Prev Med 2 Flashcards
1
Q
What is a raised frame to keep out water?
A
Coaming
2
Q
What is the total process the distilling plant forms, including evaporation and condensation?
A
Distillation
3
Q
What is the Chlorine available (after demand is met) in the forms of Hupochlorous acid and Haypchloriet ions?
A
Free Available Chlorine
4
Q
A unit of length. One miilionth of a meter?
A
Micron
5
Q
Treatment device applied to a single tap used for the purpose of reducing contaminants in drinking water at that tap
A
Point of Use
6
Q
Water that is suitable for human consumption, bathing, laundry, personal hygiene
A
Potable Water
7
Q
The Reverse of the natural osmosis achieved by external application of sufficient reverse pressure to cause the solvent to flow in its unnatural direction
A
Reverse Osmosis
8
Q
- Group of closely related, mostly harmless bacteria that live in soil as well as the guts of animals
- Presence or abscence of this bacteria is the drinking water standard
A
Total Coliform
9
Q
Type of fecal coliform bacteria commonly found in the intestines of animals and humans.
The presence of this bacteria in water is a strong indication of recent sewage or animal contamination
A
E. Coli
10
Q
Responsible for the shipboard potable water systems, including treatment facilities and processes to assure that safe drinking water is available at all times
A
Naval Sea Systems Command
11
Q
Responsible for establishing and promulgating health standards for water quality afloat
A
Chief, BUMED
12
Q
Responsible for promulgating instructions for ship-to-shore potable water connections and providing potable water from an approved source when the ship is berthed at a naval facility
A
Naval Facilities Engineering Command
13
Q
Responsible for issuing the necessary implementing directives to ensure that adequate water sanitation standards are provided and enforced in each ship within the command
A
Area, Fleet and Subordinate Commanders
14
Q
Responsible for promulgating a water sanitation bill to ensure procedures are followed for:
- Receipt
- Transfer
- Treatment
- Storage and Distribution
- Surveillance
A
Commanding Officer
15
Q
Responsible to the Commanding Officer for implementing the requirements of NAVSEASYSCOM:
- Supply and Treatment of Potable Water
- Recieve
- Store
- Distribute
- Produce
- Treat
A
Engineering Department
16
Q
Responsible for conducting a medical surveillance program of the potable water system including collection of water samples for:
- Bacteriological (BACTI) Testing
- Daily Halogen Testing
A
Medical Department Representative
17
Q
How many gallons of water per man per day is specified by NAVSEASYSCOM for new ships?
A
50 gallons
18
Q
What is the minimum gallons of water per man per day that a ship has to provide?
A
No less than 2 gallons/man/day
19
Q
Which 2 systems are able to produce potable water from bacteriology contaminater seawater?
A
- Distillation
2. Reverse Osmosis
20
Q
Where are U.S. Navy vessels able to receive shore-to-ship potable water?
A
- EPA approved public water system
- U.S. Military Sources including establishments under the cognizance of:
- British Royal Navy
- Canadian Forces
- Royal Australian Navy
- Other OCONUS locations may be obtained from U.S. Representatives ashore or NEPMU
21
Q
If the ship is receving shore-to-ship delivery from an unapproved source, what is the minimum PPM?
A
The water has to be treated to a minimum of 2.0 PPM
22
Q
What are the 3 types of Distillation Plants?
A
- Steam Distilling Plants
- Waste Heat Distilling Plant
- Vapor Compression Type
23
Q
What are the 2 types of Reverse Osmosis Plants?
A
- Single Pass
2. Triple Pass
24
Q
What does a single pass, Reverse Osmosis plant require when preparing potable water?
A
Additional disinfection such as chlorination or bromination is required
25
What does a triple pass, Reverse Osmosis plant require when preparing potable water?
Nothing. Additional disinfection is not required
26
What are the 3 types of Water Level Measurement Devices?
1. Automatic Level Gaugesn (Direct Read Guage)
2. Petcocks ( Valves at various intervals)
3. Sounding Tubes (Some carry a measuring rod)
27
Other types of Sounding tubes require the water to be disinfected to how many PPM?
100 PPM FAC for 2 Mins
28
What temp should the hot water be at the tap?
120 degrees F
29
What are the requirements for Potable Water Hose?
