surg tech: chapter 8 part 3

complete training through an agency such as the fire or police department; they are trained in all-hazards preparation and basic response such as fire safety, basic first aid, and search and rescue.

CERT

______ _______accidents are a life-threatening event that can cause severe damage to the environment. flammable, toxic, and/or caustic.

Chemical release

________ is the intentional use of infectious agents, or germs, to cause illness. Health care facilities may be the initial site for recognition and response to evens.

Bioterrorism

Triage zone near the warm zone where patients are evaluated for injuries secondary to severe injuries and transported to a facility.

Cold zone

health professional volunteers who can respond to an emergency within their state and out of state. The volunteers are deployed through the Emergency Management Assistance Compact (EMAC), an interstate agreement to coordinate the deployment of medical supplies and equipment, and health care volunteers.

ESAR-VHP

the lead federal agency during a nationally declared emergency and coordinates providing treatment to victims and food and shelter at the emergency scene.

Federal Emergency Management Agency (FEMA)

The director of ________ is responsible for activating the Emergency Operations Center (EOC); the location of the EOC is predetermined and communicated in the EOP.

LEMA

Community agency that has the lead responsibility for managing and coordinating local agencies (e.g., fire department, EMS, police, public health department) in response to an emergency.

Local Emergency Management Agency (LEMA)

Enacts the NRF; responsible for sending medical equipment, supplies, and teams to the disaster scene. Also assists with the transportation needs (e.g., transport injured and sick patients to hospitals).

National Disaster Medical System (NDMS)

Provides a national model for coordinating the emergency response of governments, public health sector, private agencies, and nongovernmental organizations to any type and size of disaster.

National Incident Management System (NIMS)

Guide for coordinating the disaster relief activities by government agencies, private sector, and nongovernment agencies when a presidential declaration has been made.

National Response Framework (NRF)

Central area where the disaster occurred. Patient is quickly assessed for airway patency and severe hemorrhage.

Hot zone

Each person will be in charge of a specific workforce and/or agency that will work together in implementing the EOP. Federal assistance must be requested through formal channels by local and state governments. If the federal government approves the request, the __________ is still responsible for coordinating the personnel, supplies, and equipment sent to the emergency scene.

ICS

a temporary site for providing vaccines and medicines to a large population, called mass prophylaxis.

Point of distribution (POD) site:

The ICS has a chain-of-command structure in order to prevent confusion and establish a single person who is in charge. The charge person is the Incident Commander (IC). However, if a disaster situation is complicated and requires the input of individuals with varying skills and knowledge, what happens?

a unified command (UC) may be established to direct the emergency response as a group effort.

The Centers for Disease Control and Prevention (CDC) has identified the following biological diseases as posing the highest risk to nations:

anthrax, botulism, plague, smallpox, tularemia, and viral hemorrhagic fevers. Of those six, anthrax and smallpox are identified by the CDC as the two most likely biological agents to be used as bioweapons.

Patients with biological diseases will probably not be surgical patients except for unusual and extenuating circumstances, such as a patient with anthrax who experiences _________.

appendicitis.

The injuries related to exploded nuclear devices are ?

blast injuries, thermal/flash burns, and ionizing radiation injuries. Additionally, flash blindness may occur as a result of peripheral vision of the intense light energy that is produced by a blast. Retinal burns may occur, resulting in scarring, permanent altered vision, or blindness.

Terrorists use many of types of weapons to strike at the populace, including?

chemical, biological, radiological, and nuclear (CBRN).

patients are triaged three times:

cold, warm, hot zone

Infrastructure incidents include: The incidents can be caused by a natural disaster such as an earthquake, flood, tornado, hurricane, or avalanche or be due to poor maintenance or poor construction.

collapse of roads, bridges, and structures.

Infrastructure incidents primarily cause what injuries?

crushing injuries and severe lacerations.

LEMA develops the local EOP; the purpose of the EOP is to ?

designate who is in charge of what, including who will coordinate the actions of public and private agencies, including the health care sector.

Radiological injuries in the civilian population will most likely occur due to the ?

detonation of an improvised nuclear device or radiological dispersal device referred to as a "dirty bomb" or because of a nuclear power plant accident.

Health care facilities have an _________________that follows state and federal emergency response guidelines as required by The Joint Commission.

emergency action plan (EAP—similar to an EOP)

Radiological injuries decrease the body's ________________________, contributing to the morbidity and mortality of patients who cannot fight off bacterial and viral infections.

hematopoietic and immune systems

The response to a disaster situation is divided into the ____________. ______ governments bear the burden of primary responsibility of responding to an emergency.

local and federal responses, local

The EAP must be scalable in order to respond to small or large community disasters. Evacuation of patients is a serious decision due to the_____________.

logistics, costs, and risks involved.

EOP The plan includes ?

maintaining an inventory of emergency response equipment and supplies, personnel training, and list of first responders including all community HCPs and their medical specialties.

Radiation exposure because of a nuclear power plant leakage can cause ______ to occur in the cells of the body, resulting in various types of cancer.

mutations

Chemicals can cause:

permanent respiratory tract damage, skin burns, and diseases and permanently damage the eyes.

LEMA initially requests federal assistance through the state government. The governor forwards the request to the president that a federal disaster be declared, which is called a _______ _______.

presidential declaration.

