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DISASTER-NURSING-MIDTERMS.pdf Flashcards
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Disaster Risk Reduction and Management Frameworks
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What is the purpose of the United Nations International Strategy for Disaster Reduction (UNISDR)?
To bring governments, partners, and communities together to reduce disaster risk losses and ensure a safer, sustainable future.
When was the UNISDR created and why?
Created in December 1999 to ensure the implementation of the International Strategy for Disaster Reduction.
What is the Sendai Framework for Disaster Risk Reduction?
A framework adopted on March 18, 2015, with 7 targets aimed at reducing disaster risk losses in various aspects of life and environment.
What are the goals of the Sendai Framework for Disaster Risk Reduction?
To prevent, reduce existing disaster risk through integrated measures, enhance preparedness for response and recovery, and strengthen resilience.
What are the 7 global targets to be achieved by 2030 according to the Sendai Framework?
1. Reduce global disaster mortality; 2. Reduce the number of affected people globally; 3. Reduce direct economic loss in relation to GDP; 4. Reduce disaster damage to critical infrastructure and disruption of basic services; 5. Increase the number of countries with national and local disaster risk reduction strategies; 6. Enhance international cooperation to developing countries; 7. Increase the availability of and access to multi-hazard early warning systems.
What are the 4 priorities for action outlined in the Sendai Framework?
1. Understanding disaster risk; 2. Strengthening disaster risk governance; 3. Investing in disaster risk reduction for resilience; 4. Enhancing disaster preparedness for effective response.
What are the 4 priorities for action in disaster risk reduction?
1. Understanding disaster risk 2. Strengthening disaster risk governance to manage disaster risk 3. Investing in disaster risk reduction for resilience 4. Enhancing disaster preparedness for effective response to build back better in recovery, rehabilitation, reconstruction
What are the 4 priorities for building a resilient nation in terms of disaster risk reduction?
1. Climate change adaptation 2. Strengthening the international system for disaster risk reduction and management 3. Building disaster-resilient cities, schools, and hospitals 4. Increasing investment for disaster risk reduction and management
What is the primary objective of the Hyogo Framework for Action on Disaster Reduction?
To build the resilience of nations and communities to disasters
What are the primary actions recommended by the Hyogo Framework for Action on Disaster Reduction?
1. Ensure Disaster Risk Reduction is a national and local priority with a strong institutional basis for implementation 2. Identify, assess, and monitor disaster risks and enhance early warning systems 3. Use knowledge, innovation, and education to build a culture of safety and resilience at all levels 4. Reduce underlying risk factors 5. Strengthen disaster preparedness for effective response at all levels
What are the 3 cornerstone methods of data collection for disaster planning?
1. Hazard identification and mapping 2. Vulnerability analysis 3. Risk assessment
What is the purpose of hazard identification and mapping in disaster planning?
To determine which events are most likely to affect a community, make decisions about protection measures, prevention, mitigation, and response using data mapped with various technologies.
What is the purpose of vulnerability analysis in disaster planning?
To determine who is most likely to be affected, which property is at risk, and the community's capacity to deal with disaster effects by collecting data on susceptibility to develop prevention strategies.
What is the purpose of risk assessment in disaster planning?
To determine the probability of specified outcomes from hazards affecting a community with known vulnerabilities and coping mechanisms, presented in numerical range, percentage, or relative form.
What are the major objectives of risk assessment in disaster planning?
1. Determine the community's risk of adverse health effects from disasters 2. Identify major hazards and their sources 3. Determine sections of the community most likely to be affected 4. Identify existing measures and resources to reduce hazard impact 5. Determine areas for strengthening to prevent and mitigate hazard effects
What is the goal of general preparedness by the Red Cross and Red Crescent societies around the world?
To improve preparedness for disasters by coordinating with national authorities, training volunteers, researching new technologies, and working with communities to understand needs.
What is the purpose of Red Cross Red Crescent organizations around the world in terms of disaster preparedness?
To improve preparedness for disasters by coordinating with national authorities, training volunteers, researching new technologies, working with communities, and setting up early warning systems.
What are some key components of general preparedness for families in disaster situations?
Providing resources for identifying hazards, encouraging exploration of options, assisting with emergency communication methods, creating a home emergency plan, and building an emergency kit.
What are the key components for community preparedness plans?
Community profile, physical infrastructure, risk assessment, early warning system, recovery plans, emergency response protocol, and community disaster reduction fund.
What does a community profile in disaster preparedness entail?
It involves identifying vulnerable communities, understanding their exposure to hazards, and assessing their relationships with agencies and institutions for aid and support.
What is the significance of manpower in community preparedness plans?
Manpower includes experts conducting risk assessments, locals trained to implement DRRM plans, rescue teams for search and rescue operations, medical assistance providers, and relief distribution facilitators.
What is the purpose of a risk assessment in disaster preparedness?
To identify potential hazards, assess the level of disaster risk for each hazard in the community, and understand the impact of disasters on the area.
What is an early warning system (EWS) in disaster preparedness?
It provides information about imminent hazards in forms like sounds, symbols, or letters to ensure immediate understanding by all stakeholders in the community.
What is the role of emergency response protocol in disaster situations?
It includes search and rescue operations to provide immediate aid to survivors, ensure safety protocols for rescuers, monitor vital signs, and prevent health hazards or contamination.