1. Approved for potable water use
2. Examined Routinely
3. Removed from use when cracks develop in the lining or leaks occur
30
How should potable water lines be labeled?
"Potable Water Only" in 1 inch high letters every 10 feet
31
How should risers be labeled?
"Potable Water Only" in 1/4 inch high letters
| Valves and valve handles should be painted Dark Blue
32
What happens to water that is being transfered to the ship is not within normal standards?
1. If not tested at the minimum 0.2, the ship must boost the halogen residual to the appropriate level
2. If halogen residual is within standards, no further treatment is required
33
What happens if the potable water hose is accidentally dropped in the harbor water?
It must be disinfected
34
What is the process for accepting water that is of doubtful quality?
1. Commanding Officer should be notified
2. The water should be tested and examined throughly
3. The minimum halogen residual should be 2.0 PPM
35
How should the ship prepare for a ship to shore water transfer?
1. Remove shore cap and flush pier side potable water outlet for 15-30 seconds
2. Immerse outlet and rinse fitting in solution containing 100 ppm FAC for at least 2 mins
3. Flush water to waste for 15-30 seconds
36
What is the purpose for checking the halogen residual of potable water?
Quick indication of water that may have been improperly treated or handled
37
Why does medical conduct bacteriological testing on water?
To assess adequacy of disinfection process
38
What is the standard for the Halogen residual aboard ship?
1. Ships with large potable water distribution, trace level in the distal ends of the distribution system
2. Unapproved source: 2.0 at point of consumption
39
How often should medical conduct water checks?
Daily
40
How many weekly water samples should be taken?
1. ships with 400 personnel or less: no less than 4 samples
2. Ships with over 400 to 800 personnel: requires 8 samples
3. More than 800 requires 12 samples
41
How often should the emergency potable water tank should be tested?
Monthly
42
What does the DPD (Diethly-p-phenylene diamine) test for?
1. DPD #1 tests for FAC or TBR
| 2. DPD # 4 tests for chloramines (total chlorine) residual
43
How accurate does the color comparator have to be?
+ or - 10 percent
44
How accurate does the Portable spectrophotometer have to be?
+ or - 2 percent
45
What are the 2 approved methods for bacteriological testing?
1. Colilert
| 2. Colisure
46
When using the Colilert test, what color does it turn for a postive test?
1. Yellow (+) total coliform
| 2. Fluorescent Yellow (+) fecal colifrom (e-coli)
47
What color does the Colisure turn when used for testing?
1. Yellow: Negative
2. Magenta: (+) total Coliform
3. Fluorescent light blue: (+) fecal colifrom
4. Postive and negative control should be conducted on the day of bacteriological testing
48
When using the Chlorine Dosage Calculator, what are the 2 strengths and types of chlorine that you can choose from?
1. 5% Sodium Hypochlorite
2. 10% Sodium Hypochlorite
3. 65-70% Calcium Hypochlorite
49
What is the required Halogen residuals for disinfecting potable water afloat?
1. From an approved source, 0.2 ppm FAC/TBR after 30 minute contact time
2. From an unapproved Source: 2.0 ppm FAC/TBR after 30 minute contact time
50
What is method 1 for disinfecting the potable water system?
Add chlorine to achieve 10 ppm FAC through the tank
51
What is method 2 for disinfecting the potable water system?
Apply directly, 200 PPM FAC to all tank surfaces for 30 minutes
52
What is method 3 for disinfecting the potable water system?
1. Fill 5% of tank volume with 50 PPM FAC Solution
| 2. Hold solution for 6 hours
53
What is the Chlorination Method for controlling the taste and odor in potable water?
1. Chlorinate to 5.0 PPM FAC
| 2. Distribute at 2.0 PPM FAC
54
When using Steam to control the taste and odor in potable water who provides the approval?
NAVSEASYSCOM
55
What are the storage requirements for HTH?
1. No more than 48, 6 ounce bottles
2. Stored in a Metal Locker
3. Drill three 1/4 inch holes in the bottom for ventilation of chlorine gas
56
What is the minimum supply of HTH storage?
No more than a 7 day supply
57
How should HTH lockers be labeled?
"Hazardous Material, Calcium hypochlorite" with red letters on a white background
58
What is the 1st element of a water sanitation bill?
