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