Midterm Flashcards
1
Q
types of decontamination
A
- gross or mass- hose -> consists of the initial removal of significant contamination and serves to reduce exposure levels of the general public and emergency responders who may become contaminated during a weapons of mass destruction (WMD) incident
- personal- shower -> performed to maintain personal hygiene and often used instead of gross decontamination; usually performed in portable or mobile shower trailers or vehicles; the use of soap and water or some other type of solution is involved
- spot - performed to remove possible contaminants from an individual who has come into contact with bodily fluids from another person
- emergency- performed in the event of suit failure, breach of downrange personnel, or injury -> special process for emergency team/staff
2
Q
exclusion zone
A
- red zone
- incident site
- area of maximum hazard
- access is tightly controlled
- rescue, containment, and sampling occur here
- biological agent is located here and is the area of maximum hazard
- access is tightly controlled at either a single entry point or, in the case of a large incident, multiple controlled-entry points
- Entry is restricted to essential personnel who are trained at the appropriate level and who use appropriate PPE
3
Q
contamination reduction zone
A
- transition area
- located in clean area, upwind side of incident
- prevents contaminants from spreading
- secured area
- decontamination occurs here
- set up in a clean area on the upwind side of the exclusion zone
- help prevents contaminants from spreading to unaffected or clean areas
- secured area because, once decontamination starts, it will become contaminated. Usually, a HazMat team will be responsible for setting up and performing decontamination.
4
Q
support zone
A
- planning and staging area for emergency functions
- located beyond the range of potential contamination
- public is excluded
- contains command post and treatment center
- The support zone is the area beyond the range of potential contamination
- The support zone is a planning and staging area.
- The command post, treatment area for decontaminated patients, and rehabilitation area (for emergency response personnel) are established in the support zone.
- PPE and respiratory protection are not required.
- The public is excluded from this area to allow emergency response agencies room to function
5
Q
Class A and B
A
Self containing breathing apparatus (SCBA) or supplied air respirator (SAR) -class A and B have the same respiratory protection and different skin protection
6
Q
Class C
A
Air purifying respiratory (APR) or powdered air purifying respirator (PAPR)
- class C has the same skin protection as B
- contaminant is known
7
Q
endemic
A
- disease or agent that is present in a community at all times but at a relatively low frequency
- you can have it in one place and not expect it in another place
- ex. Bacillus anthracis is endemic in the United States, particularly in the Midwest, West, Texas, and Oklahoma. Livestock or other herbivores are susceptible to infection from consuming contaminated soil or feed.
8
Q
outbreak
A
- a sudden rise in the incidence of a disease, such as when two or more persons who were exposed to a common source are experiencing a similar illness.
- ex. An outbreak may result from an increase in measles in unvaccinated children. An outbreak may involve as few as two cases, such as when an unexpected illness such as plague occurs.
9
Q
epidemic
A
- An epidemic is an outbreak that quickly spreads to many people within a population, resulting in more cases of a disease than would be expected in a community or region during a given time period.
- In epidemics of agents with high mortality, patients either die rapidly or recover, and survivors generally develop some type of immunity.
- ex. SARS is a viral respiratory illness caused by a coronavirus called SARS associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. The epidemic quickly spread to more than two dozen countries in North America, South America, Europe, and Asia before it was contained. This epidemic took the lives of nearly 800 people worldwide. (CDC 2004)
10
Q
disease scale
A
- baseline
- endemic
- outbreak
- epidemic
- pandemic
11
Q
biocrime
A
- an unlawful act in which an individual or group uses biological agents intentionally to cause illness or death in a target for personal reasons (such as revenge or financial gain) and lacks an ideological objective
- ex. In 1996, a hospital laboratory employee contaminated pastries with Shigella dysenteriae and left them in an employee break room. Twelve laboratory workers ate the contaminated pastries and developed acute diarrheal illness. (Dembek et al. 2007)
- usually not trying to impact someone greatly
- may be smaller scale
12
Q
agroterrorism
A
- the intentional use of biological agents against agricultural and food supply industries
- In 1985, Mexican contract workers deliberately spread screwworm (Cochliomyia hominivorax) among livestock in Mexico close to the border with the United States (Carus 2002). In 2011, a man was arrested for threatening to spread foot and mouth disease in the United States and Great Britain if not paid four million US dollars. He was convicted for terrorist activity and money laundering.