Posted conspicuoulsy in areas where potable water and associated materials are: Processed, Treated, Stored
59
What is the 2nd element of a water sanitation bill?
Should consist of the following:
1. Responsibility
2. Sources
3. Connection procedures for:
a. Ship to Shore
b. Ship to Ship
60
What are the remaining elements of a water sanitation bill?
```
Potable Water Hoses
Storage Tanks
Disinfection Procedures
Halogen Residual Testing
Bacteriological Testing
Temperature, PH and salinity testing
Disinfection of Tanks and Distribution System
Distribution System
Records
```
61
What is Medical's responsibility for Managing CHT and Waste Water Mgmt?
1. Conduct Inspections
2. Indoctrination of personnel on potential health hazards
3. Peroiodic Training
62
What 3 ways does the CHT system operate?
1. Restricted Waters
2. At Sea
3. In Port
63
What are the functional elements of the CHT System?
1. Collection Element
2. Hold Element
3. Transfer Element
64
How big are the tanks for the holding element?
Sized for up to a 12 hour holding period
65
How are the sewage pumps activated?
1. Manual Mode
| 2. Automatic Mode
66
How does the automatic mode work?
1. 10% capacity the pumps stop
2. 30% capacity signals the pump to start
3. 60% capacity signals the standby pump to activate
4. 80% capacity, a visual and audible high level alarm is activated
67
How long is an EEBD good for?
10 mins
68
During regular inspections, if there is a leak found by engineering, who do they report it to?
1. Engineering Officer
2. Executive Officer
3. SMDR
69
What are the procedures for cleaning up sewage spills?
1. Medical, Food service and Berthing spaces must be disinfected with EPA approved disinfectants
70
What are the two types of Germicides used in sewage spill clean up?
Phenolic Type
| Iodine Type
71
What is the color coding for CHT lines?
1. Ship's interior is color coded for Gold
| 2. Exterior deck is the same color as surrounding structure
72
Where can CHT be discharged when underway?
Within 3 nautical miles of shore
73
What are the 3 modes for CHT systems to operate?
1. At Sea
2. In Port
3. In Restricted Waters
74
Who is responsible for ensuring there is enough drinking water, enforcement of water discipline, informing the troops about the dangers of consuming untreated water and knowing the proper methods of disinfection of personal drinking water?
Unit Commander
75
Whose responsiblity is provide sufficient potable water for the population, construction, operation and maintenance of facilities, selecting sources of raw water?
Engineering Officer
76
Who is responsible for advising the CO on water quality issues, assist engineering, selection of water sources, surverying the potable water sources, surveying teh potable water system, conducting routine bacteriological exams, test water for halogen levels?
SMDR
77
What are the 3 sources of acceptable water supply in the field?
1. Surface Water
2. Ground Water
3. Bottled Water
78
What is the most common used Water purification unit?
Military Reverse Osmosis Water Purification Unit (ROWPU)
79
Which water purification system can produce 3,000 gallons per hour?
Light Medium Tactical (LMT) Freshwater Purfication System
80
Which purification system can be used on Fresh water, Brackish water and sea water?
ROWPU
81
Which purification system is for small units and can process 125 gallons per hour?
Lightweight Water Purifier (LWP)
82
Which purification unit processes 1500 gallons per hour and is replacing the reverse osmosis water purification system?
Tactical Water Purification System
83
What is the most common method of disinfecting field water?
Chlorination
84
What are the different types of disinfectant used for field water?
Calcium Hypochlorite (HTH) 65% to 70%
Sodium Hypochlorite 5% or 10% (unscented bleach)
Chlorine Dioxide
85
What is the required chlorine residuals for Water buffaloes?
Between 0.2 and 1 ppm FAC, rechlorinate to 1 ppm
| Less than 0.2 ppm FAC, rechlorinate to 2 ppm and ensure that at least 1 ppm remains after 30 mins
86
What is the required chlorine residuals for water canteens?
0.2 ppm FFC
87
What is the chlorine risidual for Ground Water?
2 ppm FAC after 30 min contact time
88
What is the chlorine residual for disinfecting natural surface water?
5 ppm after 30 min contact time
| Emergency only
89
What are water purification tablets?
