PREVMED 2 Flashcards
What is Reverse Osmosis
the reverse of natural osmosis achieved by external application of sufficient reverse pressure to cause the solvent to flow in its UNNATURAL DIRECTION
Define coaming
a raised frame to keep water out
What is distillation
**The total process the distilling plant forms, including evaporation and condensation
What is total coliform?
A group of closely related, mostly harmless BACTERIA that live in soil and water as well as the guts of animals
What is NAVSEASYSCOM responsibility?
**Responsible for potable water systems, including treatment FACILITIES and processes to assure that safe drinking water is from an approved source:
Design
Construction
Maintenance
What is NAVFACENGCOM responsible for
**promulgating instructions for SHIP-TO-SHORE.
Also providing water from an approved source when ship is berthed at naval facility
What is BUMED responsibility
**Promulgate instructions, notices or other publications to reflect AFLOAT water requirements
Who is responsible for promulgating the water sanitation bill?
**Commanding Officer
Who is responsible for the supply and treatment of potable water sources?
**Engineering department
how many gallons per day are specified by NAVSEASYSCOM for daily operations
**50 gallons per man per day
No less than 2 gallons per day per man while in water conservation hours
When ship-to-shore or ship-to-ship connections are about to be made, WHO must be present?
Medical
Authorized personnel
What is the requirement to receive water from an UNAPPROVED source?
**Allowed to be received onboardif the water hasbeentreated at a minimum of 2.0 ppm prior to receipt
What are the shore-to-ship approved sources that fall under
US military sources including establishment under cognizance of?
**British Royal Navy
Canadian Forces
Royal Australian Navy
What are the three types of Distillation plants
steam distilling: Uses steam
Heat distilling: uses heat
Vapor Compression Type: USES ELECTRICAL ENERGY
How many types of reverse osmosis are there and what are they?
2
**single: additional disinfection required such as bromine or chlorination
Triple: additional disinfection NOT required
a single pass RO plant requires what?
additional disinfection with chlorine or bromination is required
is additional disinfection required for a triple pass RO plant?
no, the water quality is often better than distilled water
Potable water tanks should NEVER be filled with what kind of water?
Ballast water, unless necessary for survival of the ship
What is the approving authority for Potable water tank coating
**NSF/ANSI
What are the requirements for sounding tubes?
- Disinfect prior to use: 100 ppm FAC for 2 minutes
- LABELED: “Potable Water Use Only”
Potable water filling lines must be what color and how far off the deck?
- **Dark Blue
- 18 inches from the deck
How far off the deck will potable water hose lockers be when located on the weather deck?
18 inches
What is printed, step by step instructions for disinfection of hoses and risers post CONSPICUOUSLY INSIDE THE LOCKER
**Water sanitation bill
How are hoses labeled?
POTABLE WATER ONLY
1 inch high letters every 10 feet
What is the halogen residual range?
0.2 - 2.0 ppm
if potable water is coming from sources of doubtful quality, what will the halogen residual requirements?
**2.0 ppm
How often is the emergency potable water tank tested
Monthly
Each positive sample will have how many repeat samples and from where
3 repeat
one at original
one upstream no more than 5 service connections (01-15-2-L)
one down stream no more than 5 service connections (01-20-2-L)
Which diethyl-p-phenylene diamine (DPD) test, test for FAC or TBR
**DPD #1
Which diethyl-p-phenylene diamine tests for total chlorine residual?
**DPD #4
What is the accuracy of the color comparator?
(+) or (-) 10 percent
What is the accuracy of the Portable Spectrophotometer?
(+) or (-) 2 percent
For the color comparator test how soon after additional test tab is placed will you read the results?
60 seconds
How often do you test halogen?
daily while underway
weekly otherwise
how often is bacteriological testing completed?
Weekly
Whenever abnormal halogen demand is present
after repairs to potable water systems
What temperature is BACTI samples incubated at?
Incubate samples for 24 hours at 35 degrees C
Where will you record BACTI results?
Potable water log and/or TMIP including positive and negative controls
Cross connections with non-potable systems occur when what type of Leaks in common bulkheads occur?
Potable water tanks Fuel tanks Ballast tanks Bilges Wastewater tanks
What is the least desirable method of water disinfection?
**Manual Chlorine Disinfection (batch method) because it may result in over chlorination
What is the desirable disinfectant choice
**Calcium hypochlorite (HTH)
What is the clear, slightly yellow liquid called in regards to HTH?