Terrorism is often motivated by ?(Department of Defense, 2010).

religious, political, or other ideological beliefs and committed in the pursuit of goals that are usually political"

Biological agents can enter the body through the?

respiratory tract or can be absorbed through the mucous membranes, eyes, skin, or open wounds.

Bioterrorism The first indication of an attack is usually when large numbers of patients present with the ________________.

same set of signs and symptoms.

Transportation accidents are infrequent but tend to remain in the minds of people due to their large scope of injuries and fatalities. HCPs will be treating ?

severe lacerations, fractures, crushing injuries, burns, and eye injuries.

There are a number of ways explosions occur:

such as bombs and other weapons of mass destruction, various types of factory explosions, gas tank explosions, and explosions inside mines.

Explosions have the potential to injure all body parts, challenging HCPs in determining the injuries that require immediate treatment to preserve the life of the patient (life over limb). There will be injuries that are common to many explosions:

such as penetrating wounds, blast soft tissue injuries (liver, spleen, and lungs), fractures, and burns, but there will also be injuries unique to the disaster.

The Joint Commission requires health care facilities to practice their EAP at least ________ a year; if the health care facility has an emergency department, one of the drills must have volunteer patients in the department in order to provide hands-on training.

twice

Centers for Disease Control and Prevention (CDC) storage of medications and vaccines that are divided into push packs; push packs are containers with the medications and vaccines that can be quickly shipped to the disaster scene.

Strategic National Stockpile (SNS)

__________is defined by the U.S. Department of Defense Dictionary of Military and Associated Terms as "the unlawful use of violence or threat of violence to instill fear and coerce governments or societies.

Terrorism

A popular system of triage is "Simple Triage and Rapid Treatment" (START). START uses four categories in which to place patients:

DIME (Delayed, Immediate, Minimal, Expectant). A triage tag is attached to the patient and treatment is based on the color and information written on the tag.

The following information is based on the immediate response of first responders to the scene of a disaster:

First and foremost, health care responders should not enter the scene of a disaster without ensuring it is safe in order to mitigate the potential for additional casualties. Health care responders will need to create a safe zone as soon as possible for setting up the triage and initial treatment area. Standard Precautions and personal protective equipment (PPE). Disposable sponges and towels should be used. Gowns or other clothing should be available to provide to the victim to prevent hypothermia and for the non-health care uninjured. Triage of victims. A popular system of triage is "Simple Triage and Rapid Treatment" (START). Triage of chemical and nuclear disaster victims requires a separate system of triage in order to contain the contamination. Point of distribution (POD) site: A POD is a temporary site for providing vaccines and medicines to a large population, called mass prophylaxis. Risk communication with the public: This is communicating information to the public as quickly and accurately as possible about the disaster. Questions from the media and public should be referred to the public information officer (PIO). Moral, ethical, and legal issues associated with providing care during a disaster, Emergency System for the Advanced Registration of Volunteer Health Professionals (ESAR-VHP) and Community Emergency Response Team (CERT)

Management system set up by LEMA to coordinate the response to a disaster; ensures all responders know their roles and duties, and whom to report to.

Incident Command System (ICS)

The following are steps to take in personal and family preparation:

Research the recommended emergency procedures provided by local disaster management and public health agencies. Create a family emergency plan for each type of emergency. Confirm children know the purpose of 911 and when to use it. Adults should be familiar with health care insurance, disability insurance, life insurance, and homeowners' insurance plans. Family members who are old enough should obtain certification in BLS/CPR (infant, adolescent, and adult) and first aid. Communication: Be prepared that all technology will not be available, including cell phone service. Families should designate a familiar meeting place such as a nearby bus stop, parking lot, or park. Establish an out-of-town relative and/or friend as a "communication center" if family members become separated. Every family member should know the designated person, home address, phone numbers, and email address. Family members should have the cell phone number and email address of each other. All emergency contact information should be kept by family members at all times in a wallet, briefcase, or backpack. Practice, practice, practice the emergency plan. Family should prepare emergency supplies. A "go bag" should be packed that can be quickly grabbed in the event of an evacuation that includes bottled water and nonperishable foods; cash; flashlight and batteries; battery-powered radio; battery-powered walkie-talkies; medications (make sure to replace when they expire); first-aid kit; emergency contact information of family members and the "communication center"; copies of documents; and pet supplies.

This is communicating information to the public as quickly and accurately as possible about the disaster. Questions from the media and public should be referred to the public information officer (PIO).

Risk communication with the public:

Health care facility EAPs should outline an evacuation plan, including sheltering-in-place, which is moving patients to the area of the facility that has been identified as the most secure.______________________________ is of utmost importance. Medical records should be electronically stored in offsite remote backup systems. Laptops should be available to use in case the electricity goes out and backup generators are damaged. Evacuation plans should address the procedures for transporting medical records.

Saving, protecting, and transporting patient medical records

Standard Precautions and personal protective equipment (PPE):

To the extent possible, health care responders should follow Standard Precautions guidelines to prevent cross-contamination. Just as in the health care facility, health care responders should assume all disaster victims are potentially infectious. Hand washing, handling of sharps, and wearing PPE should be followed by all health care responders. In the field, a hand-wash station might not be available, but waterless solutions such as wipes or hand sanitizers should be used between treating patients.

the process of sorting victims according to their injuries and physiological status in order to maximize the medical resources that are available.

Triage of victims:

Triage zone 300 ft or more from the hot zone. Patients are quickly triaged into the four categories.

Warm zone