Iodine tablets
90
Which potable water system is the primary means for storage of bulk drinking water in a tactical setting?
Potable Water Storage and Distribution System (PWS/DS)
91
How many gallons of water can the onion tank hold?
3,000
92
How much water can a Semitrailer-Mounted Fabric Tank hold?
3,000 or 5,000
93
What is the purpose of a Tactical Water distribution system?
Designed to distribute water for a distance of 10 miles on level terrain
94
How many gallons of water can a Water Pod System (Camel) hold?
800 gallon unit
95
What is the 1st method of disinfecting potable water containers in the field?
Chrlorinate the water to 100 PPM FAC
96
What is the 2nd method of disinfecting potable water containers?
1. 5 gallon of water with 100 ppm chlorine solution
| 2. Using a long-handled brush and a rag, swab the interior every 10 mins to keep the walls wet for 1 hour
97
What is the sanitation requirement for barbershoops?
1. Must have hot and cold water
2. Lavatory fixtures
3. Waste Disposal
4. Must use FDA/EPA approved products
98
What practices are prohibited in a barber shop?
Treating pimples
| Removing ingrown hair
99
What are the disinfecting procedures for barber shop instruments?
1. Clean and disinfected after each patron
| 2. Washed with soap and water
100
How often does the disinfectant used in barber shops have to be replaced?
Weekly or when visibly soiled
101
What should the PSI be set at for the vacuum equipped clippers in the barber shop?
not to exceed 15 psi
102
How often does barbershop personnel have to be medically cleared?
When checking in at the command to ensure they are medically up to date
103
How often are barbershop inspections conducted?
Quarterly
| Ensure barbers have their medical card
104
How often do laundry personnel have to receive a medical physical?
Periodically as determined by the SMDR or higher authority
105
What clothing should laundry personnel wear?
clean washable outer garments
106
How often should the floor in the laundry facility be cleaned?
At least once daily by a dustless method
107
Where should lint be removed from?
Bulkheads
Overheads
Structural Supports
108
When can seawater be used in plumbing fixtures aboard ship?
Outside the 50 fathom curve (25 nautical miles from shore)
| Never in polluted waters
109
What should be done with the steam and water pipes in the laundry facility?
Should be insulated
110
What control measures to be utilized when air drying chemical concentrations exceed permissible levels?
1. Engineering
2. Administrative
3. Personal Protective Equipment
111
Who requires that first aid kits be distributed throughout the ship?
OSHA
112
How should floors be kept on board ship?
No slip or trip hazards are allowed
113
What temp should the water be when washing laundry?
120-140 degrees F (without bleach)
114
What are the requirements for handling laundry?
1. Individual bags for each dept
2. linen carts must be lined with washable material
3. Linen must only be sorted in the laundry area
4. Trained personnel should utilize PPE
115
How should contaminated laundry be handled?
Should be received in a impervious, double sealed bag
Outer bag must be red and labeled with: the universal biohazard symbol and the word "Biohazard"
Contaminated linen must not be sorted
116
What policy does the OPNAVINST 621.02 and BUMEDINST 6210.4 cover?
Quarantinable Diseases
117
What is the purpose of regulating quarantinable diseases?
To prevent the introduction and dissemination of diseases affecting humans, animals and plants
118
What are some quarantinable diseases?
1. Cholera
2. Diphtheria
3. Infectious Tuberculosis
4. Plague
5. Smallpox
6. Yellow Fever
7. Viral Hemorrhagic Fevers
8. SARS
9. Influenza caused by novel or reemergent influenza viruses that can potentially cause a pandemic
119
What are the characteristics of Cholera?
1. Acute, Diarrheal illness caused by Vibrio cholera
2. Approximately 1 in 20 have severe disease symptoms
3. Without treatment death can occur within hours
120
How does a person become infected with Cholera?
Contaminated food or water
121
Where is Cholera found?
Brackish rivers and coastal waters
| and in shellfish
122
How is Cholera controlled?
Active immunizations
| Universal reports to the WHO and Medical Event Report
123
What are the characteristics of the plague?
Infectious disease of animals and humans caused by a bacterium named Yersina Pestis
124
How does a person become infected with the plague?