What are some needs of survivors in disaster situations?
Clean drinking water, ready-to-eat food, secure evacuation centers, accessible healthcare providers, and debriefing for emotional support.
What should survival kits and materials for disasters contain?
Essential items, clean drinking water, food, medicines, and materials that are waterproof and regularly checked for expiration.
What are the needs of survivors in a disaster situation?
Clean potable water, ready-to-eat food, huge secured and safe evacuation centers, visible accessible and equipped health care providers, debriefing
What should be included in a survival kit for disasters?
Essential items, waterproof container, regularly checked for expiring medicines or materials
What are some examples of food items to include in a survival kit?
Clean drinking water, easy-to-prepare store-carry foods like biscuits, cookies, crackers, canned foods, candies, food for babies or elderly
What medicines should be included in a survival kit?
Cough medicine, cold medicine, stomach upset medicine, Imodium, headaches and other pains medicine, bioflu, allergies medicine, antihistamine, special medicines like Metformin and Losartan
What first aid items should be included in a survival kit?
Medicated plastic strips, gauze, antiseptic disinfectant, antibiotic ointment, wipe packets
What sanitation and toiletries should be included in a survival kit?
Sanitary napkins or diapers, toothpaste, toothbrushes, bath soap, laundry soap, small towels, plastic garbage bags
What clothing items should be included in a survival kit?
Extra clothes, jackets, blanket, underwear
What emergency tools and gadgets should be included in a survival kit?
Whistle, flashlights, batteries, radios, mobile phones, chargers
What important items should be included in a survival kit?
Keys, cash, jewelries, important documents such as birth certificates, marriage certificates, government IDs, bank passbooks, investment records
What are the general evacuation procedures to follow in case of an emergency?
Be aware of emergency exits, warning calls, exit using stairways, do not use elevators, follow DRRM personnel instructions, notify authorities of those needing assistance, never re-enter building unless declared safe
What are the objectives of fire prevention in disaster preparedness?
Prevent fire from starting, eliminate causes of fire, save lives and property, minimize losses, confine fire in its point of origin, put out fire
What are the steps to prevent the outbreak of fire in a building?
Identify source of flammable chemicals and materials, provide early detection with alarm systems, prevent the spread of fire with barriers, provide for prompt extinguishment with blankets, cooling, removal of fuel, and fire extinguishers
What measures can be taken to prevent the spread of fire in a building?
- Use of barriers to limit the area of fire - Retard the spread of fire with fire walls, fire doors, shutters or louvers, baffles, fire dampers, and dikes
What are some ways to provide for prompt extinguishment in case of a fire?
- Blanketing or smothering - Cooling or quenching - Removal of fuel - Fire extinguishers (permanent or built-in, standpipe and hose, sprinkler system, automatic extinguishing system, portable extinguishers)
What are some examples of portable extinguishers that should be accessible, located, and maintained in operating condition?
- Dry Chemical - Red HCFC 123 - Green Aqueous Film Forming Foam (AFFF) - Blue
What should be considered for a prompt and orderly evacuation during an emergency?
- Have at least 2 ways out and remote from each other - Know your emergency exits - Ensure a travel distance to exits should be 45m without sprinklers and 60m with sprinklers - Have readily visible signs placed within 30m from exit access - Emergency lights providing illumination for at least 15 hours
What are some key components of earthquake preparedness before an earthquake occurs?
- Assembling an emergency preparedness kit - Creating a household evacuation plan - Staying informed about community's risk response plans - Ensuring family members know how to get back in touch if separated during an emergency
How can you protect your family during an earthquake?
- Talk about earthquakes with your family - Check earthquake emergency plans at workplace, schools, and day care centers - Pick safe places in each room for DROP COVER HOLD ON practice - Ensure access to radio broadcasts and have a battery-powered or hand-crank radio
What should be included in a pet emergency kit for earthquake preparedness?
Prepare a pet emergency kit for your companion animals
What measures can be taken to protect your home during an earthquake?
- Bolt or brace water heaters and gas appliances to wall studs - Install strong latches or bolts on cabinets - Secure large or heavy items closest to the floor - Learn how to shut off gas valves and keep a wrench handy - Anchor overhead lighting fixtures and top-heavy furniture to wall studs
What actions should be taken by an individual during an earthquake to protect themselves?
1. DROP: Drop down to hands and knees, hold onto something sturdy 2. COVER: Cover head and neck with arms
What should you do during an earthquake to protect yourself?
1. Drop or lock, 2. Cover, 3. Hold on
What are some tips for protecting yourself during an earthquake if you are using a wheelchair or walker?
Make sure your wheels are locked and remain seated until the shaking stops
What should you do if you are under a table or desk during an earthquake?
Hold on with one hand and be ready to move with it if it moves
What are some preparedness steps for volcanic eruptions?
Assembling an emergency kit, staying informed, creating an evacuation plan, ensuring communication among family members
What should you do if you are caught in an ashfall during a volcanic eruption?
Wear a dust mask, protect your eyes with goggles, cover skin, stay indoors if possible
What should you do after a volcanic eruption to stay safe?
Let friends and family know you're safe, return only when authorities say it's safe, continue listening to local news for updates
What are some flood preparedness steps?
