Chapter 8 Workbook
Why is personal disaster planning (PDP) important to the health care provider?
Disasters can occur in just seconds. Lessens the impact on families on workplaces and on communities. Every hospital staff member has an important role in hospital operations and in the ability of hospitals to provide care.
DHS
Division of Homeland Security
Floods
Drowning, contaminated water/GI illness
EAP
Emergency Action Plan
EOP
Emergency Operations Plan
Anaphylactic reactions: What is the treatment for anaphylactic shock?
Epinephrine, steroids, IV and plasma
When two or more rescuers are present, how often should you switch roles in CPR? why?
Every 2 minutes or every 5 cycles. Only a 5 second pause between switching
If you have a trauma patient who is in cardiac arrest, what is the most likely cause? How does this change the priorities?
Exsanguinations or critical thoracic injury. Head tilt should not be used and that restoration of circulating blood volume will help than compressions.
FEMA
Federal Emergency Management Agency
Smallpox
Fever, aches, pain, malaise, painful vesicular/pustular skin rash
Disseminated Intravascular Coagulation (DIC): What blood replacements or intravenous therapy may be used to treat DIC?
Fresh frozen plasma, cryoprecipitate, fibrinogen, heparin
BRP
Health care facilities' plan for dealing with biological terrorist events
Hurricanes, tornadoes
High wind, results in fractures, lacerations, head/eye injuries, spine injuries, disruptions of power/complications for chronically ill
HICS
Hospital incident command system
Winter storm
Hypothermia, frostbite, carbon monoxide poisoning with sudden onset
Describe the best technique for opening the airway in an injured patient
If injury is suspected, the airway should be opened using a jaw thrust without head movement
ICS
Incident Command System
Crowded shelters
Increases incident of infectious disease transmission
Many things may occur all at once. If there is a situation in which all of the indicators of an emergency occur at once, describe how you would anticipate what instruments, equipment, or actions are needed next.
It would be important to first identify the type of emergency. Then emergency action depends upon the severity of emergency. Then I would estimate the resources so that I can know if I can provide care to the people who are in the incident.
Anaphylactic reactions: How do you prevent an Anaphylactic reaction?
Knowing if the patient has allergies and those allergies are clearly identified on chart and wrist band.
LEMA
Local Emergency Management Agency
Prioritizing the conditions:
1- Patient Airway 2-Breathing 3-Circulation; pulse 4-Hemostasis maintained for severe blood loss 5-chest injuries 6-shock; drop in blood pressure 7-wound protection/closure 8- fractures 9- comfort for the patient
Describe the important components of PDP
1. Clear communication 2. Comprehensive training 3. Knowledge of assets 4. Technology fail-safes and protocols 5. Healthcare leadership involvement
Anticipation is important. Describe at least four indications suggesting an emergency may occur.
1. Difficulty breathing 2. Chest pain 3. Changes in skin color 4. Changes in vital signs
What is the significance of standardized language and acronyms, such as NIMS
National Incident Management Systems Common standards so responders have the knowledge and skills in understand how communities take action
NPRT
National Pharmacy Response Team
NRF
National Response Framework
Botulism
Neuroparalysis (nausea and vomitting), blurred vision, slurred speech, dysphasia
What is the ratio of compressions to breathing for one- or two- person CPR for a patient of any age? How fast should they be?
30:2, 100 compressions per minute
when a sudden cardiac arrest (SCA) occurs, how long before permanent brain damage occurs?
4-6 minutes
Why should the organization of disaster planning use a top-down approach based on a universal template that all communities use? Who has the lead management and coordinating authority for an emergency?
A disaster is an unplanned event in which the needs of the affected community outweigh the available resources. Emergency managment directors prepare for responding to natural disasters and other emergencies.
As a healthcare provider, what type of of role could you find yourself performing during a disaster?
A healthcare provider can deliver necessary public health services during a crisis, assist emergency response teams with patients and provide care directly to those with less serious injuries. Prioritizing on the basis of health care needed.
Describe the initial response (steps taken) when all hazards even occurs
An all encompassing term that refers to the many different emergencies. It acts as a template for generalized training and emergency preparation that can be applied to all disaster situations rather than training that is focused on a limited amount of number of local or regional types of emergencies.
Why is emergency planning the most important on a regional or local level?
An emergency management plan is a course of action developed to mitigate the damage of potential events that could endanger an organization's ability to function. Such as a plan should include measures that provide for the safety of personnel.