Being bitten by a flea infested rodent carrying the plague
125
What are the 2 forms of the plague?
1. Bubonic Plague
| 2. Pneumonic Plague
126
What part of the body does the Bubonic plague affect?
Lymph Nodes
127
How do we control the plague?
1. Education
2. Rat Proofing
3. Proper storage and disposal
4. Patient isolation
5. Clothing repellants
128
What are the characteristics of Yellow Fever?
1. Transmitted between humans by a mosquito
129
What are some precautions to avoid a mosquito bite?
1. Insect Repellant
2. Protective Clothing
3. Treated Mosquito Net
130
What is the dosing for yellow fever immunization?
one dose, (15 ml) provides 10 years of immunity
| available to those 9 months and up
131
What are the characteristics of Smallpox?
1. Known as Variola Virus
2. Global eradication was certified by the WHO in 1979
3. Causes a fever, deep-seated rash with lesions after 2-4 days of exposure
4. Infection occurs through the respiratory tract
132
When was the last naturally acquired case of smallpox?
October 1977 in Somalia
133
Where are known stocks of smallpox stored?
CDC (Atlanta, GA)
| Centre of Virology and Biotechnology (Russia)
134
How is smallpox controlled?
Immunizations
| Communication with local and state health authorities if a case is suspected
135
What instruction is the Navy's Quarantine Regulation Instruction?
OPNAVINST 6210.2
136
What instructions governs the Navy Entomology and Pest Control Technology?
NAVMED P-5010, Chapter 8
137
What instruction governs the Ship Sanitation Certificate Program?
BUMEDINST 6210.4
138
What form number is the Ship Sanitation Control Certificate?
NAVMED 6210/1
139
What form number is the Notification of 30 day extension?
NAVMED 6210/2
140
What form number is the U.S. Navy Declaration of Health Certificate?
NAVMED 6210/3
141
Who can approve Foreign health officials to be received on board?
Commanding Officer
142
What are the U.S. Port Quaratiner requirements?
1. Last 15 days prior to arrival
2. Report symptoms of:
a. Patient with a fever of 100 degrees F, rash, glandular swelling, or jaundice that has lasted for more than 48 hours
b. Diarrhea more than 3 stools in a 24 hour period
143
Who is responsible for notifying higher authorities of quarantine conditions aboard?
Commanding Officer
144
What is the time period for the CO to report quaratine conditions before pulling into port?
Between 12 and 72 hours of entering the port via message/radio traffic
145
What is the instruction number for the TB Surveillance and Control Program?
BUMEDINST 6224.8
146
What are the elements of the TB Control Program?
1. Tuberculosis Screening
2. Preventive Therapy
3. Indentification
4. Patient Mgmt
5. Contact Investigation
147
What is the approved Tuberculin Skin Test?
Purified Protein Derivative (PPD)
| Tween-80 Stabilized intermediate strength PPD (5tu)
148
What size syringe should be utilized for PPD insertion?
1/4 inch to 1/2 inch, 27 guage needle with a short bevel
149
What is the tuberculosis blood test?
Quantiferon-TB Gold
150
What circumstances is the Quantiferon-TB gold test utilized for?
All circumstances in which the TST is used
| Designed for use in place of, not in addition to a TST
151
What is considered an Active TB disease?
illness in which TB bacteria are multiplying and attacking a part of the body, usually the lugns
152
What is a latent TB infection?
TB bacteria are alive but inactive in the body
153
What is a TB skin test?
Test that is often used to find out if you are infected with TB bacteria
154
What is a TB blood test?
BCG, but is rarely used in the US, but is given to infants and small children in other countries where TB is common
155
What is direct observed therapy?
Patient is supervised when taking their TB meds
156
What is the treatment for Latent TB Infection?
Antibiotic Regimen of Isoniazid (INH) and Rifapentine (RPT) in oral weekly dose, 3 months of 15mg/kg based off of weight
157
What is an alternate Treatment for Latent TB?
Rifampin (RIF) in an oral daily dose of 10mg/kg (600mg max) for 4 months
158
What is a 2nd alternate treatment for latent TB?
INH and Rifampin orally
| INH 5mg/kg (300mg max) and RIF 10mg/kg (600mg max) for 3 months
159
When should service members be tested for Tuberculosis?
