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Nursing 202 - Midterm > Terrrorism, Mass Casuality > Flashcards

Terrrorism, Mass Casuality Flashcards

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1
Q

How many times per yr is req by Joint Commission to create plan for emergency preparedness?

A

Twice

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2
Q

Essential components of emergency plan

A
  • Activation response
  • Internal/external communication plan
  • Plan for coordinated pt care
  • Security plans
  • ID of external resources
  • Plan for people management & traffic flow
  • Data management strategy
  • Demobilization response
  • After-action reporter corrective plan
  • Plan for practice drills
  • Anticipated resources
  • Mass causality incident (MCI) planning
  • Education for above
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3
Q

Triage in disaster

Immediate

A

Priority: 1
Color: Red
Conditions: sucking chest wound, airway obstruction due to mechanical cause, shock, hemothorax, tension pneumo, asphyxia, unstable chest/abd wound, incomplete amputation, open FX, 2nd/3rd degree burns of 15-40% BSA

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4
Q

Triage in disaster

Delayed

A

Priority: 2
Color: yellow
Conditions: stable abd wounds w/o evidence of hemorrhage, soft tissue injury, maxillofacial wounds w/o airway compromise, vascular injuries w/adequate collateral circulation, GU disruption, FX needing SX repair, eye/CNS injuries

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5
Q

Triage in disaster

Minimal

A

Priority: 3
Color: green
Conditions: UE FX, minor burns, sprains, small lacerations w/o significant bleeding, behavioral D/O or psychological disturbance

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6
Q

Triage in disaster

Expectant

A

Priority: 4
Color: black
Conditions: unresponsive patients w/penetrating head wounds, high spinal cord injuries, wounds involving multiple sites/organs, 2nd-3rd degree burns over 60% BSA, SZ/vomiting w/in 24 hrs radiation exposure, profound shock, agonal respirations, no pulse/BP, fixed & dilated pupils

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7
Q

Level A PPE

A

Self-contained breathing apparatus (SCBA), vapor-tight chemical resistant suit, gloves, boots

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8
Q

Level B PPE

A

High level of respiratory protection (SCBA) but lesser skin & eye protection, chemical resistant suit

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9
Q

Level C PPE

A

Air-purified respirator, coverall w/splash hood, chemical resistant gloves & boots

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10
Q

Level D PPE

A

Typical work uniform

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11
Q

Primary blast injury

Mechanism

A

Results from pressure wave

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12
Q

Primary blast injury

Injuries

A
  • Pulmonary barotrauma, contusion
  • Head injuries
  • Tympanic membrane rupture, middle ear injury
  • Abdominal hollow organ perforation, hemorrhage
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13
Q

Secondary blast injury

Mechanism

A

Results from debris from the scene or shrapnel from the bomb

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14
Q

Secondary blast injury

Injuries

A
  • Penetrating trunk, skin, soft tissue injuries

- FX, traumatic amputation

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15
Q

Tertiary blast injury

Mechanism

A

Results from pressure wave that causes the victim to be thrown

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16
Q

Tertiary blast injury

Injuries

A
  • Head injuries

- FX (including skull)

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17
Q

Quaternary blast injury

Mechanism

A

Results from pre-existing conditions exacerbated by the force of the bast of by post blast injury complications

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18
Q

Quaternary blast injury

Injuries

A
  • Severe injuries w/complex injury patterns - burns, crush, head
  • Common pre-existing conditions = COPD, asthma, cardiac conditions, diabetes, HTN
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19
Q

Anthrax

Incubation

A

1-6 days

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20
Q

Anthrax

Spread

A

Skin contact, GI ingestion, inhalation

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21
Q

Anthrax

S/S

A

Skin lesions, fever, N/V, abdominal pain, diarrhea

Respiratory S/S mimic flu

22
Q

Anthrax

Treatment

A

Penicillin V, erythromycin

23
Q

Smallpox

Incubation

A

Virus, 12 days

24
Q

Smallpox

Spread

A
  • Extremely contagious

- Spread by direct contact, contact w/clothing or linens, droplet person-person

25
Q

Smallpox

S/S

A

High fever, malaise, HA, backache, prostration

After 1-2 days, maculopapular rash forms on face, mouth, pharynx, forearms

26
Q

Smallpox

Treatment

A

Supportive care w/ABX for additional infection

27
Q

Vesicants

Type

A

Lewisite, sulfur mustard, nitrogen mustard, phosgene

28
Q

Vesicants

S/S

A

Blistering, burning

Respiratory effects can be serious —> death

29
Q

Vesicants

Decontamination

A

Soap & water, do not scrub or use hypochlorite solutions
Eye exposure requires copious irrigation

30
Q

Vesicants

Treatment

A

Lewisite: dimercaprol IV or topically

31
Q

Nerve agents

Types

A

Sarin, soman, tabun, organophosphates, VX

32
Q

Nerve agents

MOA

A

Inhibit cholinesterase, causing cholinergic crisis

33
Q

Nerve agents

S/S

A

Cholinergic S/S progressing to loss of consciousness, SZ, copious secretions, apnea, death

34
Q

Nerve agents

Decontamination

A

Copious amts of soap and water or saline for at least 20 min
Blot, do not wipe off

**Plastic equipment will absorb sarin gas

35
Q

Nerve agents

Treatment

A

Supportive care, atropine, Benzos, pralisoxime

36
Q

Blood agents

Types

A

Hydrogen chained, cyanogen chloride

37
Q

Blood agents

MOA

A

Direct effect on cellular metabolism, resulting in asphyxiation through alterations in hgb

38
Q

Blood agents

Spread

A

Inhalation, ingestion, absorbed in the skin & mucus membranes

39
Q

Blood agents

S/S

A

Leads to respiratory muscle failure, respiratory arrest, cardiac arrest, death

40
Q

Blood agents

Treatment

A

Rapid admin of amyl nitration, sodium nitrite, and sodium thiosulfate after patient is incubated and placed on vent

41
Q

Pulmonary agents

Types

A

Phosgene and chlorine

42
Q

Pulmonary agents

MOA

A

Destroy the pulmonary membrane that separates the alveolus from the capillary bed, disrupting alveolar-capillary oxygen transport mechanisms. Capillary leakage results in fluid-filled alveoli

43
Q

Pulmonary agents

S/S

A

Pulmonary edema w/SOB, especially on exertion

Initial hacking cough followed by frothy sputum production

44
Q

Radiation exposure

External

A

All or part of the body is exposed to radiation
Decontamination not necessary
Not emergency

45
Q

Radiation exposure

Contamination

A

Exposure to radioactive gases, liquids, or solids

Immediate medical management to prevent incorporation

46
Q

Radiation exposure

Incorporation

A

Uptake of radioactive material into body

47
Q

Radiation decontamination

A
  • Triage OUTSIDE of hospital
  • Cover floor & use strict isolation precautions to prevent the tracking of contaminants
  • Air ducts and vent sealed
  • Waste double bagged and labeled “radiation waste”
  • Decontaminate each patient outside ED w/shower
  • Internal contamination: catharsis, gastric lavage w/chelating agents
48
Q

Radiation decontamination

Staff protection

A
  • Water-resistant gowns, two pairs of gloves, caps, goggles, masks, booties
  • Dosimetry devices
49
Q

Acute radiation syndrome

Probable survivors

A

No initial symptoms or only minimal s/s

50
Q

ARS

Possible survivors

A

Present w/ N/V that persist for 24-48 hrs

51
Q

ARS

Improbable survivors

A

Acutely ill w/ N/V/D, shock

Neuro S/S suggest a lethal dose

Nursing 202 - Midterm (12 decks)

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