Find out if you live in a flood-prone area, know whether your property is at risk
What organization can help you reconnect with family members during a disaster?
When should you return home after being evacuated?
Only when authorities say it is safe to do so
What actions should you take if people around you are injured during a disaster?
Practice CHECK CALL CARE - Check the scene, call for help, and if trained, provide first aid until emergency responders arrive
What steps can you take for flood preparedness?
Find out if you live in a flood-prone area, elevate your furnace, water heater, and electric panel, use sandbags to construct barriers, install check valves, and be familiar with flooding warning signs
What should you do in tornado preparedness if you see a tornado approaching?
Move to an underground shelter, basement, or safe room; if unavailable, go to a small windowless interior room or hallway on the lowest level of a sturdy building
How can you protect your home during a storm?
Make a list of items to bring inside, make trees more wind-resistant, remove debris or loose items, install permanent shutters, and strengthen garage doors
What should you do if you are outdoors during a tornado?
Seek shelter in a basement, shelter, or sturdy building; if unable to reach shelter, get into a vehicle and drive to the closest sturdy shelter, buckle your seatbelt, and stay away from bridges and highway overpasses
What preparations can you make for typhoon or cyclone preparedness?
Secure your property, cover windows, trim trees and shrubs, clear rain gutters, reinforce garage doors, bring in outdoor objects, and listen to a NOAA weather radio or TV for updates
What should you do if strong winds and flying debris occur while driving during a tornado?
Pull over, park, keep your seatbelt on, engine running, put your head down below the windows, covering it with your hands or a blanket
How can you make windows more wind-resistant?
Use screws to attach them
How can you make trees and shrubs around your home more wind-resistant?
Trim them
What should you do to ensure clear rain gutters and downspouts?
Clear loose and clogged debris
Why is it important to reinforce garage doors during a storm?
To prevent wind from causing structural damage
What should you do with outdoor objects like furniture, toys, and tools during a storm?
Bring them inside or anchor them
What should you do if a NOAA weather radio or TV advises evacuation?
Be prepared to evacuate immediately
Where should you keep valuables and important documents during a storm?
With you in a waterproof container
What should you do to have an electronic version of important documents after a storm?
Make 6 copies of documents and email them to yourself
What should you do with utilities if instructed to do so during a storm?
Turn off utilities
How should you prepare your refrigerator for a storm?
Turn the thermostat to its coldest setting and keep the doors closed
What should you do if you suspect flooding during a storm?
Duct tape your refrigerator shut
What should you do if electricity is lost during a storm to avoid power surges?
Turn off appliances
How can you ensure a water supply for sanitary purposes during a storm?
Fill the bathtub and other large containers with water
Where should you take refuge during a storm?
In a small interior room, closet, hallway, or bathroom on the lowest level away from windows and glass doors
What should you do to protect yourself during an earthquake before a tsunami?
Drop, cover, and hold on
How can you protect yourself from the effects of a tsunami?
Move from the shore to safe high grounds outside the tsunami hazard area
What signs should you be alert to for a potential tsunami?
Sudden rise or draining of ocean waters, earthquake, loud roar from the ocean, unusual ocean behavior such as a sudden rise or wall of water, or sudden draining of water showing the ocean floor
What is the purpose of a communication plan during an emergency?
To ensure employees follow protocols in contacting stakeholders, the media, and others
What are universal emergency codes used in health care facilities?
Color-coded indicators for various situations, such as violent situation, hazardous material spill, mass casualty, cardiac arrest, evacuation, etc.
What does the white emergency code indicate in a health care facility?
Violent Situation
What does the amber emergency code indicate in a health care facility?
Missing Child
What does the red emergency code indicate in a health care facility?
Fire
What is the purpose of a family communication plan during a disaster?
To plan how family members will contact each other and communicate in different disaster situations
What program provides emergency contact numbers in case of inability to go home or get in touch?
ICE (In Case of Emergency)
What should be included in a family contact sheet for emergencies?
Names, addresses, phone numbers of important contacts, and an out-of-town contact
Where should contact cards for each family member be kept?
In a purse, wallet, or child's backpack
What information should be included in a family member's contact card?
Emergency contact name and number, out-of-town contact name and number, neighborhood meeting place, and other important information
Why is it important for every family member to have emergency phone numbers and a cell phone?
To ensure communication and coordination during emergencies
What is the importance of teaching children how and when to call 911 for help?
To ensure they know how to seek help during emergencies
What alternative communication method is suggested when phone calls are not possible during disasters?
Text messages, email, and social media
What does PACE stand for in the family communication plan for emergencies?
PRIMARY, ALTERNATE, CONTINGENCY, EMERGENCY
What is the PRIMARY form of communication in the PACE methodology?
Digital cellular communications
What is the purpose of disaster triage in emergency situations?
To place the right patient in the right place at the right time to receive the right level of care
What is the purpose of primary triage in emergency care at a mass gathering scene?
Initial gross sorting of patients in the field to maximize outcomes for the greatest number of victims.
What is the goal of daily triage performed by nurses in the ED?
To identify the sickest patient and assess and treat them first.
What is the difference between incident triage and disaster triage?
Incident triage occurs when the ED is stressed but can still provide care, while disaster triage is used when EMS and hospital services are overwhelmed.
What are the categories of patients during disaster triage?
