Chapter 8 Emergency Situations

A change in the sequence of BLS from A-B-C (airway, breathing, chest compressions) to C-A-B-

(chest compressions, airway, breathing) for adults, adolescents, and infants (excludes newborns).

When treating trauma patients with cardiac arrest, the head tilt

should not be used to open the airway if any suspicion of cervical spine injury exists.

Disposable

sponges and towels should be used.

Infectious diseases can quickly

spread among a large gathering of displaced people who must stay in a crowded shelter or remain in a temporary outdoor shelter (tent camp) that may have poor sanitation infrastructure and little to no access to health care services.

However, when an emergency or disaster situation occurs, there are many similarities that exist, such as the

systems that are in place to respond to the emergency, procedures for communication and evacuation, response to caring for special needs patients, and so forth.

Additionally, there is debate as to

whether health care responders to a disaster scene should be protected from being sued due to the difficult, quick-treatment decisions that must be made.

heat waves can bring bring about

wildfires

Usually, the National Weather Service can predict a

winter storm, including where it will hit and how soon, in order for communities to prepare.

Earthquakes are measured on the

Richter scale

other serious heat-related illnesses include

severe sunburn, heat cramps, heat exhaustion, and heat stroke

Hot zone

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

The depth of compression for infants is approximately

1 1/2 in

The breath during CPR should be delivered over

1 second and produce a visible rise in the chest.

Treatment should be prioritized to fit the objectives Priorities in order:

1. Airway- Restore respiratory status 2.Cardiovascular status maintained or restored 3. Treatment/ Hemostasis

HCPs should take no more than

10 seconds to check if a pulse is present.

If the arrest for newborns is due to a cardiac etiology, the ratio should be

15:2.

The depth of compression for adolescents is approximately

2 in.

The ratio of chest compressions to rescue breaths for infants, adolescents, and adults is

30:2.

The ratio for chest compressions to rescue breaths for newborns is

3:1.

Chemical and radiation release

A life threatening event that can cause severe damage to the environment.

Heat stroke:

A life-threatening condition where the patient's internal temperature control system stops working. The body temperature can rapidly increase, causing neurological damage as well as leading to death if not immediately treated.

Recovery:

Activities performed to aid the community in returning to as normal as possible, such as rebuilding structures and homes, rebuilding the infrastructure, and restoring the local and regional health care system.

Anaphylactic Reactions

Allergic reaction to a substance or protein

The individual performing the triage of patients should follow some basic guidelines:

Assessment of each patient should quickly occur. Patients will need to be constantly reassessed; for example, a patient may have injuries that are not deemed to be life threatening, but his or her physiological condition deteriorates, requiring recategorization. The triage person will have difficult decisions to make based on the goal of providing quality treatment to as many patients as possible while using medical supplies and manpower in an economic fashion.

In 2010 the AHA published the revised Guidelines for

Cardiopulmonary Resuscitation and Emergency Cardiovascular Care that includes significant changes from the 2005 version.

What is a life threatening event that can cause sever damage to the environment?

Chemical release

The order of treatment is:

Chest injuries, Shock, Wound protection/closure, Fractures, Vital sign monitoring, Provide of reassurance and comfort for the patient

Signs of impending cardiac arrest:

Chest pain unstable blood pressure Tachycardia Cardiac dysrhythmias Respiratory changes Hypovolemia Laryngospasm

Radiological decontamination procedure:

Clothing should be removed as soon as possible; up to 90%, If the victim has any wounds, those should be first addressed by thoroughly irrigating with normal saline. Intact skin and hair should be decontaminated with warm water and soap. Injured patients or may be brought into the decontamination area on a stretcher and health care responders will need to perform the decontamination procedure

Local Emergency Management Agency (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.

Terms Related to Heat Wave

Heat index Heat cramps Heat exhaustion Heat stroke

A popular system of triage is "Simple Triage and Rapid Treatment" (START). It uses four catergories 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.