Supernatant
What is the chlorine dosage rule of thumb?
One once HTH per 5,000 gallons of water equals 1.0ppm FAC
What are the two types of brominators?
In-line (proportioning)
Recirculation
How long do you hold solution for in METHOD ONE of disinfecting water systems?
**24 hours
Drain
Refill
Test BACTI
In METHOD TWO of disinfection of water sources how long will the disinfected surfaces remain in contact with chlorine solution
30 minutes
Refill
Test BACTI
In METHOD THREE how long will you hold the solution for?
6 hours THEN
add potable water to chlorine solution to fill tank and hold THIS water for 24 hours
Drain
refill
Perform Test
When attempting to control taste and odor which method requires approval from NAVSEASYSCOM?
**Steam method
When storing HTH how long can the ready use stock stay in storage?
no more than 7 days
How many bottles of HTH can be stored in an individual locker or bin?
**no more than; 48 SIX OZ bottles
How will all fire resistant lockers, bins and enclosures containing HTH be labeled?
“Hazardous Material, Calcium Hypochlorite”
RED LETTERS WITH A WHITE BACKGROUND
How long will the MDR maintain the record of potable water surveillance?
**2 years
How will you document the results of a bacteriological test result?
Presence or absence
Include +/- controls
Purpose of test
For a colilert bacteriological test, what is the color that indicates the sample is positive for total coliform?
Yellow
Florescent yellow is positive for fecal coliform
For a Colisure bacteriological test, What color indicates the sample is positive for total coliforms?
Magenta
Florescent light blue is positive for E. coli
Yellow=negative
What are some sources of contamination?
leaks in common bulkheads between potable water tanks and fuel tanks, ballast tanks, bilges and wastewater tanks
CHT operates in three modes, what are they?
restricted waters
at sea
in port
What type of CHT is installed on the majority of navy ships?
**Type II-B Marine sanitation device
Each tank has two sewage pumps which are connected in parallels to discharge sewage and grey water to what receiving facility?
Ship Waste Off-loading Barge (SWOB)
or it will go overboard
What chemical causes the greatest danger to ships and personnel?
**H2S
Hydrogen Sulfide
who must be notified in the event of a CHT spill or leak
Engineering officer
XO
SMDR
what toxic gas is associated with a rotten egg smell?
Hydrogen Sulfide
What immunizations are required for personnel working with wastewater?
Polio (IPV)
Tetanus (Td)
What type of PPE is required by CHT workers?
Coveralls RUBBER BOOTS RUBBER GLOVES Face shield SCBA (when necessary)
When cleaning cht contaminated clothing what will you use?
Hot water and soap
If a CHT spill occurs in medical, the galley, or berthing spaces what EPA approved disinfectants will be used?
**Germicides:
Phenolic type
Iodine Type
How is CHT color coded?
**Gold (on valve handles and operating levers)
Untreated sewage in US waters is prohibited within what range?
Within 3 nautical miles of shore
In port, sewage and grey water is collected in holding tanks and discharged into a sanitary sewer through what?
**sewage risers
What test can engineering personnel use to pinpoint small leaks from pumps or pressurized systems?
Paper towel test
Why must untreated sewage, when held in larger than 2000 gallon tanks be aerated?
Because it can become explosive if not aerated
Can you enter a CHT pump room if H2S odor is detected?
Only if wearing supplied airline respirator with full face mask
Who provides on-site advice, when requested in the event of major sewage leaks or spills?
Medical department representative
What temperature does potable hot water have to be?
120 degrees
What is the purpose of BACTI testing?
**Ensure Water fit for human consumption
Assess adequately disinfected
For a crew of 400-800 people, how many samples are needed?
8 samples
How much water will you put in a bacti testing tube?
100mL
How long will you allow the water to run before obtaining your sample?
2 to 3 minutes
Who provides onsite advise in regards to CHT?
Medical department representative
Who inspects the type II B marine sanitation device?
Medical department representative
CHT pump rooms must have negative pressure as well as how many EEBD
**2 EEBD
And a warning plaque
If you’re in restricted waters, what is the disposition of CHT?(you cannot transfer it overboard)
**Remain in the holding tank
How are sounding tubes disinfected
100 ppm FAC for 2 minutes
what is the easiest and safest water source?
Public water source
What are some influences of water choice?
Quality
Quantity
Accessibility
What is the least contaminated water source?
ground
What is the water source that provides the most quantity?