Deceased, Immediate, Delayed, Minor, Ambulatory.
What does the color green represent in disaster triage for ambulatory patients?
Physiologically well-compensated patients who can wait for definitive care with minimal risk of deterioration.
What does the color yellow represent in disaster triage for urgent delayed patients?
Patients with compensated physiology but a significant potential for deterioration with long delays in care.
What does the color red represent in disaster triage for emergent immediate patients?
Patients with uncompensated physiology and life-threatening injuries amenable to rapid intervention.
What does the color black represent in disaster triage for deceased or expectant patients?
Victims with no detectable vital signs or minimal signs of life who will soon die without immediate extraordinary measures.
What are the phases of disaster triage?
Primary Triage, Secondary Triage, Tertiary Triage.
Who are the individuals responsible for conducting disaster triage?
Trained individuals, paramedical personnel, medics, EMRs, EMTs, and medical personnel like doctors and nurses.
What is the purpose of decontamination in emergency care incidents involving chemical, biological, or radioactive agents?
An organized method to remove residual contaminants from the victims' hair, skin, and clothing.
What are the three phases of disaster triage?
Primary Triage, Secondary Triage, Tertiary Triage
What is the focus of primary triage in disaster situations?
Initial gross sorting of patients in the field, aimed at maximizing the outcome for the greatest possible number of victims
What is the goal of secondary triage in disaster situations?
To determine which patients can be treated effectively on the scene and identify those whose immediate needs can only be met in hospital settings
When does tertiary triage become necessary in disaster situations?
When the hospital is damaged, functioning at a lower capacity, or overwhelmed by both disaster and non-disaster patients
What is the START triage system used for?
Simple Triage and Rapid Treatment, aimed at quickly categorizing patients based on their condition and needs
What are the five basic parameters assessed in the RPM triage system?
Respiration, Perfusion, Mental Status, Ability to walk, and Obey commands
How are patients classified in the START triage system based on RPM indicators?
Emergent (RED), Urgent (YELLOW), Expectant (BLACK), Minor (GREEN)
What is the JUMPSTART triage tool used for?
Pediatric MCI triage, developed to address the unique physiology of children
What is the main difference between the START and JUMPSTART triage systems?
JUMPSTART recognizes that very young children might not be able to walk and prioritizes assessment of respiratory status for children
What is the window of salvageability in the JUMPSTART system?
5 rescue breaths and a respiratory rate of 30, tagged as Immediate
What is the critical threshold for a low respiratory rate in a patient?
15 or 45 immediate
How is the ability to obey commands used to assess mental status in a patient?
May be unable or unwillingly to obey commands, indicating developmental or behavioral issues or fear
What does AVPU stand for in the context of assessing mental status?
Alert, Voice, Pain, Unresponsive - indicating different levels of responsiveness
What is the purpose of tagging patients during the triage process?
To help rescue technicians identify those who need to be transported and treated
What is the significance of the GREEN triage tag?
Minimal - indicates walking wounded who require medical attention after higher priority patients are evacuated
What is the meaning of the YELLOW triage tag?
Delayed - indicates patients who require medical attention within 6 hours, with potentially life-threatening injuries that can wait until immediate casualties are stabilized and evacuated
What does the RED triage tag signify?
Immediate - indicates patients who require immediate medical attention and will not survive if not seen soon
What is the indication of the BLACK triage tag?
Expectant - for deceased patients or those with injuries that are not survivable or cannot be prioritized for care
What is the main goal of triage during epidemics and bioevents?
To prevent secondary transmission from infectious individuals by implementing disease containment strategies like social distancing and isolation
What is the 'hot zone' in a hazardous material disaster field?
The area immediately adjacent to the incident where all staff must be in protective gear and limited medical care activities take place
What activities are typically limited to in the 'hot zone' during a hazardous material disaster?
a) Airway hemorrhage control b) Administration of antidotes c) Identification of expectant cases
What is the purpose of the 'warm zone' in a hazardous material disaster field?
To provide rapid triage, minimal treatment for stabilization, and prioritize decontamination, typically at least 300 feet from the hot zone perimeter
What is the purpose of ambulatory decontamination before entering the cold zone in emergency response?
To ensure that personnel leaving the warm zone are decontaminated before entering the cold zone.
What is the priority for victims with severe signs and symptoms in an emergency response situation?
They are given priority for treatment.
Where is the cold zone located in relation to the warm zone in an emergency response scenario?
The cold zone is adjacent and uphill and upwind to the warm zone.
What is the purpose of secondary triage in an emergency response situation?
Decontaminated patient victims enter secondary triage for further assessment and direction to the treatment area based on severity and nature of illness or injury.
What is the purpose of maintaining personal protective equipment (PPE) in an emergency response scenario at the hospital?
To ensure that all staff wear the appropriate PPE for their safety and protection.
What is the warm dirty zone in an emergency response scenario?
It is an area adjacent to the hospital with a water source for decontamination, where triage is performed at the entrance before entering the decontaminated area.
What is the clean zone in an emergency response scenario and what is required before entering this area?
The clean zone is the treatment area inside the hospital where victims and personnel must have been triaged and decontaminated before entering.
What is a Mass Casualty Incident (MCI) and how does it impact the local health care system?
