Nurses Role In Emergency And Disaster Situations

Front 1

Emergency/ Disaster Nursing
What is:
--containment?
--decontaination?

Back 1

1) limitation of an emergency situation within a well-defined area
2) the physical process of removing harmful substances from personnel, equipment and supplies

Front 2

Emergency/ Disaster Nursing

What does DRT stand for?
What is a DRT?
Who can be on a DRT team?

Back 2

1) Disaster Response Teams
2) Disaster medical assistance teams that are regionally organized.
3) MD’s, nurses, and other health care providers in/out of their region to care for ill/injured.

Front 3

Emergency/ Disaster Nursing

What's a incident command system?
What's a mass casualty incident?

Back 3

1) A multiagency operational structure that assist in response of personnel, facilities and equipment.
2) A disaster situation that results in a large number of victims who need the response of multiple organizations

Front 4

Emergency/ Disaster Nursing

The emergency/disaster nurse needs what skills?
What certifications should this nurse have?

Back 4

1) Assessment, Priority setting, Critical thinking, Sound knowledge base, Flexibility and adaptability, Effective communication skills.
2) ACLS, PALS, BLS, optional APLES, ATCN, and CEN

Front 5

Emergency/ Disaster Nursing

What knowledge/skills should the emergency/disaster nurse have?

Back 5

Awareness of biological and chemical agents.
Technical skills r/t care (triage, decontamination, treatment).
Admin. skills to dev. appropriate systems to respond to emergency
Leadership skills in emergency situations.
Appreciation of mental health needs of a population following emergencies

Front 6

Emergency/ Disaster Nursing
Routine Nursing Concepts (review)
Who's responsible for the direction of care?
Who controls the environment?
What expertise is required?

Back 6

1) Physician writes orders
2) Facility and staff
3) specific to assigned patient population

Front 7

Emergency/ Disaster Nursing
Routine Nursing Concepts (review)
What directs care interventions?
Ancillary personal is under whose supervision?

Back 7

1) Cost reimbursement
2) Registered nurse

Front 8

Emergency/ Disaster Nursing
Concepts of Disaster Nursing:
Who's responsible for the direction of care?
Who controls the environment?
What expertise is required?

Back 8

1) Nurse is autonomous and relies on critical thinking and set disaster training skills.
2) Uncontrolled environment. Relies heavily on instinct reaction based on disaster training
3) Various diagnoses. Focus on stabilization and life preservation.

Front 9

Emergency/ Disaster Nursing
Concepts of Disaster Nursing:
What's the impact of cost?
What should the nurse remember about ancillary personnel.

Back 9

1) Not a consideration at the time of the disaster. Often a barrier in follow through care in the rehabilitation stage.
2) They are often untrained and they rely heavily on direction an on site training of the registered nurse

Front 10

Types of disasters?

Back 10

Mass casualty, Bioterrorism, Plague, Chemical warfare, Natural diasters

Front 11

Bioterrorism

Is what?
Possible agents?

Back 11

1) The deliberate release of pathogenic microorganisms, bacteria, viruses, fungi or toxins into a communityAnthrax
2) Plague, Smallpox, Botulism, Viral hemorrhagic fevers, tularemia

Front 12

Bioterrorism

What's anthrax?
How many types of anthrax are there?

Back 12

1) A serious disease caused by Bacillus anthracis, a bacterium that forms spores. A bacterium is a very small organism made up of one cell. Many bacteria can cause disease. A spore is a cell that is dormant (asleep) but may come to life with the right conditions.

Front 13

Bioterrorism

How many types of anthrax are there?
How do you get it?

Back 13

1) 3 [skin (cutaneous)
lungs (inhalation)
digestive (gastrointestinal)]
2) Not from another person. Handling Infected animal products (wool). Eating undercooked meat from infected animals. If it was used as a weapon.

Front 14

Bioterrorism

What form was anthrax used as a weapon?
How dangerous is anthrax?

Back 14

1) In 2001, as a powder sent through mail. (Caused 22 infections).
2) Category A because it poses the greatest possible threat on public health. It may spread across a large area or need public awareness, need a great deal of planning to protect the public’s health

Front 15

Anthrax

Is anthrax curable?

Back 15

1) Cutaneous: Early txt w/antibiotics can cure. Untreated, 80% don't die.
2) GI: more serious, 25 to > 50% die.
3) Inhalation: very severe, about 1/2 die.

Front 16

Anthrax

What are the warning symptoms?
Cutaneous
GI

Back 16

1) Cutaneous: an unpainful sm. sore turns into a blister. Then, into a skin ulcer with a black area in the center.
2) GI: n/d (bloody),loss of appetite, fever, a bad stomach pain.

