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Emergency Response to Hazardous Material and Terrorism > Final Final > Flashcards

Final Final Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Managing Life Hazards

A
  • isolate
  • contain
  • evacuation
  • decontamination
  • emergency care
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2
Q

Level A and B

A
  • self-contained breathing apparatus (SCBA)

- supplied air respirator (SAR)

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3
Q

Level C

A
  • powdered air purifying respirator (PAPR)

- air purifying respirator (APR)

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4
Q

decay

A

radioactive material tries to stabilize itself by changing its structure in a natural process

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5
Q

Radioactive Material (RAM)

A

-Special Nuclear Material
Uranium- 235
Plutonium- 239

-Fissile Material
Uranium- 235, 233
Plutonium- 239, 241

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6
Q

MAD

A

mutually assured destruction

-arms race

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7
Q

Scene Management Hazards

A
  • Crowd control
  • Resource management
  • Biohazard, radiological, toxic
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8
Q

Preparedness

A
  • mitigation
  • rely on training and reference sources
  • know how and when to access specific toxicological information
  • understand how a hazardous materials scene is organized and where you fit in
  • know where to find the emergency response plan in your facility
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9
Q

General Considerations of Scene Managment

A
  • emergency operations must be conducted in a structured, consistent manner
  • strong emphasis is placed on standard operating procedures (SOPs)
  • it is critical to ensure your own safety
  • it may not be possible to identify what hazards are present
  • warning signs include:
  • signs and symptoms from patients
  • placards and labels
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10
Q

If you suspect an attack…

A
  • Ensure safety
  • notify dispatch and/or supervisor
  • request resources
  • coordinate with command
  • initiate mass casualty incident procedures
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11
Q

Mass Casuality Incident Procedure

A
  • approach scene with caution and UPWIND
  • carry out scene assessment
  • establish incident command (each responding agency)
  • recognize signs and indicators of CBRN incidents
  • determine whether CBRN or hazardous material incident
  • estimate the number of causalities/victims
  • estimate resource requirements (certain hospitals dont take certain trauma patients -> OB)
  • carry out primary triage, decontamination, secondary triage, medical care, and transport
  • consider specialist advice
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12
Q

Scene Size up

A
  • Forms an incident action plan

- Systematic

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13
Q

Lloyd Layman’s 5 Step Size Up Process

A

-Facts- time of day, location, resources, weather
-Probability- anticipate events
-Situation:
Are there enough resources for mitigation of incident
Limitations of personnel
Limitations of equipment (responding resources)
-Decision:
Are there enough resources for mitigation of incident
Is a internal attack possible
Assignment of on scene resources
Assignment of responding resources
-Plan of Operation- plan of mitigation

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14
Q

Operation Goal

A
  • life safety
  • incident control/stabilization
  • environmental protection
  • systems/infrastructure protection
  • property protection
  • mode of operation
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15
Q

Operation Actions

A
  • make immediate contact with incident commander for coordination
  • isolate the area upwind and uphill initially
  • > then in specified directions as per the incident commander or hazmat team
  • identify a safe staging location for incoming units
  • give access and egress to these units if necessary
  • mobilization points for resources may be set up away from the scene and resources deployed as necessary
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16
Q

Utilize Resources for…

A
  • Identification of hazards
  • Medical care
  • Evacuation
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17
Q

Assess Initial Isolation/Standoff Distances

A
  • green section of ERG

- specific to chemical

18
Q

When to use control zones

A
  • mitigate damage and increase safety
  • explosive devices
  • chemical or biological contamination or dispersion devices
  • potential radioactive contamination
19
Q

Perimeter Control Factors

A

-amount of available resources
-self protection capabilities
-size and configuration of the incident
-incident stability
-requires the use of scene evaluation to determine appropriate distances required to isolate the incident from unaffected individuals ->
Staging, Access routes, Egress routes

20
Q

Staging

A
  • initial emergency responders
  • uphill and upwind
  • avoid bottleneck- you need to get in and out
  • additional resources
  • establish staging area
  • location
  • size
21
Q

