Chapters 38 and 39 - Incident Management Terrorism Response and Disaster Management

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Chapters 38 and 39 - Incident Management Terrorism Response and Disaster Management
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Chapters 38 39 Incident Management Terrorism Response Disaster
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Chapters 38 and 39 - Incident Management, Terrorism Response, and Disaster Management
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  1. Use of the ____ ____ ____ (ICS) makes it possible to do the greatest good for the greatest number.
    incident command system
  2. The ____ ____ ____ ____ (NIMS) was developed to promote efficient coordination of emergency incidents at the regional, state, and national levels.
    National Incident Management System
  3. Provides a consistent nationwide template to enable federal, state, and local governments to work together effectively and efficiently, as well as private-sector and nongovernmental organizations.
    National Incident Management System
  4. The NIMS provides standardization in (four things):
    • Terminology
    • Resource classification
    • Personnel training
    • Certification
  5. Another important feature of the NIMS is the concept of ____, which refers to the ability of agencies of different types or from different jurisdictions to communicate with each other.
    interoperability
  6. The ___ is one component of the NIMS.
    ICS
  7. The major NIMS components are as follows (six things):
    • Command and management
    • Preparedness
    • Resource management
    • Communications and information management
    • Supporting technologies
    • Ongoing management and maintenance
  8. The command and management component of the NIMS is based on three key constructs:
    • ICS
    • multiagency coordination systems
    • public information systems
  9. The NIMS ____ ____ will provide strategic direction for and oversight of the NIMS, supporting routine maintenance and continuous improvement of the system in the long term.
    Integration Center
  10. The ICS is sometimes referred to as the:
    incident management system.
  11. The purpose of the ICS is (three things):
    • Ensuring responder and public safety
    • Achieving incident management goals
    • Ensuring the efficient use of resources
  12. ____ is the building block of good patient care.
    Communication
  13. The ICS is designed to control duplication of effort and ____.  ____ is when individual units or different organizations make independent and often inefficient decisions about the next appropriate action.
    freelancing
  14. One of the organizing principles of the ICS is limiting the ____ __ ____ of any one individual.  Refers to keeping the supervisor/worker ratio at one supervisor for three to seven workers.
    span of control
  15. The general ICS staff includes (five things):
    • command
    • finance
    • logistics
    • operations
    • planning
  16. Command functions of the ICS include (three things):
    • the public information officer (PIO)
    • safety officer
    • liaison officer
  17. The IC is the:
    incident commander
  18. A ____ ____ system is one in which one person is in charge, even if multiple agencies respond.  Ideally, it is used for short-duration, limited incidents that require the services of a single agency.
    single command
  19. At a very large incident, the ____ section is responsible for managing the tactical operations usually handled by the IC.
    operations
  20. This ICS section solves problems as they arise.
    planning
  21. Another function of the planning section of the ICS is to develop an ____ ____ ____, which is the central tool for planning during a response to a disaster emergency.
    incident action plan
  22. ____ has historically been the weak point at most major incidents.
    Communication
  23. On arrival at an incident, you should check in with the ____ section.
    finance
  24. ____ means keeping your supervisor advised of your location, actions, and completed tasks.  Includes advising your supervisor of the tasks that you have been unable to complete and what tools you need to complete them.
    Accountability
  25. ____ involves the decisions made and basic planning done before an incident occurs.
    Preparedness
  26. Sizing up a scene starts with ____.
    dispatch
  27. The size-up will be driven by three basic questions:
    • What do I have?
    • What do I need to do?
    • What do I need?
  28. ____ ____ ____ is also known as the medical (or EMS) branch of the ICS.
    Medical incident command
  29. The medical branch director will supervise the primary roles of the medical branch (three things):
    • triage
    • treatment
    • transport of injured people
  30. Ultimately in charge of counting and prioritizing patients
    Triage supervisor
  31. -Locates and sets up the treatment area with a tier for each priority of patient.
    -Ensures that secondary triage of patients is performed and that adequate patient care is given as resources allow.
    -Have a responsibility to assist with moving patients to the transportation area.
    treatment supervisor
  32. -Coordinates the transportation and distribution of patients to appropriate receiving hospitals and helps to ensure that hospitals do not become overwhelmed by a patient surge.