Front 17

Anthrax

What are the warning symptoms?
Inhalation

Back 17

1) Cold/flu-like symptoms including a sore throat, mild fever and muscle aches. Later s/s include: cough, chest discomfort, shortness of breath, tiredness and muscle aches. (Caution: Don't assume that a person w/cold or flu symptoms has inhalation anthrax.)

Front 18

Anthrax

How soon do infected people get sick?

Back 18

For all three types: sx appear within 7 days of contact.
For inhalation anthrax: sx appear within a week or up to 42 days

Front 19

Anthrax

How is anthrax treated?
If HCP is exposed how is anthrax prevented?
How is it treated?

Back 19

1) Early ID and txt are important.
2) antibiotics (cipro, levofloxacin, doxycycline, or pcn) combined w/anthrax vaccine.
3) 60-day course of antibiotics. Success depends on the type of anthrax and how soon treatment begins.

Front 20

Anthrax

Can it be prevented?

Back 20

There's a vaccine to prevent it, but it's not available for gen public. Anyone possibly exposed (including U.S. armed forces, lab. workers, and workers entering contaminated areas). Or an attack using anthrax as a weapon, people exposed would get the vaccine.

Front 21

Plague

What is it?
When do the sx start?
What are the 1st sx of it?

Back 21

1) A rare bacterial disease caused by Yersinia pestis.
2) sx 2 to 6 days after getting plague
3) fever, chills, weakness, swollen and painful lymph nodes, and pneumonia.

Front 22

Plague

Can people get this from animals?
How else can it spread?

Back 22

1) yes but it's rare. Rodents (mice, rats, and squirrels), cats, and fleas carry it.
2) breathing in tiny droplets of water contaminated with Y. pestis

Front 23

Plague

What's the best protection from getting it?
What should you report, if the plague is found in your neighborhood?

Back 23

1) Don't pick up or touch dead animals
2) Report any sick or dead animals to the local health department or law enforcement officials.

Front 24

Plague

How can you make areas rodent proof?

Back 24

Eliminate food sources and nesting places. Remove brush, rock piles, junk, cluttered firewood, and potential food supplies, such as pet and wild animal food.

Front 25

Plague

How can you prevent rodent flea bites?

Back 25

Apply insect repellents to clothing and skin. Wear gloves when handling potentially infected animals.
Treat pets for flea control regularly and don't allow them to roam.
Health authorities may use appropriate chemicals to kill fleas at selected sites during animal plague outbreaks.

Front 26

Smallpox

Where does it come from?
How often does it occur?

Back 26

1) From Variola virus emerged in human populations thousands of years ago.
2) Its been eliminated but avail. in lab stockpiles.
3) US concerned it cd be used as chemical agent.

Front 27

Smallpox

How's it transmitted?

Back 27

1) Direct prolonged face-to-face contact required to spread to another person. Can be spread through direct contact with infected bodily fluids or contaminated objects such as bedding or clothing. Rarely, smallpox has been spread by virus carried in the air in enclosed settings such as buildings, buses, and trains. Humans are the only natural hosts of variola.

Front 28

Smallpox

When's is a person contagious?
How long are they contagious?

Back 28

Sometimes with onset of fever (prodrome phase).
Most contagious with the onset of rash. The person's usually very sick and not able to move around in the community.
2)The infected person is contagious until the last smallpox scab falls off.

Front 29

Smallpox

How long is the incubation period?
Contagious or not?
Sx?

Back 29

1) 7 to 17 days; avg. 12-14 days
2) Not contagious
3) No symptoms and may feel fine.

Front 30

Smallpox

What happens during the Prodrome stage?
Duration?
Contagious or not?

Back 30

1) The first sx occur and include fever, malaise, head and body aches, and sometimes vomiting. The fever's high (101 to 104). Client's too sick to carry on their normal activities.
2) 2 to 4 days.
3) Sometimes it is.

Front 31

Smallpox

Describe the early rash phase?
days 1-2.

Back 31

1st starts as small red spots on the tongue and in the mouth. Spots dev. into sores. When they break open lg amt of the virus goes into the mouth and throat. Meanwhile, a skin rash appears. Starts on face and spreads to arms, legs, hands, and feet. Usually it spreads to the entire body within 24 hours. As the rash appears, the fever usually falls and the person may start to feel better.
By the fourth day, the bumps fill with a thick, opaque fluid and often have a depression in the center that looks like a bellybutton. (This is a major distinguishing characteristic of smallpox.)
Fever often will rise again at this time and remain high until scabs form over the bumps.