13
Q
HAZWOPER
A
Hazardous Waste Operations and Emergency Response
-1990
14
Q
routes of exposure
A
- injection
- inhalation- 1-5 microns
- absorption
- ingestion
15
Q
disease transmission
A
- droplet
- contact
- airborne
16
Q
anthrax
A
-bacteria
17
Q
plague
A
bacteria
18
Q
smallpox
A
virus
19
Q
influenza
A
virus
20
Q
toxins
A
botulinum toxin and ricin from castor beans
-poison ivy
21
Q
disseminators
A
- paint sprayer
- trailer sprayer
- backpack sprayer
- rose duster
- two gallon garden sprayer
22
Q
point source delivery
A
- single source dissemination
- depends on wind direction and speed
- mostly used on small , discrete targets
23
Q
line source delivery
A
- product sprayed perpendicularly to the wind
- target can be many kilometers downwind
- line source delivery can be used on much larger targets
24
Q
START
A
simple triage and rapid treatment
- LOC
- capillary refill
- respiratory rate
- normally the first person on scene is the incident commander (until someone else comes)
- 30 secs
- telling the people to move to a certain area -> separates all the wounded that are able to understand and walk
- black tag- expectant, dead or expected to die, not breathing
- red tag- immediate patients, life threatening injury, priority 1
- yellow tag- serious non-life threatening injury, priority 2, urgent
- green tag- walking wounded, priority 3, delayed
- white tag- involved, in the vicinity, not hurt
25
Q
isolation perimeter
A
during a biological incident response, a designated crowd control line surrounding the incident; a line between the general public and the outside edge of the support zone
26
Q
exposure + toxicity =
A
health hazard
27
Q
Superfund amendment and reauthorization act (SARA)- 1986
A
- in the past we knew hazardous things were bad but this act made OSHA responsible for it
- hazardous waste operations and emergency response (HaxWOPER)- 1990
28
Q
BLEVE
A
boiling liquid expanding vapor explosion
29
Q
concentration x time =
A
dose
30
Q
ionizing radiation
A
- high frequency radiation
- not balances and shedding particles
- excited and sending particles out -> dangerous to us
- radioactive waste
- x-rays
- ultraviolet radiation
- visible light
- infrared devices
31
Q
non-iodizing radiation
A
- low frequency
- power lines
- radio and TV waves
- cell phones
- microwaves
32
Q
alpha, beta, gamma
A
- alpha- stops when it hits the skin
- beta- goes through the skin, high frequency, more dangerous than alpha
- gamma- very strong, very fast, very penetrative, lead shielding -> need something more substantial to block this
33
Q
protection
A
- time
- distance
- shielding
34
Q
decontamination procedure
A
- blot
- strip (80%)
- flush
- cover
35
Q
choking agent
A
- chlorine gas
- prevent breathing
- pulmonary edema - fluid in lungs
36
Q
blister agents
A
- causes blisters
- can be in the airways too
- eyes can be affected
- can last 2 hours
37
Q
blood agents
A
- cyanide- organ cells cant take up the oxygen
- affects the way the body can use oxygen
- affects the hemoglobin -> cant pick up oxygen
- CO poisoning - hemoglobin cant pick up oxygen
- hypoxia leading to:
- AMS
- seizures
- respiratory arrest
- cardiac arrest
- can spread through fire
- hydrogen cyanide
- oder: bitter almonds
38
Q
pathophysiology of nerve agents
A
- agent binds with ACh
- ex. sarin binds with ACh constantly
- Acetylcholine releases constantly -> overstimulation -> Seizures, secretion of fluids
39
Q
tokyo subway attack
A
- leader created his own religion
- when you joined you sign off your wealth -> rich
- experiments with nerve agents
- used sarin gas in bags in the subway
- use umbrellas to puncture the bags
- 13 people died
- this disrupts the economy, the public, in mass amounts
- so easily available and yet instills fear, death, pain
- march 20, 1995
40
Q
treatment of nerve agents
A
- decontamination
- ventilation
- administration of antidotes- atropine, pralidoxime
- supportive therapy
41
Q
nasal cannula
A
- 1-6 LPM (liters per minute)
- delivers 24-40% oxygen
42
Q
nonrebreather mask
A
- 8-15 LPM
- delivers 90% of oxygen
- more difficulty of breathing
43
Q
bag valve mask
A
- 15 LPM
- delivers up to 100% oxygen
- when someone cannot ventilate themselves
- lung size depends on height
- issue comes in when you start over inflating -> pneumothorax
- meant to be used by two people- bc cramping
- add a filter to decrease spread of germs
- put on mask then attach bag
44
Q
peep valve
A
- red cap on a BVM
