Prepping communities: Explosives Flashcards

1
Q

What are some newer explosive devices?

A

Enhanced blast weapons, improvised explosive devices

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2
Q

What is an explosive event?

A

Conversion of a solid or liquid explosive material into gas causing energy release

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3
Q

What is the degree of blast injury based on?

A

Size of charge, distance, surrounding environment

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4
Q

What occurs when a blast is reflected by a solid surface?

A

Magnified many times

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5
Q

What should be done in detection during an explosive event?

A

Not typical or predictable

Used mostly by terrorists

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6
Q

What does the incident commander do when there is an explosive event?

A

Should manage traumatic and explosive events like any other disaster

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7
Q

What should be done in security and safety in an explosive event?

A

Scene must be secured and perimeter established, safety hazards must be relayed to incident commander

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8
Q

What types of hazards should be assessed?

A

Downed power lines, fire, debris, blood, structural instability

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9
Q

Who must be communicated with is the support part of an explosive event?

A

The trauma and burn team/center

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10
Q

What types of injuries can you see from a blast?

A

Primary, secondary, tertiary, quaternary, quinary

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11
Q

What are the characteristics to a primary blast injury?

A

Unique to explosions with high explosives, causes damage to air filled organs
Blast lung, TM rupture in ear, abd injury, brain injury

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12
Q

What will a pressure differential show in a primary blast injury?

A

Tear is alveolar walls, disruption of alveolar-capillary interface

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13
Q

What are the signs of a primary blast injury

A

Difficulty to complete a sentence in one breath, rapid/shallow respiration, poor chest wall expansion, dec breath sounds, wheezing/hemoptysis, cutaneous emphysema

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14
Q

What would the x-ray of someone suffering from over-pressurized lung from a primary blast injury look like?

A

“Butterfly” pattern

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15
Q

What can occur from a system air embolism from a primary blast injury?

A

Vascular obstruction, chest pain, focal neurological deficits, blindness, tongue blanching, cutis marmorata
Most related to sudden deaths in the first hour

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16
Q

What is the treatment for a pulmonary blast injury (primary)?

A

Spontaneous respiration preferred, supplemental O2, airway pressure must be more than vascular, lung isolation, unilateral intubation

17
Q

What is a secondary blast injury?

A

Penetrating trauma caused by accelerations of shrapnel or blast debris

18
Q

What are some characteristics of secondary blast injuries?

A

Possible small entrance wound and requires a detailed exam

19
Q

What is a tertiary blast injury?

A

Displacement of body or structural collapse

20
Q

Describe compartment syndrome.

A

Ecchymosis, tenderness, swelling, pain with passive motion, hypotension and shock, numbness and flaccid paralysis, may have loss of distal pulses

21
Q

Describe crush syndrome.

A

Traumatic rhabdomyolysis, release intracellular toxins, potentially toxic when circulated through blood

22
Q

How is crush syndrome treated?

A

Treat hyperkalemia, treat w/ iV glucose and insulin is cardiotoxic, beta-2 agonist, exchange resin. dialysis
Early, agressive treatment, IV normal saline, refer/perform fasciotomy if there is compartment syndrome

23
Q

What is a quaternary blast injury?

A

All explosions related the burns and burn related injuries, environmental toxins, exacerbation of underlying illness

24
Q

What is a quinary blast injury?

A

Purposeful addition of agents; chemical, biological, nuclear

25
Q

What should you be aware of during triage in a blast injury?

A

Tympanic membrane rupture - they can’t hear you

CT pts of head, thorax, abs should go to OR

26
Q

What are the treatment ABCs?

A

Airway (burns and hemorrhage), breathing (pneumothorax), and circulation (possible tourniquet use)

27
Q

What is the parkland formula?

A

Adults: 2-4 mLs LR x kg body weight X TBSA; first half in 8 hours rest over 16 hrs
Less than 10: 3-4 mls LR x kg body weight x TBSA

28
Q

In treatment ABCs, there is a D which stands for…

A

Disability; needs neurological exam, consider psychological impact of disaster

29
Q

In treatment ABCs, the E stands for…

A

Exposure, elimination, environmental control;

Allow for exam, hypothermia, warm IV fluids, removal from outside

30
Q

What should be done for evac in an explosive event?

A

Benefit most from rapid, orderly scene, balance flow of pts

31
Q

What occurs in the recovery stage after an explosive event?

A

Starts when casualties have been removed, analyze post-incident