Front 32

Smallpox

Describe the early rash phase?
days 3-4.

Back 32

By the 3rd day of the rash, the rash becomes raised bumps. By the 4th day, the bumps fill with a thick, opaque fluid and often have a depression in the center that looks like a bellybutton. (This is a major distinguishing characteristic of smallpox.) Fever often will rise again at this time and remain high until scabs form over the bumps.

Front 33

Smallpox

Describe the Pustular Rash.
Duration?
Contagious or not?

Back 33

1) The bumps become pustules—sharply raised, usually round and firm to the touch as if there’s a small round object under the skin. People often say the bumps feel like BB pellets embedded in the skin.
2) 5 days
3) Yes.

Front 34

Smallpox

Describe the Pustules and Scabs.
Duration?
Contagious or not?

Back 34

1) The pustules begin to form a crust and then scab. By the end of the second week after the rash appears, most of the sores have scabbed over.
2) 5 days
3) Yes

Front 35

Smallpox

Describe resolving scabs?
Duration?
Contagious?

Back 35

1) The scabs begin to fall off, leaving marks on the skin that eventually become pitted scars. Most scabs will have fallen off three weeks after the rash appears.
2) 6 days
3) Yes

Front 36

Smallpox

When are scabs resolved?
Contagious?

Back 36

1) Scabs have fallen off. Person is no longer contagious. * Smallpox may be contagious during the prodrome phase, but is most infectious during the first 7 to 10 days following rash onset.
2) No

Front 37

Botulism

What is it?
What's it caused by?
How many neurotoxins are made by ...?

Back 37

1) A serious illness that causes flaccid paralysis of muscles.
2) A neurotoxin, generically called botulinum toxin, produced by the bacterium Clostridium botulinum.
3) 7 types (A-G)

Front 38

Botulism

Which of the neurotoxins are most common in human?
Which of these causes flaccid paralysis in humans?
Contagious?

Back 38

1) A, B, E, F
2) A, B, E
3) No
4) 6 hours- 10 days after eating the food. Avg. 18-36 hours.

Front 39

Tularemia

What's the cause?
Animal or human disease?
How do humans get it?

Back 39

1) The bacterium Francisella tularensis
2) Both (Rabbits, hares, & rodents )
3) Tick bites, deer fly bites, skin contact w/infected animals, ingestion of contaminated water, or inhalation of contaminated dusts or aerosols. In addition, humans could be exposed as a result of bioterrorism.

Front 40

Tularemia

What are the sx?
Why the concern?
Txt?
Prevention?

Back 40

1) Vary depend on route of infection.
2) Could be life-threatening
3) Antibiotics

Front 41

Tularemia

Prevention?

Back 41

Use insect repellent (with 20-30% DEET, picaridin or IR3535), wear gloves when handling sick or dead animals, and not mowing over dead animals. Wear long pants, long sleeves, and long socks to keep tick and deer flies off your skin. Remove attached ticks promptly with fine tipped tweezers. Don’t drink untreated surface water. Consider using dust masks to reduce your risk of inhaling the bacteria. Cook game meat thoroughly before eating.
Vaccine avail. for lab tech. and being checked by FDA.

Front 42

Viral hemorrhagic fevers

What is this?

Back 42

A group of illnesses caused by several distinct families of viruses. In general, the term "viral hemorrhagic fever" is used to describe a severe multisystem syndrome (multisystem in that multiple organ systems in the body are affected).  Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired. 

Front 43

Viral hemorrhagic fevers

Sx?

Back 43

1) Hemorrhage

Front 44

Emergency Disasters

For these patients, what needs to be managed?

Back 44

Isolation Precautions
Patient Placement
Patient transport
Cleaning and disinfection
Postmortem care
Discontinuation of isolation

Front 45

Emergency Disaster

How is a patient decontaminated?

Back 45

Specifically designed room or portable showers
Fire department of hazardous response team (HAZ MAT)
Remove clothing showering

Front 46

Chemical Warfare

What are the 5 nerve agents?
What do they do?

Back 46

1) tabun (GA), sarin (GB), soman (GD), cyclohexylsarin (GF), and VX
2) These agents initially stimulate and then paralyze certain nerve transmissions throughout the body and cause other toxic effects such as seizures.

Front 47

Chemical Warfare

S/S?

Back 47

Nerve agents produce various signs and symptoms depending on the agent someone might be exposed to, its concentration, and length of exposure