- increases pressure so when you squeeze the bag it keeps pressure within the system (if you have a good seal)
- when you have built up fluid the alveoli will open up and STAY open*
- helps with bringing oxygen in when fluid is present
- o2 doesn’t move easily in fluid but CO2 does
45
Q
igels
A
you dont need to look into the airway to be intubate
46
Q
autoinjectors
A
- atropine/pralidoxime combination- injects at same time
- atropine- inject first
- pralidoxime- inject second
47
Q
atropine
A
- anticholinergic -> blocks acetylcholine receptors
- chemicals have nothing to bind to
- initial dose- 2 mg
- muscle relaxer
- mydriasis
- for people with hypersalivation or large amount of fluids
- comes from atropa belladonna (Nightshade)
- onset: Minutes after
- IV administration
- Duration: 3-5 minutes
48
Q
pralidoxime
A
- 600 mg dosage
- attaches to nerve agent receptor
- doesnt allow it to bind to ACh
- nerve agent has nothing to attach to
- less effective if aging present (bond between ACh and nerve agent is strong and hardened)
49
Q
diazepam
A
- valium
- benzodiazepine
- 10mg IV/IM- dosage
- seizure history
- anticonvulsant, hypnotic
- motor cortex- planning, control and voluntary movement
- onset- (IV 1-5min)
- onset- IM 15-30 min
- (PR) Varied
- Duration: (IV) 15 min-1 hour; (IM) 15 min-1 hour; (PR) Peak concentration 1.5 hour
50
Q
midazolam
A
- aka Versed- before a procedure or anesthesia to cause drowsiness, decrease anxiety, and cause forgetfulness of the surgery or procedure.
- Class: Benzodiazepine
- Initial dose: 1-2 mg IVP or 5 mg IM/IN
- Anticonvulsant
51
Q
cyanokits
A
- cyanide poisoning
- block ability to use oxygen
- form a vitamin B12
- binds to cyanide to create cyanocobalamin -> not toxic to the body
- 5g max of 10 g over 15 min IV
52
Q
methods of dissemination
A
- ventilation systems
- misting, aerosolizing devices, or sprayers
- passive release (container of chemical left open)
- bombs, mines, or other explosive devices
- sabotage of plants or vehicles containing chemicals
- introduction of toxins in the food and water supply
- improvised chemical devices that combine readily available chemicals to produce a dangerous chemical
53
Q
mustard gas
A
blister agents
- effects:
- eyes
- lungs
- skin
- 2-24 hours onset
- odor of garlic
54
Q
nerve agents
A
- nerve agents affect the nervous system
- do not occur naturally
- the first know nerve agent was created in the 1930s- tabun (GA)
- new agents known as g-agents were stockpile by Germany during WW2- sarin (GB) and Soman (GD)
- 1960s- more focus on creating their potency and environmental persistence
- creation of the v-agents
- VX more potent than Sarin
55
Q
tabun (GA)
A
- persistent
- evaporates in 1-2 days
56
Q
soman (GD)
A
- non persistent
- evaporates rapidly
57
Q
sarin (GB)
A
- non persistent
- evaporates rapidly
58
Q
v agent (VX)
A
- persistent
- remains for weeks or longer
59
Q
national response framework (NRF)
A
- guide on response to major disasters
- framework
- scale it to small or large incidents
- scope is domestic incident response
- immediate actions to save lives, protect property and the environment, and meet basic human needs
- The execution of emergency plans and actions to support short-term recovery
- ALWAYS IN AFFECT
- elements can be implemented as needed on a scalable, flexible basis to improve response
- living document
- needs support from government BUT also private business to have a successful outcome
60
Q
NRFs applicability
A
- applies to everyone
- state, government, companies
- apples to all federal dept and agencies that may be requested to provide assistance in Catastrophic Incidents including:
- Major disasters, emergencies, and terrorist incidents/threat
- Other events requiring Department of Homeland Security (DHS) assistance with national coordination
61
Q
response doctrine
A
-response doctrine define basic roles, responsibilities and operational concepts for response across all levels of government, Non Governmental Organizations (NGOs) and the private sector
62
Q
5 key principles of NRF
A
- engaged partnership
- tiered response- handle at the lowest level and go from there -> can come all the way back around to low level (bell curve)
- scalable, flexible, and adaptable operational capabilities
- unity of effort through unified command (use common lang)
- readiness to act- best care possible through preparedness
- handle at the lowest level and go from there
- needs to be scaled (may start small and get bigger)
63
Q
