Term
| What are the guidelines of the Homeland Security Advisory System? |
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Definition
Green - low risk for terrorist attacks
Blue - guarded; review procedures
Yellow - Elevated Condition
Orange - High risk of terrorist attacks; coordinate w/ local law enforcement
Red - Severe threat of terrorist attack;
intense monitoring of public transportation |
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Term
| What are the Triage Catagories? |
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Definition
Immediate - Red - injuries that are life threatening
Delayed- Yellow - significant injuries but can wait hours
Minimal - Green - minor injuries- can wait hours or days
Expectant - Black - extensive injury - comfort only |
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Term
| What types of injuries are Immediate? |
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Definition
Airway obstruction/CPR-intubate
2 or 3rd degree burns - wrap them
Incomplete amputations - lay down- stop bleeding
Sucking chest wound
Open fractures bleeding |
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Term
| What types of injuries are delayed? |
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Definition
abdominal wounds
closed fractures
soft tissue injury
facial wounds
GU disruption
CNS problems |
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Term
| What types of injuries are minimal? |
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Definition
| Minor burns/sprains, upper extremity fractures, behavioral and psychiatric disturbances, pain (classified under psyche) |
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Term
| What types of injuries are Expectant? |
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Definition
Expected to die
Unresponsive w/ head wound
severe trauma w/ external bleeding
2 or 3 degree burns > 60% of body |
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Term
| What are the roles of the Nurse during a disaster? |
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Definition
May be asked to perform skills out of normal realm (ie. intubation)
Managing Media- should be designated spokesperson
Families need to be in separate areas w/ counselors, social services- not in triage areas |
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Term
| What should the nurse recognize as a possible terroristic act? |
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Definition
Unusual inc. in # of people w/ respiratory and GI sx.
Unusual illnesses for time of year
Large number of rapidly fatal cases
Inc. in disease in normally healthy cases
Clusters of pts. in one location |
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Term
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Definition
| education about stress recognition and management |
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Term
|
Definition
| discussion about emotionsl reactions to incident |
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Term
| What do different PPE's do? |
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Definition
Level A - totally encapsulating, SCBA, Skin,eye,respiratory protection
Level B - Resp protection (SCBA) less skin/eye protection
Level C - air purified respirator w/ filters, chemical resistant cover-all w/ splash hood
Level D Least potentioal for exposure
same as the work uniform
Level B - |
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Term
| What are the necessary components of decontamination? |
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Definition
Remove clothing & jewelery
Rinse w/ water
Soap and water
(may vary w/ specific agents) |
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Term
| What are the needs/problems of natural disasters? |
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Definition
Many immediate casualties are trauma related
Loss of communication
Loss of water, food, electricity
Attacks by animals
Need shelter
Diseases (ie. malaria) |
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Term
| How does anthrax attack the body? |
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Definition
| When spores get into the body, they grow rapidly and produce a substance (anthrax toxin) that destroys the cells in the immune system |
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Term
| What is the Tx. for anthrax? |
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Definition
Cipro (do not take w/ calcium - dec. potency)
Doxycycline (Vibramycin)
Penicillan
Erythromycin |
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Term
| What are the characteristics of Inhalation Anthrax? |
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Definition
Incubation period may be up to 60 days.
Starts with flu like symptoms
Improvement- then worse
Second phase : bacteria enters blood
Abdominal pain, hematemesis, cyanosis, confusion, meningitis (50%) may progress to CV collapse |
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Term
| Nursing interventions for inh. anthrax |
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Definition
appropriate decontamination
standard and contact isolation
need to address long term compliance - can have post exposure symptoms for 60 days |
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Term
| How is smallpox transmitted? |
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Definition
droplet and direct contact
cough, sneeze
lives on linen and clothing
begins to be contageous after rash appears
Remains contagious until all scabs are gone
Incubation period 7 - 17 days |
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Term
| What are the S/S of smallpox? |
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Definition
Begins as flu like symptoms
Fever > 101
Maculopapular rash (red spots) starts on face, tongue, mouth, arms, hands and throat
then spreads to trunk and feet in 24 hrs.
Progression of rash : macules - vesicles- pustules-scabs
some bleeding may occur |
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Term
| What are the nursing interventions with smallpox? |
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Definition
Strict respiratory and contact isolation with negative pressure
Virus is very smalll in size and can be carried far distances on dust particles
Linens need to be carefull put in one big sealed bag and a second leak proof leak bag.
Antibiotics for secondary infections
Supportive care:
Hydration
Sedation
Pain meds
Vaccine for smallpox contains polymyxin B, streptomycin, neomycin so anyone allergic to these cannot take the vaccine |
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Term
| How is smallpox diagnosed? |
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Definition
culture for lesions
symptoms
mortality - at least 30% |
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Term
| What are the characteristics of chemical agents? |
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Definition
Tendancy to become vapor
cyanide most volatile
* most chemicals are heavier than air so victim should first stand up* |
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Term
| How do nerve agents affect the body and what are the most common nerve agents? |
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Definition
Permanently binds with acetylcholinesterase so that acetylcholine accumulates at nerve endings causing a massive cholinergic response.
ie. Sarin, Soman, DDT, Organophosphates (pesticides)
may be inhaled or absorbed |
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Term
| What are the S/S of chemical nerve agents? |
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Definition
miosis/visual disturbances, NVD, Bradycardia and heart block, laryngeal spasm/bronchial constriction, weakness, incontinence, fasciculations
SLUDGEM (salivation, lacrimination, urination, defecation, gastric disorders, emesis, miosis) |
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Term
| What is the treatment for exposure to chemical nerve agents? |
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Definition
Atropine
Decontamination w/ soap and water or saline
May need fqt suctioning
alium for benzodiazepams
Pralidoxine
(frees up acetylcholinesterase to break down acetylcholine - given w/ atropine) |
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Term
| What are blood agents and how are they treated? |
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Definition
Act on cellular metabolism resulting in asphyxation through alteration in hemoglobin
ie. cyanide - inhibits aerobic metabolism
S/S flushing, tachycardia, cherry red lips, neuro symptoms, seizure, death
Tx: amyl nitrate, intubation, ventilation |
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Term
| What is the long term effect of radiation? How is it treated? |
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Definition
Thyroid cancer and leukemia
Exposure affected by time, distance, shielding
Tx: potassium iodide to protect thyroid |
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Term
| What are the 3 types of anthrax and how is each transmitted? |
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Definition
Cutaneous - direct contact
Gastrointestional - eating contaminated animal or animal products
Inhalation - airborne |
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Term
| Differentiate between bubonic and pneumonic plague |
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Definition
bubonic - infects lymph nodes - buboes
flu like symptoms
mortality <10% w/ tx. 40-60% w/o tx.
Pneumonic- similar to severe pneumonia w/ hemoptosis and chest pain
Respiratory isolation
Mortality 60% w/ tx. 95-100% w/o tx. |
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