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54 Cards in this Set
- Front
- Back
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What type of threat causes panic and anxiety for longer periods of time?
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Biological
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What are some of the stressors on health team members during times of threats?
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1. work longer shifts
2. increased vol. of patients 3. trying to care for your own family 4. emotional reaction of team and pts |
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Color Advisory System
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Low - Green
Guarded- Blue Elevated - Yellow High - Orange Severe - Red |
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Who assigns the advisory system?
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the Attorney General w/ coordination of director of homeland security
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The three dxs most likely to be used as biological weapons?
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Smallpx, Anthrax and plaque
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What are Category A weapons?
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1.most deadly
2.most easily disseminated 3. highest mortality rate or public health threat 4.risk to health care providers 5.limited number of labs qualified to handle specimens or conduct research |
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What are Category A diseases?
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Anthrax, botulism, plague, smallpox, tularemia (found in dead rabbits, tick bites & fleas, fever, chills, headache and diarrha, muscle aches, dry cough, pneumonia, bloody sputum, progressive weakness), viral hemorrhagic fever viruses (ebola, marburg, and Lassa
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What are Category B weapons?
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1. 2nd highest priority
2. potential for moderate mortality and lower mortality than A 3. moderately easy to disseminate. May be very toxic but harder to spread 4. pose a significant health risk |
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What are Category B diseases?
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Salmonella, shigella, E coli, ricin toxin, typhus, encephalitis, cholerae
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What are Category C weapons?
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emerging agents that could create potential future threats
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What are Category C diseases
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Nipah fever and hantevirus
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What is the only orthopox that can be transmitted from person to person?
What is the mortality rate? |
Smallpox
30% |
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How does Smallpox kill?
How does it spread? |
Death is from toxemia to the circulating antigens and circulating immune complexes.
Transmitted from person to person in droplets or from clothing or bedding. Highly contagious and remains stable for months on inanimate objects. Takes fewer than 10 virus particles to infect 50% of the time |
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If a tribe member is found to have smallpox after lab testing do the other tribe members need to be tested?
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no not necessary - one positive means all with symptoms have it
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How could smallpox be delivered?
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it could be aerosolized, if 50-100 people infected it would spread by factor of 10
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What type of Anthrax is lethal?
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aerosolized
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How is Cutaneous Anthrax contracted?
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not person to person - usually from dirt, can get from contaminated clothing
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In what time period does a pt with inhaled Anthrax usually go to the hospital?
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3-4 day, then death 24-48 hrs later
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What is the hallmark sign of Inhaled Anthax poisioning?
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a widened mediastinum on x-ray
there is severe edema and hemorrhage in the mediastinum |
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If a person that was healthy shows up the next day with overwhelming febrile illness or sepsis what would cause this?
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inhaled Anthrax
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What is the name of the organism that causes Anthrax?
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bacillus anthracis
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Is Anthrax a viral or bacterial disease?
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bacterial
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How is Anthrax treated?
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Post exposure prophylaxis with cipro or doxycycline
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What member of the health care team may figure out that there is an outbreak?
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Pharmacists - demand for cipro
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What are the 3 forms of plaque?
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bubonic, pneumonic and septicemic
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How is the plaque contracted?
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bite of infected flea from a rodent
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What organism causes the plaque?
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bacteria Yersinia Pestis
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A pt shows up at the ER with painful swollen lymph nodes called bubos. What should the nurse suspect?
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bubonic plague (black plague)
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What is the manisfestation of the Bubonic Plaque?
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bubos, Progresses to sepsis, DIC, necrosis of fingers and toes, fever, chills, myalgias, multiorgan system failure
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What is the fatality rate of Pneumonic plaque?
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rate is 57%
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What are the symptoms of the Pneumonic plague?
How is it contracted? |
Symptoms hemorrhagic necrotizing bronchial pneumonia, dyspnea, chest pain, cough, hemoptysis.
Can be contracted through droplets from infected individuals |
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What is the nursing management of Pneumonic plague?
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strict isolation, gowns, gloves, eye protection, mask for the 1st 48 hrs of treatment
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What would be the fatality rate if pneumonic pl. was aerosolized and dropped over a populated area?
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25%
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What is the treatment for the Plague?
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prophylactic antibiotics Doxycycline and Cipro if exposed
Treatment is Streptomycin or Gentamycin |
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How is Botulism contracted?
What organism causes it? |
neuroparalytic food borne illness
clostridium botilinum |
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What is the most lethal organism known to man?
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Botulism
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What are the symptoms of Botulism?
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Progressive symmetric descending paralysis.
Begins as cervical nerve palsy, cranial nerve palsy, dilated or nonreactive pupils, paralysis involving respiratory muscles. Duration 6-8 weeks. Nausea, vomiting, diarrhea, late stage constipation. Infants flaccidity (floppy baby), poor suck, poor feeding, and poor head control. Universal precautions with droplet protection Botulism antitoxin |
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What are some chemical agents used?
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nerve agents-sarin
chocking agents-phosgene blister agents- mustard gas blood agents-hydrogen cyanide |
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What are the symptoms of nerve agents?
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Symptoms of nerve agents are salivation, urination, sweating, bradycardia, hypotension, collapse, convulsion, respiratory distress, death
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How does Sarin work?
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Toxic organophosphate compounds that inhibit acetylcholinesterase.
Increased levels of acetylcholine cause respiratory and cardiovascular collapse. Similar to insecticide poisoning Treatment atropine and (antidote of sarin) oximes (2-Pam) Salivation, and fluids controlled by ACH- start off with 2mg q 3-5 hrs – |
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Why would the medical response to radiation poisoning be to treat the injury-not worry about decomtamination?
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because the chance of getting enough radiation from a victum is low, but if non-life threatening than should decontaminate first
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What are symptoms of radiation sickness?
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nausea, vomiting, burns, immune suppression with infection
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What is the NNRT?
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Partnership between Assistant Secretary for Public Health Emergency Preparedness and the American Nurses Association.
Rapid response team that can be deployed to a disaster rapidly when mass immunization or chemoprophylaxis is needed. |
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What does CISM stand for?
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Critical Incident Stress Management - it is post incident
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The CISM had two processes. What are they?
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Defusing and Debriefing
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Defusing means?
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a process by which the individual receives education about recognition of stress reactions and management of stress
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Debriefing means?
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a more complicated process requiring 2-3 hrs in which participants are asked about their emotional reactions following an incident and any persistent symptoms of stress like flash backs, insomnia, intrusive thoughts.
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What does Triage mean?
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to sort, patients are quickly evaluated and ranked according to severity of illness/injury and cared for in the appropriate place and time frame
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What is the overriding priniciple of Triage?
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do the greatest good for the greatest number of people
decisions are made on the basis of likelihood of survival and resources availble. |
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NATO has a system of tags that show priority to be triaged. What are they
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priorty 1-red
priority 2- yellow priority 3 - green priority 4 - black |
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Nato's color system of Priority 1 means?
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immediate injuries are life threatening but survivable with minimal interventions
RED |
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Nato's color system of Priority 2 means?
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Yellow- delayed injuries are significant and require medical care, but can wait for hours without threat to life or limb
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Nato's color system of Priority 3 means?
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Green -minimal injuries are minor and treatment can be delayed hours and days
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Nato's color system of Priority 4 means?
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Black - injuries are extensive and chances of surival are unlikely even with definitive care. Comfort measures only. Remove to a private place
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