Terrorism

Define as the "unlawful use of violence or threat of violence to instill fear and coerce governments or societies.

Prior surgery, the surgeon or anesthesia provider should be notified immediately of the following emergency situation:

Difficulty breathing Chest pain Changes in skin color Changes in vital signs Open bleeding wounds or visible punctures not indicated on the pt's chart Inability to move an extremity Misshapen/ misaligned body part Disorientation or confusion Severe cephalagia (headache)

Signs of Anaphylactic Reactions

Difficulty breathing, hypotension, tachycardia, diminished urine output

Heat exhaustion:

Due to exercising or working for a period of time in a hot, humid place and body fluids are lost at a great rate through sweating without replacement. Mild form of shock because the body increases the blood flow to the skin, thus reducing blood flow to the vital organs.

ESAR-VHP:

Each state has this system to preregister health professional volunteers who can respond to an emergency within their state and out of state.

Successful resuscitation requires:

Early recognition of cardiac arrest. Early activation of trained responders. Early CPR. Early defibrillation. Early advanced cardiac life support (ACLS).

The volunteers for ESAR-VHP 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.

The director of LEMA is responsible for activating the

Emergency Operations Center (EOC); the location of the EOC is predetermined and communicated in the EOP.

NDMS National Disaster Medical System

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). Three of the more well-known specialty teams are: 1:Disaster Medical Assistance Teams 2:Disaster Mortuary Operations Response Team 3:National Pharmacy Response Teams

Treatment of Anaphylactic Reactions

Epinephrine, oxygen, intravenous fluids, plasma, Levophed

Information for first responders on a scene:

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.

Chemicals can be:

Flammable toxic Caustic

NRF National Response Framework

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

Moral, ethical, and legal issues associated with providing care during a disaster:

HCPs must make quick decisions on how to treat a patient and carry forward with the treatment plan.

Mitigation

Identification of hazards located in the community and plans to prevent emergencies as well as reduce the dangers.

Preparedness:

Includes development of an EAP and establishing the health care facility EOC.

CERT:

Individuals who wish to be a member of this 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.

DIC may be stimulated by the following factors:

Infection of the blood by bacteria or fungus Severe tissue trauma (e.g., head injury, shock, or burns) Leukemia or cancer Severe liver disease Recent blood transfusion reactions Obstetric complications

Disseminated Intravascular Coagulation

Is a pathological process in the body that occurs when blood begins to coagulate within the body.

Malignant Hyperthermia

Life threatening, acute pharmagogenic disorder, develops during or after anethesia

Common Causes of Anaphylactic Reactions

Local anesthetics codeine antibiotics animal derived drugs insulin Contrast media Latex

Who is at higher risk for heat-related illness due to sweating more?

Males

Anesthesiologist will

Manage the code for CPR

Incident Command System (ICS):

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.

saving, protecting, and transporting what is the most important?

Medical records and they should be electronically stored in offsite remote backup systems

The EAP plan should include the following:

Mitigation Preparedness Response Recovery Hospital Incident command system HCP responsibilities

For trauma pt storing the circulating blood volume is:

More important and may require resuscitate thoracotomy

Natural Disasters

Most commonly occurring type of disasters that affects large populations.

Heat cramps:

Muscular pains and spasms due to activity; often first sign/reaction by the body to the heat.

Summary of local response agencies

National Incident Management System (NIMS) a national model for coordinating the emergency response Local emergency management agency (LEMA) the lead responsibility for managing and coordinating local agencies Incident Command System (ICS) 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.

Winter storms are often not thought of as a

Natural disaster

Heat index:

Number in degrees Fahrenheit that tells how hot it feels when relative humidity is added to the air temperature. Exposure to full sunshine can increase this by 15 degrees F

The HCP should be familiar with the following:

Personal responsibilities in responding to an emergency Departmental role in the health care facility Chain of command Knowledge of the health care facility's signals and codes to indicate there is an emergency and the type of emergency and signals/codes used during the emergency Procedure for how supervisors will communicate to HCPs that the EAP is activated Communication procedures with HICS and between health care facility departments

What takes precious time when preparing for CPR?