An MCI overwhelms the local health care system with a large number of casualties that exceed local resources and capabilities in a short period of time, creating a surge of individuals requiring immediate assessment and care.
What is the goal of emergency management according to FEMA?
The goal is to save lives, prevent injuries, and protect property and the environment by analyzing, planning, decision making, and assigning resources to mitigate, prepare for, respond to, and recover from all hazards.
What is the METHANE method used for in emergency response situations?
It is used for a more detailed assessment of the scene after the proper agency has arrived, summarizing the information necessary for response: M - Mass casualty incident declared, E - Exact location, T - Type of incident, H - Hazard present, A - Access, N - Number of casualties severity, E - Emergency services.
What is the cornerstone of emergency management in protecting life and property according to health care emergency management principles?
The cornerstone is to protect life and property.
What is mass gathering management and why is planning in advance important for disaster or special event management?
Mass gathering management involves planning for large events to ensure coordination and cooperation of health care services. Planning in advance is crucial to ensure preparedness and effective response to disasters or special events.
What are the types of advance planning activities mentioned for emergency preparedness in health care emergency management?
1. Strategic Planning: Focus on preparing the organization for any type of threat. 2. Contingency Planning: Planning activities related to a site-specific threat that may occur at any time. 3. Forward Planning: Planning activities for a known imminent event, for example, an impending snowstorm or rock concert.
What is the focus of strategic planning in advance planning activities for health care services at events?
Preparing the organization for any type of threat
What type of planning activities does contingency planning involve in advance planning for events?
Activities related to a site-specific threat that may occur at any time
What is forward planning in the context of advance planning activities for events?
Planning activities for a known imminent event, such as an impending snowstorm or rock concert
What information is typically collected at the beginning of forward planning for major events involving large crowds?
Type of event, location, purpose, sponsors, expected attendees
What is the goal of on-site health care services at events according to guidelines?
To provide rapid access to patients, early triage, stabilization, and transport to definitive care
What is the primary goal in planning emergency care at mass gatherings?
To evaluate, stabilize, and support participants, staff, and spectators while preserving local healthcare capacity
How can health care usage data from previous events be useful in planning services for future events?
It provides valuable information for predicting patient presentation rates
What environmental factor is important to consider in predicting patient presentation rates at events?
Weather conditions, including heat-related issues
What is heat stroke and how should it be managed in an emergency situation at an event?
High body temperature, hot skin, call 911, move to a cooler place, cool clothes, do not give anything to drink
What are the symptoms of heat exhaustion and how should it be managed at an event?
Heavy sweating, nausea, move to a cool place, cool wet clothes, sip water, seek medical help if symptoms worsen or last longer than 1 hour
What are the symptoms of heat cramps and how should they be managed at an event?
Muscle spasm, move to a cool place, drink water, rest, seek medical help if cramps last longer than 1 hour or under certain health conditions
How should sunburn be managed at an event to provide relief to the affected individual?
Stay out of the sun, cool cloths, moisturizing lotion, do not break blisters
What are heat rash and how should it be managed to provide relief to the affected individual?
Red clusters of blisters on the skin, stay in a cool dry place, keep the rash dry, use powder like baby powder
What should you do if you experience cramps lasting longer than 1 hour?
Get medical help right away.
What should you do if you have a sunburn?
Stay out of the sun until it heals, put cool cloths on sunburned areas, take a cool bath, put moisturizing lotion, and do not break blisters.
What is the recommended treatment for heat rash?
Stay in a cool, dry place, keep the rash dry, and use powder like baby powder to soothe the rash.
How does the duration of an event influence the number of attendees seeking medical care?
In general, the longer the duration of the event, the greater the number of individuals who will seek care.
What are the characteristics of a crowd that can impact medical considerations?
Size, density, time, and collectivity.
What is the connection between alcohol and drug usage and medical issues at events?
Alcohol and drug usage have been associated with increased morbidity and mortality at events, with a significant increase in presentations at events where alcohol is sold.
What should be considered when setting up medical aid stations at large events?
Stations should be easily accessible, clearly marked, and equipped with necessary supplies such as IV drugs, oxygen, cardiac monitors, and stretchers for large outdoor events.
Why is good communication essential for the operation of large healthcare activities?
Good communication ensures the successful coordination of medical services and response efforts at large events.
How should staffing be determined for medical and nursing stations at events?
Staffing should be based on the total anticipated size of the gathering, type of event, and anticipated medical problems, with recommendations for basic first aid and life support provision within specific timeframes.
What are the basic principles of disaster nursing during special events or mass casualty incidents?
Rapid assessment, security of the scene, mass casualty triage, initiation of life-saving measures, knowledge of role in Incident Command System (ICS), essential nursing interventions, adaptation of skills, potential need for decontamination, and leadership in coordination of patient care and transport.
What are the basic principles of disaster nursing during special events?
1. Rapid assessment of the situation and victims' immediate nursing care needs 2. Security of the scene and assessment of the potential for a secondary disaster 3. Mass casualty triage and initiation of life-saving measures first 4. Knowledge of one's role within the ICS 5. Selected use of essential nursing interventions and elimination of nonessential nursing activities 6. Adaptation of necessary nursing skills to mass casualty situations 7. Potential need for decontamination 8. Leadership in coordinating patient triage care and transport 9. Teaching, supervision, and utilization of auxiliary medical personnel and volunteers 10. Provision of understanding, compassion, and emotional support to all victims and their families 11. Appreciation of and knowledge to keep oneself safe during MCI response
What are the two distinct phases of care in a mass casualty event in hospital management?