Medical Sector

A
  • size up
  • strategy
  • tactics
  • largest component of the incident command system (ICS) involving incident command and victim care
  • supervisor -> treatment, triage, transport
  • treatment -> support
  • transport -> hospital coordinator
22
Q

Initial Actions: Medical Sector

A
  • supervisor
  • request dedicated EMS staging officer
  • determine need for medical staff PPE
  • request safety officer for medical sector
23
Q

Medical Sector: Treatment Zones and Treatment Support

A
  • may need to establish treatment zones
  • requires the most medical personnel
  • established prior to 1st arriving victims
  • not hot zone preferably
  • treatment support:
  • provides medical supply support to teams
  • provides pharmaceutical support to teams
24
Q

Medical Sector: Transportation and Hospital Coordinator

A
  • determines victim transport needs
  • determines initial assessment of area hospital medical care capability
  • determines the need to activate national disaster medical system NDMS
  • Hospital Coordinator:
  • determines the need to activate NDMS (national disaster medical system)
  • NDMS- assist hospitals in incidents
  • coordinate patient allocation
  • hospital coordinator decides to deploy or not
25
Q

Standard Operating Procedure (SOP)

A
  • treatment
  • transportation
  • triage
  • establish support for these zones- early hospital assessment is crucial for control and NDMS
  • PPE upon arrival
26
Q

Incident Command System (ICS)

A
  • management system (not just a chart)
  • standardized management tool for meeting the demands of small or large emergency or nonemergency situations
  • “best practices” for emergency management -> standard
  • for planned events, natural disasters, acts of terrorism
  • part of the National Incident Management System (NIMS)
  • applies to all levels of government
  • incident commander
  • safety officer, liaison officer, public information officer
  • operations, planning, logistics, and finance/administration
  • flexible (not beyond standard) and scalable
27
Q

Components of National Incident Management System (NIMS)

A
  • resource management- before and after incidents, sharing resources, personnel, equipment, supplies, team, facilities
  • command and coordination- describes leadership roles, processes, and recommended organization structures for incident management at the operational and incident support levels
  • communications and information management- describes systems that help ensure incident personnel and decision makers have the information needed to make decisions
28
Q

NIMS: Incident Action Planning

A
  • guides incident management activities
  • record and communicate incident objectives, tactics, and assignments for operations and support
  • recommended for all incidents
  • not always written but important when:
  • its likely to extend beyond one operational period
  • becomes more complex
  • involves multiple jurisdictions or agencies
29
Q

NIMS: Managing Span of Control

A
  • number of subordinates that directly report to a supervisor
  • ensures effective incident management by enabling supervisors to direct and supervise subordinates and communicate and manage resources
  • 1 supervisor to 5 subordinates -> 1:5
  • redistribute when unmanageable
  • depends on distances between personnel and resources
30
Q

Unity of Command vs Unified Command

A
  • unity of command- clear up potential communication problems
  • unified command- -sometimes replaces incident command when there are multiple jurisdictions involved
  • unified command maintains unity of command by reporting to only 1 supervisor
31
Q

Formal Communication

A
  • follows lines of authority but information can be passed horizontally or vertically without restriction
  • must be used when:
  • receiving and giving work assignments
  • requesting support or resources
  • reporting progress of tasks
  • other information exchange that is passed horizontally or vertically without restriction is informal communication
32
Q

Informal Communication

A
  • used to exchange incident or event information only
  • NOT used for formal requests for resources of tasking work assignments -> this is formal communication
  • ex. communications unit leader contacts resources unit leader to determine # of people requiring communication devices
33
Q

ICS structure

A
  • incident commander
  • command staff- liaison officer (coordinates with reps from cooperating agencies), public information officer (interface with public and media), safety officer
  • general staff- operations section chief, planning section chief, logistics section chief, finance/administration section chief
  • public information officer has no assistants
34
Q