Positioning the head, attaining a tight seal in mouth-to-mouth rescue breathing, or obtaining and assembling a device such as a bag-mask device

Response:

Preparations before the emergency event and actions during and after the event.

National Incident Management System (NIMS):

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.

Signs of Malignant Hyperthermia

Rapid increase in body temperature Unexplained tachycardia Unstable blood pressure muscle rigidity Tachypnea cyanosis

Federal Emergency Response

Request need to be made through formal channels. Apply to the federal government and if approved goes to ICS. The state will request assistance with LEMA that will then be sent to the president aka presidential declaration.

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

Research the recommended emergency procedures Create a family emergency plan for type of emergency Teach children how to use 911 and when Know your health care insurance, disability insurance, life insurance and homeowner's insurance plans All family members know CPR Communication: how to communicate when cellphones don't work, get a meeting place Establish an out-of-town relative and/or friend as a communication center Family members should know cell phones and email addresses Know all emergency contact information and keep with you Practice emergency plan Prepare an emergency supply to go bag

Disaster Medical Assistance Teams (DMATs)

Specialized teams that can be rapidly deployed to the emergency scene to supplement the local HCPs in caring for victims. Surgical technologists are members of this. The surgical technologist who has completed additional training in first aid, starting IV lines, CPR/BLS, and other emergency care is used on this

MH treatment

Stop administration of triggering anesthetic Deepen anesthesia Opioids, Barbiturates, Propofol Follow hospital protocol Packing the patient in ice Circulating ice water through nasogastric tube Irrigation of the open cavity with chilled irrigation Dantrolene, steroids, and diuretics Adjust ventilation to compensate for increased CO2 Administer 100% oxygen

Circulator will provide

Support for CPR

National Pharmacy Response Teams (NPRTs):

Team members are pharmacists and pharmacy technicians who dispense drugs and provide vaccinations to the population within the disaster area.

Disaster Mortuary Operations Response Team (DMORT):

Team members include medical examiners, pathologists, radiographers, and dental assistants who aid in recording the identification of victims.

Every facility should have an Emergency Action Plan(EAP) in placed as required by

The Joint Commission

Hospital Incident Command System (HICS):

The Joint Commission and federal standards require health care facilities to establish this that has a chain of command that specifies the roles of HCPs. this allows the health care facility to work efficiently with other health facilities and responding agencies.

Chemical decontamination procedure:

The initial treatment of the patient contaminated with a chemical agent is removal of the clothing. The skin and wounds are decontaminated with 0.5% sodium hypochlorite

Patient decontamination area:

This is particularly important when it is a radiological or chemical disaster.

Objectives and Priorities in Emergency Situations

To preserve life To prevent further deterioration of patient condition To provide whatever care necessary to restore the patient to his/her previous lifestyle

Logistical factors include:

Transportation and preservation of medications, blood and blood products. Availability of backup gas-powered generators in order to keep electrical equipment running. Agreements with other health care facilities Safest location for patients to be moved and wait. Tracking of patients Health status of patient must be tracked ST serve a valuable role in the evacuation of pts due to their knowledge of pt position, transporting and pt factors be considered

Warm zone:

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

Cold zone:

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

The Infrastructure 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.

Point of distribution (POD) site:

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

if a disaster situation is complicated and requires the input of individuals with varying skills and knowledge

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

What is a storm surge?

abnormal rise of the ocean waters due to the high winds that sweep forward inland.

A chain-of-survival concept applied to both in-hospital and out-of-hospital arrests

addresses the ABCs

ABCs

airway, breathing, and circulation—as well as providing the "D," definitive treatment.

an infectious disease by itself can become a natural disaster, turning into

an epidemic or pandemic event.