POD
Point of Distribution
Volcano
Poisonous gas, lava, ash, and mudflows result in respiratory/lung conditions, burns and death
Nature-caused disasters
affects more than 100 people with 10 or more dead or any event that overwhelms the systems. These include cold and heat disasters, earthquakes and tsunamis, topical storms, hurricanes, flood and tornadoes
Malignant hyperthermia (MH) What triggers an MH episode?
an anesthetic agent, such as halothane, enflurane or isoflurane and by muscle relaxants such as succinylcholine
What does AED stand for?
automated external defibrillator
What are some warning signs of impending cardiac arrest?
chest pain (awake0, unstable blood pressure, pain in arms (male), women in jaw, tachycardia
Heat wave
dehydration, cramps, exhaustion, sunstroke, psychological effects
mustard gas (vesicant)
is treated with epinephrine for extreme cases
Earthquakes
magnitude 6.1 or greater causes catastrophic damage and fires, resulting in lacerations, crushing injuries, fractures, serious head injuries, and disruptions of emergency response
Anthrax
skin lesions, flu-like symptoms, dyspnea, high fever, shock
DMAT
Disaster Medical Assistance Team
DMORT
Disaster Mortuary Operational Response Team
CBRN
Disaster code that requires decontamination procedures for patients coming into the hospital
Disseminated Intravascular Coagulation (DIC): Describe what occur with DIC.
Blood begins to coagulate within the body, doesn't just go to the localized area uses up all coagulation factors and platelets. Seesaw effect of hyper coagulation and hypo coagulation.
Avalanche
Causes asphyxiation (buried alive), fractures, and hypothermia; destroys all in path
CDC
Center for Disease Control and Prevention
What is the first priority of cardiopulmonary resuscitation (CPR) for an adult after establishing unresponsiveness?
Chest compressions
Describe the decontamination procedures for a radiological disaster.
Clothing removal and it removes 90% of contaminations if wounded they should be thoroughly irrigated with saline, intact skin used warm water and soap.
MOU
Memorandum of Understanding
NDMS
National Disaster Medical System
NIMS
National Incident Management System
OSHA
Occupational Safety and Health Administration
UC
Unified Communications
Disseminated Intravascular Coagulation (DIC): Describe the prognosis for patients who develop DIC
Very poor if the cause can not be figured out.
Tsunami
Wave hits, causing devastation, injury, and death; if large can disrupt emergency response
What is the primary role of the surgical technologist during CPR in the OR setting?
Protect your sterile field unless given other directions
Phosgene (choking agent)
Pulmonary edema
Human-caused disasters
Refers to transportation accidents and acts of terrorism or industrial incidents. This includes: chemical or radiation release; explosions; infrastructure incidents; transportation accidents; terrorism
Describe the chemical decontamination procedures
Removal of clothing, skin wounds need to be decontaminated with 0.5% sodium hypochlorite
Wildfire
Respiratory and cardiovascular conditions, burns
Nerve agent
Rhinorrhea, Dyspnea, Seizure, Paralysis
Malignant hyperthermia (MH) Describe the symptoms?
Rigidity, heat, lactic acid and carbon dioxide build up. Tachycardia, unstable blood pressure, cyanoic, temp as high as 107.
Describe START. What do the the colors mean?
Simple Triage AND Rapid Treatment Green: Minor Yellow: Delayed Red: Immediate Black: Expectant
Most likely bioweapons
Smallpox and anthrax
SNC
Strategic National Stockpile
Anaphylactic reactions: What are the symptoms of an Anaphylactic reaction?
Swelling, hives, difficulty breathing, bronchospasm, vascular collapse, hypotension, respiratory failure
Dirty radiological bomb
Thermal burns, flash blindness, poor immune response
Anthrax and botulism are treated using standard precautions because person-to-person transmission does not occur
True
Anthrax patients may experience appendicitis necessitating surgery, but otherwise most patients exposed to biological substances will not be treated in surgery unless they received direct injuries from the blast exposure.
True
Bioterrorism readiness plans (BRPs) should include annual disaster drills to test and refine the plans
True
Chemical exposure protocol recommends a no-touch technique during decontamination and debridement while wearing double gloves with frequent glove changes.
True
Chemical injury may present a vapor exposure hazard for health care personnel
True
Decontamination by clothing removal, bathing, and wound irrigation with normal saline is important to reduce radioactive exposure
True
Linen for a patient with smallpox lesions must be autoclaved and then laundered with bleach
True
Smallpox treatment includes vaccination and patient isolation precautions to prevent transmission
True
The first indication of a biological attack is when large numbers of patients arrive with the same set of signs and symptoms of a disease that is not endemic to an area
True
The most common method of biological transmission is through direct person-to-person contact
True