1. First Phase: Arrival of casualties, full magnitude of event unknown, conservation of limited hospital resources, only critical but salvageable patients have access to key hospital resources 2. Second Phase: After containment of the event and arrival of all casualties, comprehensive priority-oriented plan for definitive care of all patients
What are the three waves of casualties flowing to the hospital during a mass casualty event?
1. First Wave: Casualties with minor injuries 2. Second Wave: Casualties with more serious injuries, may require extrication and initial treatment 3. Third Wave: Casualties with minor injuries and patients with emotional stress
What are the color-coded categories in patient triage during a mass casualty event?
- RED: Immediate (severely injured patients with high probability for survival) - YELLOW: Delayed (require operative intervention that may be delayed) - GREEN: Minimal (patients without serious injuries) - GRAY: Expectant (considered to have low probability of survival) - BLACK: Deceased or expectant
What are the treatment priorities in the initial hospital management of casualties during a mass casualty event?
- Save salvageable patients - Prevention of complications and future handicaps - Teamwork is crucial
What is the purpose of using radiology in the initial hospital management of casualties during a mass casualty event?
To save salvageable patients and prevent complications and future handicaps. Radiography should be used judiciously, with chest, cervical spine, and pelvic images not performed routinely.
What are the principles of initial hospital management treatment priorities?
Save salvageable patients, prevention of complications and future handicaps, teamwork is crucial.
What is the use of radiology in initial hospital management?
Use judiciously, radiography of the chest, cervical spine, pelvis not performed on a routine basis.
What is FAST (Focused Assessment with Sonography for Trauma) used for?
A bedside abdominal ultrasound used for unstable patients to confirm or rule out intraabdominal bleeding.
When is the operating room indicated in initial hospital management?
Indicated for patients with compromised airway or active control of bleeding, fundamental approach is damage control.
What does secondary transport refer to in initial hospital management?
Refers to the transfer of casualties between medical facilities when the primary admitting hospital is unable to provide proper care.
What is scene size-up in emergency management?
The ongoing process of information gathering and scene evaluation to determine appropriate strategies and tactics to manage an emergency.
What are standard precautions in emergency response?
Protective measures recommended by the CDC for dealing with objects, blood, body fluids, and potential exposure risks of communicable diseases.
What is the incident command system in emergency response?
Emergency responders work in groups according to their function or assigned area, with the leader of each group reporting to the incident commander.
What is a protective suit designed to prevent contamination by potentially lethal hazardous materials?
Hazmat suit
Why is determining the number of patients critical in emergency situations?
To determine the need for additional resources such as firefighters, specialized rescue groups, hazardous materials teams, or ambulances
What system do emergency responders use to work in groups according to their function or assigned area during incidents?
Incident Command System
What is the primary purpose of a primary assessment in emergency medical situations?
To quickly identify life threats
What does the form of general impression help determine in patients?
Patients' severity and set priorities for care and transport
What are some examples of specialized resources that may be needed in medical situations?
Ambulances, Advanced Life Support (ALS) units, air medical support, hazardous materials management, technical rescue services, etc.
What does the assessment of level of consciousness reflect in patients?
Patients' neurologic and physiologic status
What does the Glasgow Coma Scale assess in patients during the primary assessment?
Eye opening, verbal response, motor response
What does the AVPU scale test criteria assess in patients' responsiveness?
Awake and alert patients, responsive to verbal stimuli, responsive to painful stimuli, unresponsive patients
What does the AVPU scale indicate when a patient is responsive to verbal stimuli?
The patient is not alert and awake, but their eyes open when spoken to
What does the 'A' in AVPU scale stand for?
Alert
What does the 'V' in AVPU scale stand for?
Verbal stimuli
What does the 'P' in AVPU scale stand for?
Painful stimuli
What does the 'U' in AVPU scale stand for?
Unresponsive
What criteria does an awake and alert patient meet on the AVPU scale?
Patient's eyes open spontaneously and appear aware and responsive to the environment. Follows commands and is oriented to time, person, and place.
What criteria does a patient responsive to verbal stimuli meet on the AVPU scale?
Patient is not alert and awake, but their eyes open when spoken to.
What does it mean when a patient is responsive to pain?
The patient does not respond to questions but moves or cries out in response to a painful stimulus.
What does it mean when a patient is unresponsive to pain?
The patient does not respond spontaneously or to a verbal or painful stimulus and usually lacks the ability to protect their airway.
What are methods to assess responsiveness to pain in a patient?
Gently but firmly pinch the ear, press on the bone above the eye, and gently and firmly pinch the muscle of the neck.
What are some signs of respiratory distress in a patient?
Agitation, anxiety, restlessness, lethargy, stridor, wheezing, tachypnea with periods of bradypnea, or agonal respirations.
How can you assess the circulation of a patient?
Evaluate the patient's mental status, pulse, and skin condition. Good circulation is indicated by warm, pink, and dry skin, while shock is indicated by pale, clammy, cool, and moist skin.
What are examples of high-priority patients who should be transported immediately?