Incident Commander

A
  • responsible for incident activities, including strategies and tactics and the ordering and the release of resources
  • has overall authority for conducting incident operations and is responsible for the management of all incident operations at the incident site
  • scope of authority is derived from existing law, agency policy, procedures, or through delegation of authority from agency administrator or elected official
35
Q

Operation Section

A
  • responsible for all tactical operations at the incident
  • includes:
  • branch- functional, geographical, or jurisdictional responsibility for major part of incident operations
  • division- responsible for operations within a define geographical area
  • group- divide the incident into functional areas of operation
  • unit-responsible for a specific incident planning, logistics, or finance activity
  • task force- group of resources with common communications and a leader that may be preestablished and sent to an incident or formed at an incident
  • strike team/resource team- specified combination of the same kind and type of resources, with common communications and a leader
  • single resource- an person, piece of equipment and its personnel complement, or an established crew with an identified work supervisor that can be used on an incident
36
Q

Planning Section

A
  • responsible for collection, evaluation, and dissemination of information related to the incident, and for the preparation and documentation of the incident action plan
  • maintains information on current and forecasted situations and status of resources assigned to the incident
  • includes:
  • situation
  • resources
  • documentation
  • demobilization units
  • technical specialists
37
Q

Mutual Aid Topics

A
  • reimbursement- either paid or unpaid (based on providing reciprocal services
  • recognition of licensure and certification- guidelines to ensure recognition of licensure across geopolitical boundaries
  • procedures for mobilization (request, dispatch, and response)- specific procedures to request and dispatch resources through mutual aid
  • protocol for voice and data interoperability- protocols for how different communications and IT systems share information
  • protocol for resource management- standard templates for packaging resources based on NIMS resource typing definitions and/or local inventory systems
38
Q

Mutual Aid at all Levels

A
  • used at all levels of government
  • local jurisdiction participate in mutual aid through agreements with neighboring jurisdictions
  • states can participate in mutual aid through Emergency Management Assistance Compact (EMAC)
  • federal agencies offer mutual aid to each other and to states, tribes, and territories under the National Response Framework (NRF)
39
Q

Effective Incident Objectives

A
  • must be:
  • specific and state what to accomplish
  • measurable and include a standard and timeframe
  • attainable and reasonable
  • in accordance with the incident commanders’ authorities
  • evaluated to determine effectiveness of strategies and tactics
  • ex. establish a controlled perimeter around the incident within 45 minutes (by 6 PM)
40
Q

Evaluation Elements for Triage and Countermeasures (VIDEO)

A
  • laboratory testing
  • radiation survey with detection equipment
  • focused radiation exposure history including assessment for adverse health effects
  • measures presence, type, and dose of internal radiation
  • internal exposure is apparent when a spot continues to be contaminated after multiple decontaminations
  • whole body counting- technology to measure internal exposure
  • serial lymphocyte count (low indicates radiation) and cytogenetic biodosimetry measure the amount of radiation dose absorbed
  • prodromal symptoms, lab results, and injury status determine resource management
  • severe prodromal symptoms -> fever, shock, LOC, nausea, diarrhea -> do not allocate resources bc probably will die
  • potassium iodide (prevent incorporation into thyroid), DTPA, and prussian blue insoluble (excreted radiation out), and colony stimulating factor (regeneration of bone marrow) -> medications that help rid of internal radiation
  • Radiation survey w/ detection equipment -> Completed ASAP.
41
Q

Surviving Nuclear Attack (Irwin Redlener) Video

A
  • 1949- Russia becomes a nuclear power
  • Totally dependent on (M.A.D.) → Mutually assured destruction -> If you attack we both die
  • not enough bomb shelter, treatment, providers, resources
  • 1991- threat for war gone but single event is still in question
  • 4 components to nuclear threat: Global nuclear weapons is not secure and material is available, Global stockpile of HEU; 1,300 - 2,100 metric tons , resources on how to build nuclear weapons, Evil do-ers are organized, dedicated, stateless, and retaliation proof.
  • You have 10-20 minutes to get away if you survived a nuclear attack
  • Shelter for 48-72 hrs

Emergency Response to Hazardous Material and Terrorism (18 decks)

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