Surface water
What is the most common WATER TREATMENT METHOD?
ROWPU
Reverse osmosis water purification unit
What can the ROWPU produce water from?
fresh water
brackish water
sea water
How many gallons per hour does the lightweight purifier produce?
125 gallons per hour
What is the most common method of disinfecting field water?
Chlorination
sufficient chlorine is added to the water to achieve the desired free available chlorine after 30 minute contact time
When disinfecting natural surface water or well water under the direct influence of surface water for drinking, and no other treatment is available what is the treatment?
**5 ppm FAC after 30 minute contact time
Emergency use only!!!**
What is the primary means for the receipt and storage of bulk drinking water and for issue to combat forces under tactical conditions?
Potable water storage and distribution systems (PWS/DS)
How long will you KEEP ALL INTERIOR SURFACES WET for? (Field water sanitation)
60 minutes
If either water or the required chemical are short in supply how will you disinfect after preparing 5 gallon of water with 100ppm?
USE A LONG HANDLED BRUSH, STICK, OR ROD with a cloth secured to the end, swab the interior of the tank every 10 minutes or as often as necessary to keep the walls clean for an HOUR
what type of disinfectant is most common and in granular form?
**Calcium Hypochlorite (HTH)
How many gallons is the semitrailer mounted fabric tank carry?
3000-5000
Define surge
**Personnel embarked aboard ship for SHORT DURATION during SPECIAL OPERATIONS or exercises, and mobilization
Define transients
refers to personnel embarked for short duration who DO NOT CONTRIBUTE TO THE HOST SHIP operational capability
What is the maximum temperature of berthing, messing, and medical?
80 degrees F
Berthing, messing, normal working spaces and medical shall be heated to what temperature?
**minimum 65 degree F dry bulb temperature
What is the ventilation exchange rate?
Exchange rate of 15 changes per hour
designed to minimize humidity and odors
What type of pillows are prohibited?
**polyurethane
What type of mattress foam inserts are required on ship
Low smoke foam rubber
Each lavatory shall have what?
one mirror
one shelf
two electrical outlets
is hot bunking authorized?
no
What personnel will make routine sanitary inspections of toilets, lavatories, and berthing spaces?
xo mdr ood jood chief master at arms divo Division chief
What action is performed to shower curtains to prevent mildew, odor, and soap accumulations
sanitize
Berthing spaces, common rooms and head facilities should be cleaned how often?
**Daily
When will a barber shop worker wash their hands?
between patrons
after touching likely contaminated items
before leaving the shop
What therapeutic practices are prohibited?
- **treating pimples
- removing ingrown hair
how is hair removed from the deck?
**by a DUSTLESS method
What is the max psi for vacuum equipped clippers
**15 psi
how often is bedding changed to prevent odor?
frequently
How often does the barber shop get inspected by a medical department representative?
quarterly
what must be provided to supply laundry workers with drinking water?
Sanitary angle jet type water fountains
How far from shore must you be to use seawater with plumbing fixtures?
50 fathom curve (25 miles from shore)
hygienically safe laundry WITHOUT BLEACH should be what temperature
**120-140 degrees F
What is a necessary step when chlorine bleach is not included in the formulation?
heated air dryers
When handling contaminated laundry what will you NOT do?
contaminated linen MUST NOT be sorted
soiled is sorted
what training must be provided tp personnel prior to using laundry/dry cleaning equipment?
Safety
First aid
PPE
How will you contain contaminated laundry
received in impervious, double sealed bags
outer bag is red and labeled with biohazard symbol and word biohazard.
inner bag must be hot water soluble
what is the purpose of quarantine regulations?
the movement of DoD equipment and personnel (ships, aircraft, and other modes or method of transport) entering or departing US or foreign country/ ports may introduce undesirable non-native species and disseminate communicable diseases
what are the quarantinable diseases
cholera diphtheria infectious TB plague small pox yellow fever viral hemorrhagic fevers SARS Influenzas caused by novel or reemergent viruses or have potential to cause a pandemic
Cholera is the acute diarrheal illness caused by infection of the intestine with what bacterium
Vibrio Cholerae
Where can the cholera bacterium also live?
brackish rivers and coastal waters
what are the methods of control for cholera?