Unresponsive patients, those with a poor general impression, difficulty breathing, uncontrolled bleeding, responsive but unable to follow commands, severe chest pain, pale skin or signs of poor perfusion, complicated childbirth, or severe pain in any area of the body.
When should a secondary assessment be performed on a patient?
If the patient is in stable condition and has an isolated complaint at the scene or enroute to the hospital.
What are the components of a secondary assessment?
Patient history (history of present illness, past medical history) and physical examination (head to toe or focused assessment, body system approach, vital signs).
What questions should be asked to family or bystanders during patient history taking?
Ask about the patient's name, what happened, if anything was seen, if the patient complained before, known illnesses or medications, and events leading to the injury or illness.
What does the OPQRST acronym stand for in the history of present illness?
Onset, Provocation, Quality, Region, Relief, Severity, Time.
What does DCAP BTLS stand for in the physical examination of a patient?
Deformities, Contusions, Abrasions, Punctures and penetrations, Burns, Tenderness, Lacerations, Swelling.
What is the purpose of the rapid trauma assessment?
To rapidly assess each part of the body, ruling out life-threatening conditions and determining responsiveness within 60-90 seconds.
What does BSN 4L 17 stand for in the context provided?
BSN 4L 17 stands for Contusions A Abrasions P Punctures and penetrations B Burns T Tenderness L Lacerations S Swelling.
What are the steps involved in the primary assessment process?
1. Determine Responsiveness 2. Begin HIT HOPS (History, Inspection, Observation, Palpation, Special Testing) 3. Check ABCs (Airway, Breathing, Circulation)
What are some general principles to follow during the assessment process?
- Communicate with the patient - Expose the injured area before examining it - Maintain eye contact - Assume spinal injury - Stop or alter assessment process to provide care
What is the purpose of a rapid trauma assessment?
To rapidly assess each part of the body in a few moments (60-90 seconds) to identify and prioritize life-threatening conditions.
What are the steps involved in performing a rapid exam to identify life threats?
1. Rapid assessment of the head 2. Rapid assessment of the neck 3. Apply cervical collar if indicated 4. Assess the chest 5. Rapid assessment of the abdomen 6. Rapid assessment of the pelvis 7. Rapid assessment of the extremities 8. Rapid assessment of the posterior body immobilization on a backboard
What is the method for checking distal circulation in the lower extremities?
Feeling the posterior tibial pulse just behind the medial malleolus of the ankle.
When is a detailed physical exam most appropriate for a trauma patient?
When the patient is unresponsive, has a significant injury, or unknown mechanism of injury.
How often should a stable patient be reassessed during patient assessment?
At least every 15 minutes.
What are the components of reassessment in patient assessment?
Repeat the primary assessment, recheck for life-threatening problems, reassess mental status, maintain an open airway, monitor breathing, reassess pulse, monitor skin color and temperature, reestablish patient priorities, repeat pertinent parts of history and physical exam.
What are the 4 classes of personal protective clothing for decontamination?
Level A, Level B, Level C, Level D.
Describe the method of physical removal in decontamination.
Removing cloth, flushing with water or aqueous solution, using absorbent materials, rubbing with flour followed by wet tissue or military M291 resin kits, and using a tongue depressor or popsicle stick to scrape bulk agent.
What is the purpose of chemical deactivation in decontamination?
To remove agents through mechanical force or hydrolysis using chemical solutions like oxidation and hydrolysis.
What is the proper body mechanics for safe patient lifting and moving?
Keep your back in a straight upright vertical position, lift without twisting, face the patient, point your feet in the same direction, use your legs, and keep weight close to your body.
What are the rules of lifting when it comes to body mechanics?
Position feet properly, use legs, never turn or twist, keep weight close to body, use a stair chair on stairs when possible
What should be considered before lifting any patient according to body mechanics guidelines?
The object's weight, your limitations, and communication with your partner to make a plan
What are the guidelines for reaching safely according to body mechanics?
Keep back locked in, avoid twisting, avoid reaching more than 20 inches in front, avoid prolonged reaching during strenuous effort
What are the guidelines for pushing or pulling safely according to body mechanics?
Push rather than pull, keep back locked in, keep line of pull through center of body, keep weight close, avoid pushing or pulling overhead
What is the power grip technique in patient lifting?
Grasping the handle of the stretcher with palm facing up, thumb extended up, hands 10 inches apart, fingers at the same angle, handle fully supported on curved palm, back locked in, legs spread and bent
How should you position yourself when pulling a patient who is on the ground according to body mechanics guidelines?
Kneel to pull, extend elbow just beyond anterior torso, bend knees to balance force of pull
What are the guidelines for carrying a patient on a stretcher according to body mechanics?
Estimate weight of patient and equipment, coordinate movements with team, keep weight close to body, do not twist body, do not bend at waist but flex at hips and knees
How is the diamond carry performed in patient lifting?
Position providers facing patient, providers at each side turn head end hand palm down and release other hand, providers at each side turn toward foot end, provider at foot end faces forward
How is the one-handed carry performed in patient lifting?
Face each other, use both hands to lift backboard, turn in direction of walk and switch to using one hand
What is the Diamond Carry technique used for?
To move a patient by flexing at the hips and bending at the knees while facing the patient and turning in different directions.