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.

The Signs of Anaphylactic Reactions may cause

apprehension in the patient and should not be ignored, as these symptoms can rapidly escalate to a systemic anaphylactic attack

Risk communication with 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).

HCPs should be ready to treat the victim from a natural disaster for

asphyxiation, fractures, and hypothermia.

Early recognition of SCA is based on

assessing responsiveness and abnormal or no breathing.

Just as in health facilities, HCPs standard Precautions and personal protective equipment (PPE) 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.

Rapid defibrillation has been shown to

be a highly important factor in the survival of the VF SCA patient.

A separate ambulance loading area should

be established for triage

The symptoms of vascular collapse and shock must also

be treated to prevent death from cardiovascular failure.

When two HCPs are present, one should d activates the ERS and obtains the AED the other should:

begin chest compressions

tropical storms is winds

between 39 and 73 miles per hour

Injuries that can occur due to exploded nuclear devices:

blast injuries, thermal/flash burns, ionizing radiation injuries, flash blindness, retinal burns, mutations and cancer.

Arterial lines are used to monitor

blood pressure and blood gases.

Explosions can be from

bombs, various types of factory explosions, gas tank, mines that can lead to all types of body injuries to body part; penetrating objects, fractures, burns.

Epinephrine causes

bronchodilation, reduces laryngeal spasm, and raises blood pressure.

Second priority in any emergency situation is:

cardiovascular status should be maintained or restored and hemostasis should be provided to maintain circulatory status.

Strategic National Stockpile (SNS):

center 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.

The first priority in any emergency situation is to

check for and provide a patent airway to ensure or restore respiratory status and breathing.

The man-made disasters that will be discussed are

chemical or radiation release, explosion, infrastructure incidents, transportation accidents, and terrorism.

Types of weapons for terrorism

chemical, biological, radiological, and nuclear

In trauma patients, it has been shown that

chest compressions usually are not adequate to reverse the cardiac arrest and that the more critical factor is the restoration of circulating blood volume.

What tasks are performed concurrently and not in a stepwise fashion?

chest compressions, airway management, rescue breathing, rhythm detection, defibrillation, and administration of emergency drugs,

Types of injuries for transportation accidents include:

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

The depth of compression for adults has changed from a depth of 1 1/2 to 2 in. to a

consistent depth of 2 in.

Blood clotting leads to the

consumption of coagulation factors and platelets, and the overstimulation of fibrinolytic degradation products that act as anticoagulants.

the initial hypercoagulation is replaced by a

deficiency in clotting factors, leading to hypocoagulability and internal hemorrhaging.

the number one heat-related complication is

dehydration

There is an increase in the focus on

delivering high-quality chest compressions at the appropriate rate and depth, including complete recoil of the chest after each compression.

LEMA develops the local EOP; the purpose of 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. The plan includes maintaining an inventory of emergency response equipment and supplies, personnel training, and list of first responders including all communityHCPs and their medical specialties.

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).

Radiological injuries may occur

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

Among the more powerful natural disasters are

earthquakes

emergency are defined as those that require the

emergency response of outside assistance whether local, county, state, or federal levels.

The ST must be able to anticipate:

emergency situations and prepare for them in advance.

earthquakes produce an incredible amount of

energy when two portions of the earth's crust slide by one another along a fault line.

Health care responders should not

enter a home or other building that has sustained damage until it has been declared structurally safe and sound.

It may be necessary to first allow electricians, firefighters, and public safety individuals to

enter the scene to remove hazards.

A separate triage area should be

established in the treatment area or close to the scene of the disaster. Once the victims arrive at a health care facility, they may be triaged a second time.

Emergency planning tends to focus on the

events that could occur locally or regionally; therefore, it is "individualized."

When two or more rescuers are available, it is recommended to switch chest compressors

every 2 minutes, or about every five cycles of compressions and ventilations.

Retinal burns may occur, resulting in

scarring, permanent altered vision, or blindness.