federal response goals of NRF
A
- support the states to:
- ensure basic human needs are met
- Restore critical infrastructure
- Restore essential government services
- Roles:
- provide resources and capabilities to support the state response
- serve as first responders for incidents involving primary federal jurisdiction or authorities
- Work with private sector and nongovernmental organizations who support response efforts
64
Q
federal response key players
A
- president leads the federal government response
- secretary of Homeland Security is the principal federal official for domestic incident management consistent with HSPD-5
- The FEMA Administrator is responsible of the preparation for, protection against, response to, and recovery from all-hazards incidents
- When DHS coordination is NOT required, federal agencies may provide assistance consistent with their authorities
- attorney general- serves as the chief law enforcement officer
- secretary of defense- approves requests for military support
- secretary of state- coordinates international response
- director of national intelligence- oversees national intelligence
65
Q
emergency management
A
- the people who create the framework for responding to incidents
- the managerial function charged with creating the framework within which communities reduce vulnerability to hazards, emergencies and cope with disasters.
- comprehensive, risk-drive, integrated, coordinated, progressive, collaborative, flexible, professional
- creates safer communities that can cope with disaster
- comprehensive
- risk-driven- emergency managers need to ensure unity of effort in order to assess situations and use a risk management approach to respond to things
- integrated- networking with private and public entities
- coordinated
- progressive- anticipate disasters
- collaborative
- flexible- the plan needs to change with the situation
- professional- use science and evidence based decisions
66
Q
integrated management system
A
- adapted by emergency managers in 1980s
- well coordination and networked
- big picture approach
- all threats/hazards approach:
- direction
- control
- coordination
- whole community preparedness
67
Q
why integration
A
-Existing networks, linkages, and partnerships.
-Communication across organizational and jurisdictional boundaries,
enabling all emergency functions to communicate with each other.
-Creative thinking about resource shortfalls.
-Coordinated testing, training, and exercising.
-Improved ability to see the “big picture” for simultaneous responses
68
Q
The Stafford Act
A
- Covers all hazards, including natural disasters and terrorist events.
- Provides primary authority for the Federal Government to respond to disasters and emergencies.
- Gives FEMA responsibility for coordinating Government response efforts.
- The President’s authority is delegated to FEMA through separate mechanisms.
- Describes the programs and processes by which the Federal Government provides disaster and emergency assistance to State and local governments, tribal nations, eligible private nonprofit organizations, and individuals affected by a declared major disaster or emergency
- presidential disaster declaration triggers financial help for the state or person -> any disaster or emergency
69
Q
executive order 12127 (1979)
A
-the order that established FEMA
70
Q
under the stafford act the president can designate any disaster as….
A
-an emergency
-or major disaster
-In certain circumstances, the President may declare an “emergency”
unilaterally, but may only declare a “major disaster” at the request of a
Governor or tribal Chief Executive who certifies the State or tribal
government and affected local governments are overwhelmed
71
Q
emergency vs major disaster
A
- emergency- federal assistance for the local and state level
- major disaster- natural disaster beyond the local and state level
72
Q
major disaster declaration process
A
- joint preliminary damage assessment (PDA)- how bad is the damage
- formal governors request for assistance
- FEMA recommendation
- presidential declaration
73
Q
FEMA mission and goals
A
- Federal Emergency Management Agency
- 1979.
- became part of the Department of Homeland Security (DHS) in 2003.
- mission is to support the Whole Community to ensure that as a Nation we work together to build, sustain, and improve our capability to prepare for, prevent, protect against, respond to, recover from, and mitigate all hazards.
