagia

difficulty breathing

muscle weakness

Question 25

Foodborne botulism

Answer 25

From unsafe canning techniques

improper handling of food or undercooked meat

symptoms N/V, abdominal pain, diarrhea

Diagnose with stool culture, symptoms

Question 26

Wound Botulism

Answer 26

Get from injection drugs & traumatic injuries

symptoms red wound, edema, pain, warm, pus, fever

diagnose with wound culture, blood culture

Question 27

Infant botulism

Answer 27

from bacteria in home and ingested honey

symptoms lethargy, poor feeding, constipation, weak cry, poor muscle tone

diagnose with blood culture

Question 28

Adult Intestinal Botulism

Answer 28

unknown etiology

very rare

affects GI tract

diagnose with stool culture

Question 29

Iatrogenic

Answer 29

injections of botulism from healthcare provider

Question 30

Botulism Intervention

Answer 30

botulinum anti-toxin

supportive care - symptoms of paralysis, airway!

reversible within weeks-months from bottom up

standard precautions

Question 31

Ebola

Answer 31

transmitted through blood and body fluids - animal vector host

viral hemorrhagic fever

unexplained hemorrhage from every orifice of body, renal failure

Question 32

Ebola symptoms

Answer 32

fever

severe headche

muscle pain

weakness

fatigue

diarrhea

vomiting

abdominal pain

unexplained hemorrhage

onset 2-21 days, average 10 days

Question 33

Ebola diagnosis

Answer 33

blood sample

must have combination of symptoms and possible exposure within 21 days

blood sample AFTER the onset of symptoms

Question 34

Ebola intervention

Answer 34

hydration and supportive care - transfusion and antipyretic

vaccine to reduce transmission

contact precaution

if clinically unstable - bleeding, vomiting, diarrhea - use full PPE boot covers & coveralls

Question 35

Plague Types

Answer 35

Bubonic

Septicemic

pneumonic

Question 36

Bubonic Plague

Answer 36

Get from flea bites, common in hunters who handle carcasses

sudden onset of fever, headache, chills

one or more swollen, painful lymph nodes (groin, axillae, cervical)

diagnosed with lymph node aspiration

standard precautions

Question 37

Septicemic Plague

Answer 37

Fever, chills

Get from untreated bubonic

abdominal pain

shock

bleeding into skin, organs

necrotic skin

diagnosed with blood culture

standard precautions

Question 38

Pneumonic Plague

Answer 38

from untreated bubonic or weaponized, aerosolized

fever, chills

rapidly developing pneumonia

SOB, cough

blood, watery sputum

chest pain

Resp failure, shock

spread person to person

airborne isolation needed, airborne precautions

diagnosed with blood culture, sputum culture, bronchial/tracheal washings

Question 39

Plague intervention

Answer 39

antibiotics - gentamicin, fluroquinolones (levolfoxacin, ciprofloxacin)

Question 40

Smallpox Assessment

Answer 40

incubation with no symptoms for 7-19 days

intitial symptoms high fever, headh and body aches (very sick)

early rash - most contagious stage! starts in mouth and face and spreads to arms, legs, hands, feet.

lesions fill with pus, scab over and peel off

Question 41

Smallpox diagnosis

Answer 41

blood samples, symptom of legion

Question 42

Smallpox intervention

Answer 42

vaccine:

• before contact can protect
• within 3 days of exposure, may protect, less severe
• within 4-7 days of exposure: some protection, less severe
• once symptoms develop - no protection!

antivirals - not tested on humans, may benefit

contact, airborne isolation

Question 43

Tularemia

Answer 43

hemmorhagic inflammation of lungs

risk from tick, deer flies, other insects especially hunters handling carcasses

contaminated food or water

symptoms similar to pneumonia, dry or slightly productive cough

abrupt fever

headache

chills

generalized body aches (low back)

sore throat

Question 44

Tularemia analysis

Answer 44

respirtory secretions

blood specimen

chest XR

sputum culture

Question 45

Tularemia Intervention

Answer 45

vaccine for researchers only

contained causality setting: IV streptomycin or gentamicin

mass casualty setting: oral doxycycline or ciprofloxacin

standard precautions