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.

For trauma patients in cardiac arrest , it has been shown that cardiac arrest is usually caused by

exsanguinations or a critical thoracic injury.

heat waves

extended period of abnormally hot weather with humidity. More cautions in infants, adolescents, elderly, obese, and chronically ill people.

Flash floods are

extremely dangerous since they rarely allow any preparations; more common in desert regions. You will see GI illness and any infection diseases associated to this storm.

An earthquake can cause the

formation of a tsunami aka tidal wave.

Disseminated Intravascular Coagulation May need a transfusion of

fresh frozen plasma to replace the coagulation factors. Cryoprecipitate may be initiated if fibrinogen is extremely low.

malignant hypothermia usually triggered by an anesthetic agent

halothane, enflurane, isoflurane and/ or muscle relaxants: succinylcholine.

HCPs should be prepared to treat fractures for tropical storms and hurricanes such as:

head, spine, and eye injuries due to flying debris or collapse of a structure; or a person who was picked up and thrown a distance by the high winds. Electrical power to a community can be out, causing complications for the chronically ill.

If the emergency is a CBRN disaster,

health care responders trained in those specific disasters will be deployed (e.g., trained in patient decontamination procedures, including removal and proper disposing of contaminated clothing, and handling of chemicals used to decontaminate the skin).

Hurricanes are large storms that produce

heavy amounts of rain, storm surges, and high winds.

The HCP should place the

heel of one hand on the middle of the victim's chest and the heel of other hand on top of first in parallel fashion, push down 2 in, and allow chest to completely recoil after each compression

Radiological injuries decrease the body's

hematopoietic and immune systems, contributing to the morbidity and mortality of patients who cannot fight off bacterial and viral infections.

Tropical storms can lead to:

hurricanes when wind reach 74 mph.

People stuck in cars on barren highways or mountain passes are exposed to what during winter storms?

hypothermia and frostbite; carbon dioxide poisoning can occur if they leave the vehicle running for heat, especially if the tail pipe becomes plugged with snow.

The 2010 guidelines stress

immediate activation of the ERS and starting chest compressions.

Beginning chest compressions

immediately rather than giving two rescue breaths prevents delay in giving the first compression and getting the circulation moving.

A tsunami is an

immense wave of water that can reach land.

Associated with many of these natural disasters are

infectious diseases.

When an advanced airway is in place during two-person CPR, one breath

is given every 6 to 8 seconds without attempting to synchronize between chest compressions

FEMA Federal Emergency Management Agency

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

The injuries the HCP will encounter during a earthquake include

lacerations, fractures, serious head injuries, eye injuries, and crushing injuries due to falling debris, collapse of houses and buildings, and collapse of sidewalks, streets, and bridges.

The first indication of an attack is usually when

large numbers of patients present with the same set of signs and symptoms.

Hurricane Katrina brought forth many

legal aspects of treating disaster victims.

The switch during CPR should be made in

less than 5 seconds.

A winter storms can bring

life- threatening cold temperatures, low visibility and dangerous driving conditions, hypothermia, frostbite, carbon dioxide poisoning. Transportation can be impaired for emergency vehicles.

A team should be assigned to the

loading area, with one person who is assigned to coordinate the actions of the team as well as remain in communication with the IC and receiving health care facilities to make the decisions on where patients should be transported.

During an anaphylactic reaction, the surgical team must

maintain the airway and provide supplemental oxygen or the patient may die of respiratory failure.

CPR is a technique of

manually providing chest compression and ventilations to patients in cardiac arrest in an effort to provide oxygenated blood to the brain and vital organs and reverse the processes that lead to death.

All Hazards preparation refers to the

many different emergencies

Clinical death begins the

moment heart action and breathing stop; the patient has only 4 to 6 minutes before the cells of the brain begin to deteriorate.

malignant hypothermia may be diagnosed with a

muscle biopsy taken under a local anesthetic.