How is the One-Handed Carry performed?
Providers face each other, lift the backboard to carrying height using both hands, then switch to using only one hand while turning in the direction they will walk.
When should Emergency Moves be used in patient lifting and moving?
In situations where the scene is hazardous, or life-threatening conditions require repositioning before assessment and care can be provided.
Describe the Firefighters Drag technique for emergency patient movement.
Place the patient on his back, tie his hands together, straddle him, pass your head through his trussed arms, crawl on your hands and knees while keeping the patient's head as low as possible.
What is the purpose of the Blanket Drag technique in emergency patient movement?
To gather half of the blanket material against the patient's side, roll the patient onto the blanket, and drag the patient while keeping their head as low as possible.
Explain the One-Rescuer and Two-Rescuer Assist method for emergency patient movement.
Both rescuers place the patient's arms around their shoulders, grip the patient's hands, place their free arms around the patient's waist, and help the patient walk to safety.
When are Urgent Moves necessary in patient lifting and moving?
Urgent moves are needed for patients with altered consciousness, inadequate ventilation, shock, or in extreme weather conditions where immediate relocation is essential.
What is the Rapid Extrication Technique used for in patient movement?
To move a patient quickly from a sitting position inside a vehicle to a supine position on a backboard in less than 1 minute when standard immobilization is not feasible.
In what situations should the Rapid Extrication Technique be used?
When the vehicle or scene is unsafe, there are hazardous materials present, there is a fire risk, the patient needs immediate intervention in a supine position, or when rapid transport to the hospital is critical.
Describe the steps involved in performing the Rapid Extrication Technique.
The 1st provider supports the head and cervical spine, the 2nd provider gives commands, applies a cervical collar, and performs the primary assessment, the 3rd provider frees the patient's legs, and the team rotates the patient as a unit onto a backboard.
What is the role of the 2nd provider when moving a patient with a suspected spinal injury?
Applies a cervical collar and performs the primary assessment, supports the torso
What does the 3rd provider do when moving the patient's legs during the process?
Frees the patient's legs from the pedals, moves the legs together without moving the pelvis or spine
How should the 1st provider or 4th provider position the backboard during the movement of the patient?
Places the backboard on the seat against the patient's buttocks
What are the steps involved in moving a patient onto a long spine board in urgent situations?
Supine log roll onto side, place spine board next to body, log roll onto board, lift onto a stretcher, secure to stretcher, load into ambulance
How should a patient with suspected spinal injury be handled when moving them onto a carrying device?
Immobilize head, neck, and spine before moving, perform manual stabilization, place a rigid cervical collar, maintain manual stabilization until the patient is immobilized on the spine board
What should be done before moving a patient with no suspected spine injury?
Perform manual stabilization, place a rigid cervical collar, and maintain manual stabilization until the patient is immobilized to a spine board.
What is the Extremity Lift used for?
Carrying a patient to a stretcher or stair chair.
What can be used as dressing for a wound in an emergency situation?
Clean handkerchief, towels, sheets, cloth, or sanitary napkins.
What should dressing for a wound be?
Sterile.
Types of dressing
Non elastic self adhering dressing, Sterile gauze pad, Multi trauma dressing, Occlusive dressings
Types of bandages
Triangular bandage, Cravat, Roller bandage
BSI precautions for body substance isolation
Wear properly sized gloves, Wear eye protection, Wear mask, Wear gown, Wash hands after removing gloves
Guidelines in dressing and bandaging
Use sterile or clean material, Control bleeding, Cover the wound adequately, Avoid tight bandaging, Expose fingers or toes, Bandage in original position, Adjust bandage for comfort, Tie knots over wounds, Check circulation every 10 minutes, Loosen bandages if constricting
Signs and symptoms of impaired circulation
Skin discoloration, Swollen limb, Distention in limbs, Numbness, Tingling sensation, Pain, Inability to move affected fingers or toes
Method of bleeding control
Apply direct pressure, Elevate the extremity, Assess bleeding and apply additional pressure if needed, Compress the pulse point
Types of splints
Rigid splint, Traction splint, Circumferential splint, Improvised splint, Self splint
Stabilizations and restraints
Splinting musculoskeletal injuries, Using rigid splints, Applying traction splints, Using circumferential splints, Making improvised splints, Securing self splints
General rules of splinting
Stabilize the limb, Assess pulse, movement, and sensation, Expose the injury site, Control bleeding, Align with gentle traction, Immobilize the limb, Pad the splint, Secure the limb, Reassess pulse, movement, and sensation
What are the general rules of splinting an injured limb?
Stabilize the limb, assess pulse movement and sensation below the injury site, cut away clothing to expose the injury, control bleeding, place a sterile dressing over any open wounds, align severe deformities with gentle traction, maintain immobilization, pad the splint, secure the limb to the splint, reassess pulse movement and sensation
How should you secure the injured limb when applying a splint?
Secure it against the patient's body with a cravat or roller bandage
What should be done before applying a traction splint?
Assess pulse movement and sensation below the injury site, manually stabilize the limb
What are the steps for applying a traction splint?
Apply the ankle hitch, apply and maintain manual traction, position the splint, attach the ischial strap, fasten the splint to the ankle hitch, apply mechanical traction, fasten the leg, reassess pulse movement and sensation
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