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Emergency Medical Technician > Terrorism Response and Disaster Management > Flashcards

Terrorism Response and Disaster Management Flashcards

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Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

Terrorism

A
  1. Involves violent acts or acts dangerous to human life that violate the law
  2. Appears to be intended to intimidate or coerce a civilian population, government policy, or to affect the conduct of government by mass destruction, assassination, or kidnapping
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2
Q

Difference between domestic and international terrorism

A

Location

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3
Q

The deliberate creation and exploitation of fear through violence or threat of violence committed by a single actor who pursues political change linked to a formulated ideology, whether their own or that of a larger organization, and who does not receive orders, direction, or material support from outside sources

A

Lone wolf terrorism

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4
Q

Categories of terrorist attacks

A
  1. Religious extremist groups/doomsday cults
  2. Extremist political groups
  3. Cyber terrorists
  4. Single-issue groups
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5
Q

THREAT

A
  1. Threat suppression
  2. Hemorrhage control
  3. Rapid Extrication to safety
  4. Assessment by medical providers
  5. Transport to definitive care
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6
Q

Response plan for active shooter

A

THREAT

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7
Q

WMD

A

Weapon of mass destruction

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8
Q

WMC

A

Weapon of mass casualty

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9
Q

Any agent designed to bring about mass death, casualties, and/or massive damage to property and infrastructure

A

WMD or WMC

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10
Q

Different kinds of WMDs (mnemonic)

A

B-NICE or CBRNE

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11
Q

B-NICE

A

Biologic
Nuclear
Incendiary
Chemical
Explosive weapons

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12
Q

CBRNE

A

Chemical
Biologic
Radiologic
Nuclear
Explosive weapons

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13
Q

Preferred WMD for terrorists

A

Explosives

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14
Q

Manufactured substances that can have devastating effects on living organisms

A

Chemical agents

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15
Q

Types of chemical agents

A
  1. Vesicants (blister agents)
  2. Respiratory agents (choking agents)
  3. Nerve agents
  4. Metabolic agents (cyanides)
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16
Q

Organisms that cause disease

A

Biologic agents

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17
Q

Performed to artificially maximize the target population’s expose to the germ

A

Weaponization of biologic agents

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18
Q

Primary types of biologic agents

A
  1. Viruses
  2. Bacteria
  3. Toxins
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19
Q

Nations that hold close ties with terrorist groups

A

State-sponsored terrorism

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20
Q

RDD

A

Radiologic dispersal devices (dirty bombs)

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21
Q

Key to response to terrorism

A

Situational awareness

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22
Q

The planning of most acts of terror is ___

A

Covert

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23
Q

NTAS

A

National Terrorism Advisory System

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24
Q

Alerts from the NTAS contain ___

A

A summary of the threat and the actions that first responders, the government agencies, and the public can take to maintain safety

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25
Q

Observations to make on a call to determine the potential for a terrorist attack

A
  1. Type of location
  2. Type of call
  3. Number of patients
  4. Victim’s statements
  5. Preincident indicators
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26
Q

Most important clue that a terrorist attack has occurred

A

Number of patients

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27
Q

Second-best indicate that a terrorist attack has occured

A

Victim’s statements

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28
Q

Actions to take after determining a terrorist attack has occurred

A
  1. Scene safety
  2. Responder safety
  3. Notification procedures
  4. Establishing command
  5. Reassessing scene safety
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29
Q

How far to park from terrorist incident

A

Usually 1 to 2 blocks

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30
Q

Intended to primarily injure responders and to secure media coverage

A

Secondary device

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31
Q

Greatest threats facing you in a WMD attack

A

Contamination and cross-contamination

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32
Q

Occurs when you have direct contact with a WMD or are exposed to it

A

Contamination

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33
Q

Occurs when you come in contact with a contaminated person who has not yet been decontaminated

A

Cross-contamination

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34
Q

Who to notify of a terrorist attack first

A

Dispatcher

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35
Q

What info to provide dispatch about terrorist attack

A
  1. Nature of event
  2. Additional resources required
  3. Estimated number of patients
  4. Upwind route of approach or optimal route of approach
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36
Q

Liquids or gases that are dispersed to kill or injure

A

Chemical agents

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37
Q

The properties or characteristics of an agent can be described as ___

A

Liquid, gas, or solid

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38
Q

Describe how long the agent will stay on a surface before it evaporates

A

Persistency and volatility

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39
Q

How the agent most effectively enters the body

A

Route of exposure

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40
Q

Enter the body through respiratory tract in the form of vapors

A

Vapor hazard

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41
Q

Give off very little vapor or no vapors and enter the body through the skin

A

Contact hazard

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42
Q

Blister agents are also called ___

A

Vesicants

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43
Q

Primary route of exposure for blister agents

A

Skin

44
Q

If vesicants are left on the skin or clothing long enough, ___

A

They produce vapors that can enter the respiratory tract

45
Q

Vesicants cause ___

A

Burn-like blisters on the skin and in the respiratory tract

46
Q

Vesicant agents

A
  1. Sulfur mustard (H)
  2. Lewisite (L)
  3. Phosgene oxime (CX)
47
Q

Vesicants usually cause the most damage to ____

A

Damp or moist areas of the body

48
Q

Signs of vesicant exposure on the skin

A
  1. Skin irritation, burning, and reddening
  2. Immediate, intense skin pain (with L and CX)
  3. Formation of large blisters
  4. Gray discoloration of skin (signs of permanent damage seen with L and CX)
  5. Swollen and closed or irritated eyes
  6. Permanent eye injury (including blindness)
49
Q

Signs of vesicant exposure if inhaled

A
  1. Hoarseness and stridor
  2. Severe cough
  3. Hemoptysis
  4. Severe dyspnea
50
Q