Another issue during a disaster situation is that HCPs

must remember that medical care life goes on—meaning that not only must the disaster victims be treated, but patients from all of the population will continue to need health care treatment and surgery.

Earthquake and Tsunamis

not the most common but the most powerful natural disasters.

Radiation exposure because of a

nuclear power plant leakage can cause mutations to occur in the cells of the body, resulting in various types of cancer.

Detection of a pulse can be difficult, especially in an emergency situation when the HCP is in a hurry, and therefore HCPs

often incorrectly assess the absence or presence of a pulse.

For the decontaminated area

separate shelter from the main treatment area should be set up that includes separate rooms for males and females.

Tropical Storms and hurricanes are

one of several reasons for the cause of floods. You will see lacerations, broken bones, head and eye injuries associated to this storm.

volcanos are an .

opening in the Earth's crust that allows poisonous gases and magma (melted rock) to escape

airway maneuvers should be

performed quickly and efficiently and minimize the interruption of chest compressions.

chemical can cause

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

The use of a backboard is recommended as long as

placement avoids a delay in initiating CPR or minimizes interruptions in CPR.

Family history of muscle disorders may indicate

predisposition.

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).

Triage of victims: Triage is the

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

The role of the surgical technologist during cardiac arrest in the surgical setting is to

protect the sterile field from contamination during the resuscitation efforts. In some cases, the surgical technologist may be required to assist by providing artificial respiration (bagging the patient) or providing chest compressions

In the OR, the surgical technologist's primary function during CPR is to

protect the sterile field; however, circumstances may require the surgical technologist to use CPR skills in the OR.

Surgical technologists may complete training in performing triage and/or serve in support roles such as

providing BLS/CPR, first aid treatment, and transporting patients. Patients should be tagged if possible to indicate the triage category

Excessive heat causes

psychological stress

One major reason for this low rate of SCA is the fact that fewer than one-third of SCA victims

receive bystander CPR and the CPR that is delivered is not high quality.

Terrorisms is often motivated by

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

Triage of chemical and nuclear disaster victims

requires a separate system of triage in order to contain the contamination. The patients are triaged three times: 1: hot zone 2: warm zone 3: cold zone

Wildfires can lead to:

respiratory and cardiovascular problems by the smoke. Later when rain comes, can produce heavy rain that can lead to landslides

Biological agents can enter the body through the

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

The HCP can check for

responsiveness and breathing simultaneously.

Health care responders will need to create a

safe zone as soon as possible for setting up the triage and initial treatment area.

Due to these similarities from an emergency or disaster the term all-hazards preparation is used, which provides 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 number of local or regional types of emergencies.

The body's blood clotting mechanisms are activated throughout

the body instead of being localized to a specific area of injury.

An epidemic or pandemic event can quickly overwhelm

the health care systems and create a shortage of HCPs who themselves become ill.

indicators such as rapidly dropping blood pressure, cardiac dysrhythmia, and any vital sign out of the normal range provide

the surgical team with information about impending emergent situations.

anthrax and smallpox are identified by the CDC as

the two most likely biological agents to be used as bioweapons.

Tsunamis can also be caused by

the underwater eruption of a volcano.

Gowns or other clothing should be available to provide to

the victim to prevent hypothermia and for the non-health care uninjured.

Uninjured non-health care individual(s) who came to the aid of contaminated victim(s) are to

transport to the treatment area must also undergo the decontamination procedure.

Man-made disasters refer to

transportation accidents and acts of terrorism or industrial incidents.

the type of natural disaster is often

unique to the area where it occurs, and the severity can vary.

In the absence of evidence of head or neck trauma, the HCP should

use the head tilt-chin lift maneuver to open the airway.

Bioterrorism

using infectious agents or germs. Health care facilities may be the initial site for recognition and response to these events

Many of the individuals who experience sudden cardiac arrest (SCA) exhibit

ventricular fibrillation (VF) at some point during the arrest.