1. When Entering active duty
| 2. Individuals with employment as CIVMAR for the MSC
160
For those members who have a hx of active disease or reaction to the skin test what is the process for testing?
1. Must provide their medical record as proof
| 2. If unable to provide documentation, proceed with skin testing
161
For individuals deemed to be at risk for TB, additional testing can be done when?
As directed by combatant command
| Part of a contact or outbreak investigation
162
When is an x-ray indicated for TB screening?
If clinically indicated
| To rule out active TB
163
What is Bacillus Calmette Guerin (BCG)?
Vaccine for tuberculosis that is often given to infants and small children in other countries where TB is common.
164
What should be considered when a patient who was previously vaccinated by BCG tests positive>
Indicative of a TB infection
165
When measuring the a induration for the Skin test, what risk is 5mm or greater?
High Risk
166
When measuring the a induration for the Skin test, what risk is 10mm or greater?
Medium Risk
167
When measuring the a induration for the Skin test, what risk is 15mm or greater?
Low Risk
168
How is a single dose of the PPD prepared?
A tuberculin syringe with a single dose of 0.1 ml intermediate strength PPD
169
When should a PPD test be read?
Within 48-72 hours of administration
170
Where should the PPD test results be recorded?
1. NAVMED 6230/4
2. DD Form 2766
3. AHLTA
4. MRRS
5. SAMS
171
How is an absence of indurations recorded?
Reported as 0 mm or zero mm
172
How is a TB test where the patient didn't return for a reading recorded?
Recorded as "not read"
173
What are some reasons for a false negative test results?
Immunosuppression due to TB infection or disease
| Receipt of immunosuppressive medications
174
What questions should be asked when screening for TB?1.
1. Is active disease present
2. Any contraindications to IHN present?
3. Should INH be prescribed and for what duration?
175
When following up with a patient during their INH preventive therapy, what requirements should be met?
1. Monthly Evaluation
2. Physical assessment
3. Counseling on drug reactions
4. Discuss reasons for discontinued use of meds and when to report to medical
176
What form is the INH therapy follow up documented on?
NAVMED 6224/9
177
What actions should be taken for non-compliance with INH therapy?
Consult with NEPMU for guidance
| Directly observe the patient taking their meds
178
What is a concern for patients taking INH medications?
Liver Enzymes should be checked with a liver function test
179
Who should be contacted when a suspected or confirmed case of active TB?
NEPMU
| Local Health Dept
180
Who should be contacted when a patient who is on INH therapy is separating from AD service?
Contact the local health dept for testing
| Patients will go to the VA for medications
181
Who is responsbile for continuation/completion of investigation of those assigned to or has transferred from their command?
CO or OIC
182
Where are investigation reports for active TB submitted?
1. Cognicant Fleet/TYCOM surgeon, Navy Marine Corps Public Health Center
2. Should be documented in MERS
183
What is an effective treatment for active TB?
Chemotherapy
184
What are the 2 types of medications used when treating active TB?
Bactericidal
| Bacteriostatic
185
What is the preferred treatment regiment for active TB?
2 months of meds, followed by a continuation of 4 or 7 months (total of 6 to 9 months)
186
What should be monitored for patients on INH therapy?
Periodic Liver Function Test to monitor for hepatotoxicity
187
What is the technical manual for Medical Event Reporting?
NMCPHC-TM 6220.12
188
What is a medical event report?
Events, usually disease or etiologic agent specific which may pose an inherent, significant threat to public health or military operations
189
When should a MER be utilized?
Any diagnosis, case or medical event that has been identified in a DON beneficiary and classified as reportable
190
Who is the primary consultant resource for MERs?
NEPMU
191
Where should a MER be submitted?
Disease Reporting System Internet (DRSi)
192
How should a MER be reported if the internet is down?
Submitted via snail mail to the nearest NEPMU
193
When should Urgent reports be submitted?
Within 24 hours
194
When should Routine reports be submitted?
No later than 7 days
195
What are some diseases that should be reported within 24 hours?
```
Anthrax
Botulism
Diphtheria
Influenza, Novel
Malaria
Measles
Plague
Rabies, Human
Small Pox
Tuberculosis
```
196
What is an incidence that requires submission of a MER?