Commonly known as mustard gas

A

Sulfur mustard (H)

51
Q

Sulfur mustard appearance

A

Brownish, yellowish oily substance

52
Q

Mustard gas smell

A

Garlic or mustard

53
Q

Mustard gas damage to the cells happens within ___

A

1 to 2 minutes

54
Q

Absorption of mustard gas through the skin or mucous membranes happens within ___

A

Seconds

55
Q

Mustard gas is a ___

A

Mutagen

56
Q

How long after mustard gas exposure will the patient show signs and symptoms

A

4 to 6 hours

57
Q

Mustard gas attacks cells within the bone marrow and depletes the body’s ability to produce ___

A

White blood cells

58
Q

Primary complication associated with vesicant blisters

A

Secondary infection

59
Q

Produce similar blister wounds to mustard gas, but have a more rapid onset of symptoms

A

Lewisite (L) and phosgene oxime (CX)

60
Q

Which vesicants have antidotes?

A
  1. None for mustard gas or CX exposure
  2. British anti-lewisite for agent L
61
Q

Who is best equipped to handle vesicant injuries

A

Burn centers

62
Q

Gases that cause immediate harm to people exposed to them and include chlorine (Cl) and phosgene

A

Pulmonary agents

63
Q

Pulmonary agents are also called ___

A

Choking agents

64
Q

Primary route of exposure for choking agents

A

Respiratory tract

65
Q

How to pulmonary agents affect the lungs?

A

Damage the tissue, and fluid leaks into lungs. Pulmonary edema develops

66
Q

Chlorine has a distinct odor of ___

A

Bleach

67
Q

Chorine creates a ___ when released as a gas

A

Green haze

68
Q

Signs and symptoms of chorine exposure

A

Upon initial exposure:
1. Upper airway irritation and a choking sensation
Later:
1. Shortness of breath
2. Tightness in chest
3. Hoarseness and stridor
4. Gasping and coughing

69
Q

Ammonia and bleach are similar to ___

A

Chlorine

70
Q

Burning Freon creates ___

A

Phosgene

71
Q

Onset of phosgene symptoms

A

Hours

72
Q

Odor of phosgene

A

Freshly mowed grass or hay

73
Q

Mild exposure of phosgene signs and symptoms

A
  1. Nausea
  2. Tightness in chest
  3. Severe cough
  4. Dyspnea on exertion
74
Q

Severe expose of phosgene signs and symptoms

A
  1. Dyspnea at rest
  2. Excessive pulmonary edema
75
Q

What might be coughed up with phosgene exposure?

A

White or pink-tinged fluid

76
Q

Severe phosgene exposure can cause pulmonary edema so bad that ___

A

The patient may become hypovolemic and subsequently hypotensive

77
Q

Best initial treatment for a patient exposed to a pulmonary agent

A

Remove from the environment

78
Q

Do not allow a patient with choking agent to be ___

A

Active

79
Q

Antidote for pulmonary agent

A

None

80
Q

Position for patient of pulmonary agent

A

Position of comfort with the head elevated

81
Q

Treatment for pulmonary agent

A

Manage ABCs and rapid transport (CPAP may help)

82
Q

Deadliest chemicals

A

Nerve agents

83
Q

Nerve agents are classified as ___

A

WMDs

84
Q

Nerve agents cause ___

A

Cardiac arrest within seconds to minutes of exposure

85
Q

Nerve agents are a class of chemicals called ___

A

Organophosphates

86
Q

How do nerve agents work?

A

Block an essential enzyme in the body’s organs to become overstimulated and burn out

87
Q

G agents from high to low volatility

A
  1. Sarin (GB)
  2. Soman (GD)
  3. Tabun (GA)
88
Q

Highly volatile colorless and odorless liquid

A

Sarin (GB)

89
Q

Lethal concentration of Sarin in air

A

About 28 to 35 mg/m^3 per minute for a two minute exposure by a healthy adult

90
Q

Sarin is a ___ hazard

A

Vapor

91
Q

The vapors are continually released over time

A

Off-gassing

92
Q

Twice as persistent as sarin

A

Soman

93
Q

Odor of soman

A

Fruity

94
Q

Soman route of exposure

A

Contact and vapor

95
Q

Irreversible binding to the cells

A

Aging

96
Q

Half as lethal as sarin and 36 times more persistent

A

Tabun

97
Q

Odor of tabun

A

Fruity

98
Q

V agent (VX) appearance

A

Clear, oily agent that has no odor and looks like baby oil

99
Q

How much worse is V agent to G agents

A

100 times more lethal and extremely persistent

100
Q

VX is a ___ hazard

A

Contact

101
Q

Persistence of VX

A

Weeks to months

102
Q

Symptoms of exposure to nerve agents mnemonic

A

SLUDGEM
DUMBELS

103
Q

SLUDGEM

A

Salivation, sweating, seizures
Lacrimation
Urination
Defecation, drooling, diarrhea
Gastric upset and cramps
Emesis
Muscle twitching, miosis

104
Q

DUMBELS

A

Diarrhea
Urination
Miosis, muscle weakness
Bradycardia, bronchospasm, bronchorrhea
Emesis
Lacrimation
Seizures, salivation, sweating

105
Q

What makes nerve agent seizure different?

A

Will continue until dead or until treatment is given

106
Q

Nerve agent antidotes

A
  1. DuoDote Auto-Injector
  2. Antidote Treatment Nerve Agent Auto-Injector (ATNAA)
107
Q

DuoDote Auto-Injector contains ___

A
  1. 2.1 mg of atropine (Block agent)
  2. 600 mg of pralidoxime chloride (2-PAM) (Eliminates agent from body)

Emergency Medical Technician (100 decks)

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