CONCURRENT DISINFECTION OF FECES AND VOMITUS OF LINENS AND ARTICLES USED BY PATIENTS
immz
case reporting
isolation
what type of plague is extensively involving the lungs and the sputum is loaded with causative agent
pneumonic
how do people usually contract the plague
bite from a rodent flea that is carrying the plague bacterium Yersinia pestis
how is yellow fever transmitted
between humans by a mosquito (AEDES EGYPTI)
What is variola virus
small pox
where are small pox stocks held under security at?
**CDC Atlanta GA
Biotech- Koltsoco, Russia
what do you immunize with, in regards to small pox
vaccinia virus
what is OPNAVINST 6210.2
Quarantine regulations of the navy
-provides guidance on navy responsibilities, liaisons, foreign quarantine and public health service requirements
what is BUMEDINST 6210.4
Ship sanitation certificate program
how does small pox present within 2 to 4 days
skin eruption
can a foreign official come on board with CO approval?
yes, but only to verify certs
within 12 to 72 hours, if is there is a quarantine disease on board who will the CO send a radio message to?
senior naval officer in command of port to be entered
In the last 15 days prior to US arrival what conditions are reported
Patient has temp 100F or greater accompanied by rash, grandular swelling or jaundice or which has presented for more than 48 hours
Pt has diarrhea in a 24 hour period of three or more loose stools
death due to illness other than battle casualties
What are the elements of the TB control program?
tb screening preventative therapy tb case identification tb patient management contact investigation
What are the tests used when a person has been identified as being exposed to mycobacterium tuberculosis
Tuberculin skin test - Mantoux Method
Interferon Gamma Release Assays (IGRA)
What is the effect therapy to prevent the development of tb in a newly infected
(1) the antibiotic regimen of choice is: Isoniazid (INH) and Rifapentine (RPT) in an oral weekly dose of 15mg/kg (900mg max) of INH
who requires periodic SCREENING
All active duty and reserve personnel
- Annual screening during PHA
- Document on NAVMED 6224/8
What is the monthly INH evaluation documented on?
NAVMED 6224/9
What is direct observed therapy?
Those who have difficulty with treatment adherence?
MUST BE USED ON PATIENTS ON INH REGIMENS GIVEN TWICE WEEKLY
When would you consider withholding INH?
patients transaminase level exceed 3x the upper limit of normal if associated with symptoms
or 5x upper limit of normal if asymptomatic
what is an active TB case?
an illness in which TB bacteria are multiplying and attacking a part of the body. Usually the lungs
what is latent TB?
a condition where TB bacteria is alive but inactive in the body
how long after administration of the TST does the results have to be read by a competent medical authority
48 to 72 hours
how would you record the result of a TST
Record any size in duration in mm
absence of induration reported as 0mm or zero mm
what is TB treatment dosage based off?
weight
what is the primary objective of medical event reports?
Enables navy public health experts to be proactive in offering their assistance to local level medical staff
Who is the primary consultant with medical event reporting?
Cognizant Navy Environmental and Preventative medicine unit (NEPMU)
A diagnosis, case or medical event becomes reportable once it has been classified as:
Based off of clinical assessment, lab and epidemiology reports will determine if it is,
Suspected
Probable
Confirmed
What is a disease and injury report?
Disease and injury surveillance involves monitoring the incident of specific pre diagnostic syndromes and injuries occurring in a unit
MER is generally unclassified material however should be marked, what?
For official use only
to have a MER updated to a higher classification who do you contact?
security officer
or
Commanding officer
what are the two types of MER?
urgent: within 24 hours
routine: no later than 7 calendar days
What is 6220.12?
medical surveillance and medical event reporting TECHNICAL MANUAL
INFECTIOUS TB is what priority of medical event report?
urgent
Whats the official system that is used to capture, store, and communicate information related to RME’s?
DRSi Disease Reporting System Internet
How often will you get the typhoid vaccine if exposed to the typhoon organism continually or repeatedly
2 years
What temperature do you store yellow fever at?
Store between 36F to 46F (2 to 8C)
What must be properly stored and readily available at all vaccine locations?
Epinephrine
Where will vaccine information sheets be prepared
US department of health and human services
Centers for disease control and prevention
What instruction states yellow fever cannot be given underway on an IDC ship
COMNAVSURFORINST 6000.1
What is required in barbershops?
Hot and cold running water
What must be worn when attending to patrons?
(2) A clean smock or other freshly laundered over garment must be worn while attending patrons.
Employees must be medically screened and determined to be free of what?
free of communicable disease prior to their initial assignment.