An Outbreak
197
What classification is given to a MER?
Unclassified
198
Reporters who are concerned that their report might have an adverse impact on operational units, should contact who for guidance?
CO or Security Officer
199
How should MER's be marked?
For Official Use Only
200
What are the 3 types of Communicable Disease Reporting?
Suspected
Probable
Confirmed
201
What are the 2 Conditions that require a report to be confirmed?
Suspected
| Probable
202
What is the Navy's Immunization Instruction?
BUMEDINST 6230.15
203
What is the dosage for the Anthrax Vaccine?
5 shots over 18 months
| 0.5 ML
204
What is the dosage for Hepatitis A (Havrix)?
1. 2 doses at 0 and 6 month intervals
2. For patients 6 months to 18 yrs (Give 0.5 ml)
3. For patients 19 years and older (Give 1.0 ml)
205
What happens if a patient misses a Hep A vaccine?
Just give dose #2
206
What type of patients are at most risk for Hep B?
Occupational exposure to blood or bodily fluids
Healthcare workers
Any person who contacts a sexually transmitted disease
207
What is the dosage for Hep B?
O-19 years old, O.5 ml
Give at 0, and 1 month intervals, minimum of 8 weeks to 16 weeks after 1st dose
For 20 yrs and older, 1.0 ml
208
When should immunity for Hep B be checked after receiving all doses?
1 to 2 months after the completion of the vaccine series
209
What is the dosage for Hep A/B (Twinrix)?
3 doses, 1.0 ml
| 0,4,4 weeks, 5 months
210
Who should receive a Japanese Encephalitis vaccine?
For personnel going to endemic areas, should complete the series prior to departure
211
What is the dosage of Japanese Encephalitis?
2 doses, 0.5 ml
212
When should the last dose of Japanese encephalitis be given?
7 to 28 days prior to departure
213
Who is required to receive the Measels, Mumps and Rubella (MMR)?
All active duty personel
214
Who should avoid receiving the MMR vaccine?
Women should avoid getting pregnant for at least 28 days after vaccination
215
What is the dosage and route for MMR?
Sub q, 2 doses, 0.5 ml
| 0 and 4 weeks
216
Who is required to receive the Typhoid vaccination?
Personnel being stationed or deployed overseas to typhoid endemic areas
217
What is the dosage and route for Typhoid?
0.5ml
Intramuscular
Booster every 2 years
218
Who is required to receive the Yellow Fever vaccine?
all active duty or reserve components traveling to yellow fever endemic areas within 10 days of deployment
219
What is the dosage and route for the Yellow fever vaccine?
Dosage = 5ml
Route = Sub Q
Booster every 10 years
220
What temp should yellow fever be stored at?
36 to 46 degrees F and stored in a dark place
221
What temp is the MMR vaccine stored at?
-58 to 5 degrees F
222
When should a MMR vaccine be discarded?
After 8 hours following reconstitution
223
How often should the immunization program be inspected?
annually
224
How often should personnel's vaccination status be verified?
At every health care visit
225
Where should immunization clinics receive their vaccine information and vaccine education from?
The CDC and the Department of Health and Human Services
226
How often should personnel administering vaccines attend training?
At orientation to the clinic and annually
227
Where should you report adverse vaccine reactions?
Vaccine Adverse Event Reporting System
228
Are pregnancy tests required prior to administration of vaccines?
No
229
What is the importance of the Advisory Committee on Immunization Practices (ACIP)?
1. Committee develops written recommendations for the routine administration of vaccines to children and adults in the civilian population
2. Only Federal Gov't entity that makes such recommendations
230
The Navy immunization program must follow the recommendations of the CDC and ACIP recommendations unless:
There is a military relevant reason to do otherwise
231
Where should yellow fever immunizations be administered for IDC ships?
In port during normal working hours after notification and concurrence of local Regional Medical Representative
232
How long can a medical exemption to vaccines be granted for?
May be temporary up to 365 days or permanent
233
What is an administrative exemption to vaccines?
Separation or Retirement, May be exempt from deployment imms 180 days before separation or retirement
234
What is required for a religious exemption?
Command decision with Chaplain advice, JAG, and medical
235
What form is utilized for recording immunizations?