- leads and supports the Nation in a risk-based, comprehensive emergency management system of preparedness that includes prevention, protection, response, recovery, and mitigation
- Coordinate the Federal resources in case of Federal emergency or disaster
- Provide disaster assistance to individuals and communities
- FEMA is not responsible (they assist) -> the state is responsible*
74
Q
national response coordination center (NRCC)
A
- Monitors potential or developing incidents
- Supports the efforts of regional and field components
- Initiates mission assignments or reimbursable agreements to activate other federal departments and agencies
- Activates and deploys national-level specialized teams
75
Q
The Joint Field Office (JFO)
A
- Is the primary federal incident management field structure
- Provides a central location for the coordination of response and recovery efforts
- established locally
- facilitates the way FEMA responds to a location -> facilitates federal response to local area
76
Q
phases of emergency management
A
- mitigation- effort to reduce loss of life and property by lessening the impact of disasters and emergencies
- response
- recovery
- preparedness
77
Q
mitigation
A
-The effort to reduce loss of life and property by lessening the impact of disasters and emergencies
-Structural and non-structural measures (observation a shelf may fall in a disaster and cause harm)
-Comprehensive plan -> Period prior to an imminent or actual
hazard (not after…after = a response)
-1. organize the planning process and response
-2. assess risks and capabilities
-.3 develop of mitigation strategy
-4. adopt and implement the plan
78
Q
preparedness
A
- continuous cycle
- planning, organizing, training, exercising, evaluate/improve
- reevaluate plans to make sure they work
79
Q
response
A
- actual hardware
- addressing the issue
- coordination and management of resources
- personnel
- equipment
- safety
- the response phase is a is a reaction to the occurrence of a catastrophic disaster or emergency.
80
Q
recovery
A
-national disaster recovery framework (a book)
-overall process by which communities can capitalize on opportunities to rebuild stronger, smarter, and safer
-not everybody recovers
-mitigation makes recovery more likely (being more prepared)
-Recovery is focused on a timely restoration, strengthening and
revitalization of:
-Infrastructure
-Housing
-Sustainable economy
-Health, social, cultural, historic and environmental fabric of
communities affected by a catastrophic incident
81
Q
mass casualty incidents (MCI)
A
- Any incident causing injury and/or death of a number of patients beyond what medical care resources can routinely manage within a specific geographic area.
- An MCI may be the result of any number of events including natural disaster, human error, accident, or terrorist activity.
- more people injured than one EMS unit can support
82
Q
MCI plan
A
- The goal of the MCI plan is to ensure rapid medical assistance is received by victims and to provide this assistance through adequate and coordinated efforts that will minimize loss of life, disabling injuries, and human suffering
- saving lives -> maximize
- how do we determine who to save and who not to save -> who is the most likely to survive -> triage
83
Q
LCAN
A
- first thing you do when you get to a scene
- information you need to relay
- im at stony brook, there is a school bus crash, im going to start triage, i need ambulances
- L – Location
- C – Condition
- A – Actions
- N – Needs
84
Q
pulse but no breath
A
black tag
85
Q
which organizations are involved in HazMat
A
- US environmental protection agency (EPA)
- US occupational safety and health administration (OSHA)
- US department of transportation (DOT)
- US nuclear regulatory commission (NRC)
86
Q
Federal Aviation Administration (FAA): hazardous materials safety program
A
- regulatory body
- protects the airline industry
- heavily regulates chemical transportation via plane
- public transportation
- airline industry is a zero fail industry -> cannot have any failure because people will die
87
Q
classes
A
- class 1- explosives- orange
- class 2- gasses
- class 3- liquid
- class 4- solid
- class 5- oxidizers / organic peroxides - yellow
- class 6- poison/infectious material
- class 7- radioactive
- class 8- corrosives
- class 9- miscellaneous
88
Q
OSHA HMIS
A
-hazardous material identification guide
-The HMIS Color Bar is similar to the fire diamond, created by the National Fire Protection Association (NFPA)
-numerical hazard rating that incorporates the use of labels with color coded bars
-Before 2002 the fire diamond and the color bar had sections colored blue, red, white, and yellow.
-After April 2002, with the release of HMIS III, yellow in the color bar (which stood for reactivity) was replaced by orange, standing
for physical hazard.
89
Q
level of incident
A
- level 1- local
- level 2- major incident
- level 3- disaster