NAVMED 6230/4
| Adult Health Record Immunization Record
236
What form number is the International Certificate of Vaccination (Yellow Card)?
CDC 731
237
What form number is the Adult Preventative and Chronic Care Worksheet?
DD Form 2766
238
What information is required when documenting vaccine information?
1. Date, Manufacturer name, Lot Number, Dose Given, site and route of administration, Vaccine Information given and Name, address and title of person administering the vaccine
2. If recruits do not receive an immunization due to evidence of prior immunization or immunity
239
What standards will water tank coating follow?
NSF, ANSI
240
What is the purpose of vent and overflow lines?
Reduce accidental contamination by reducing water pressure
| Openings of vents will be screened with 18 gauge or finer, non corrosive mesh
241
How do automatic chlorine disinfectors work?
Inject hypochlorite into the system in proportion to the water flow
242
What is another name for Manaul Chlorine Disinfection?
Batch Method
243
What is the disinfectant of choice?
HTH (Calcium Hypochlorite)
244
What is the strength of HTH with disinfection?
One ounce of HTH per 5,000 gallons of water equals 1.0 ppm FAC
245
What happens if the ship's brominator can't achieve TBR of 2.0 ppm?
The water must be chlorinated using the batch method
246
What is the 3rd method for disinfecting the potable water system?
Fill the tank 5% of tank volume with 50 ppm FAC solution
247
If medical requires outside assistance with controlling the taste and/or order of potable water, who should be contacted?
NEPMU via TYCOM
| NAVSEASYSCOM via COC
248
How long will the MDR maintain the potable water surveillance records?
2 years
249
What should the medical department train Personnel in regards to CHT and Waste Water Mgmt?
Potential Health hazards onboard, associated with human waste, proper personal hygiene necessary to reduce the risks
250
What are the type of CHT system is found onboard navy vessels?
Type II-B Marine Sanitatin Device
251
What chemical poses the greatest danger to ships and personnel?
```
Hydrogen Sulfide (H2S)
Can become explosive if not aerated
```
252
Where should warning plates be located for pump rooms?
Outside pump rooms and near tank access
253
What are some health hazards associated with CHT systems?
1. Hydrogen Sulfide (rotten eggs)
2. Methane
3. Ammonia
4. Carbon Dioxide
254
What can CHT workers do to protect themselves from the transmission of disease?
PPE and Hygiene Practices
255
What is the ship to shore hose handling instruction?
NAVFAC TMO 340
256
What is the most common water treatment for potable water in the field?
ROWPU
257
What are the 3 modules of the Water Distribution and Waste Mgmt System (WDWMS)?
1. Water distribution set
2. Hospital
3. Deployable Medical System (DEPMEDS)
258
What is the Alternative Procedure (Method 3) for disinfecting potable water tanks?
Chlorinate the water to 10 ppm FAC
hold for 24 hours
Drain and Rinse
259
What are accomodations?
Number of personnel to be supported in a given ship, by habitability space, systems, fixtures and equipment
260
What is a surge?
personnel embarked aboard ship for short duration during special operations
261
What is a transient?
Personnel embarked for short durations who do not contribute to the host ship's operational capability
262
What is hot bunking?
assigning more than one person to a single berth
263
What are some habitability factors?
```
Ventilation
Heating
Sanitary Fixtures
Water Supply
Lighting
Color
```
264
What type of pillows are prohibited?
Polyurethane
265
Who is allowed to make routine sanitary inspections of bathrooms, and berthing spaces?
```
XO
Medical Dept Representative
OOD
JOOD
Chief Master at Arms
DIVO
Division Chief Petty Officer
```
266
What type of cosmetics, tonics, bleaches, dyes, disinfectants, and sanitizing agents should be used in barber shops?
FDA/EPA approved
267
How much compressed air should be used with vacumm equipped clippers?
15 psi
268
How often should barbershop instruments be cleaned and disinfected?
After each patron
269
When should hearing protection be worned?
84 dbs or above
270
When cleaning laundry machines with water, what is the next step?
Hot Air Dryers must be used
271
what is used as a diagnostic for mycobacterium tuberculosis infection?
Quantiferon Gold
272
What are the 2 types of PPD used?
Tubersol - Preferred Product
| Aplisol - Alternate Product