    -A key role is to communicate with the area hospitals to determine where to transport the patients.
    -Documents and tracks the number of vehicles transporting, patients transported, and the facility destination of each vehicle and patient.
    Transportation supervisor
  33. A ____ supervisor should be assigned when scenes require response by numerous emergency vehicles or agencies.  The vehicles should not drive into the scene without direction from the ____ supervisor.
    staging
  34. The ____ ____ should be established away from the scene because the parked vehicles can be in the way.
    staging area
  35. The ____ supervisor should establish an area that provides protection for responders from the elements and the situation; must also monitor responders for signs of stress.
    rehabilitation
  36. The ____ ____ should be located away from exhaust fumes and crowds and out of view of the scene itself.
    rehabilitation area
  37. ____ is where a responder’s needs for rest, fluids, food, and protection from the elements are met.
    Rehabilitation
  38. An ____ supervisor or rescue supervisor determines the type of equipment and resources needed for extrication situations.  Because extrication and rescue are medically complex, the supervisors will usually function under the EMS branch of the ICS.
    extrication
  39. -Make difficult triage decisions.
    -Provide secondary triage decisions in the treatment sector, deciding which priority patients are to be transported first.
    -Provide on-scene medical direction for EMTs, and they can provide care in the treatment sector as appropriate.
    Physicians on scene
  40. -Works with area medical examiners, coroners, disaster mortuary assistance teams, and law enforcement agencies to coordinate removal of the bodies and body parts.
    -Should attempt to leave the dead victims in the location found until a removal and storage plan can be determined.
    Morgue supervisor
  41. The ____ ____ should be out of view of the living patients and other responders, and it should be secured from the public.
    morgue area
  42. -Any call involving three or more patients.
    -Any situation that requires a mutual aid response.
    -Any incident that has the potential for one of these situations
    Mass-casualty incident (MCI)
  43. Simply means “to sort” patients based on the severity of their injuries.
    Triage
  44. ____ triage is the initial triage done in the field.   ____ triage is done as patients are brought to the treatment area.
    • Primary
    • Secondary
  45. START triage stands for:
    Simple Triage And Rapid Treatment
  46. Four categories of START triage assessment:
    • limited assessment of the patient’s ability to walk
    • respiratory status
    • hemodynamic status (pulse)
    • neurologic status
  47. In START triage, all walking wounded are considered:
    minor/green
  48. In START triage, what do you do if there are no respirations?
    • Open the airway.
    • If there are no respirations, the patient is categorized black/deceased.
    • If there are respirations, the patient is categorized red/immediate.
  49. In START triage, what do you do if respirations are present?
    • If respirations are under 30, check perfusion.
    • If respirations are over 30, categorize as red/immediate.
  50. In START triage, what do you do if respirations are present but under 30/min?
    • Check perfusion, if capillary refill is over two seconds or radial pulse is absent, control bleeding (if present) and categorize as immediate/red.
    • If capillary refill is under two seconds or radial pulse is present, check mental status.
  51. In START triage, what do you do if respirations are present but under 30/min and radial pulse is present or capillary refill is under two seconds?
    • Check the metal status.
    • If the patient can't follow simple commands, categorize as red/immediate.
    • If the patient CAN follow simple commands, categorize as delayed/yellow.
  52. What is the mnemonic for START triage?
    • 30
    • 2
    • Can do
  53. What triage system is used for pediatric patients?  Who is it specifically used for?
    • JumpSTART triage
    • Used for kids 8 and younger under 100 pounds
  54. What is JumpSTART triage initiated?
    identify walking wounded and take babies/infants immediately to the treatment sector
  55. Where does jumpSTART triage differ from START triage?
    respiratory assessment
  56. When using jumpSTART triage, what do you do when you find a pediatric patient not breathing?
    • Immediately check the pulse.  If there is no pulse, label the patient as black/expectant.
    • If the patient is not breathing but has a pulse, open the airway with a manual maneuver.  If the patient does not begin to breathe, give five rescue breaths and check respirations again.  A child who does not begin to breathe should be labeled expectant.
  57. Patients who are hysterical and disruptive to rescue efforts may need to be made an ____ priority and transported out of the disaster site, even if they are not seriously injured.
    immediate
  58. A rescuer who becomes sick or injured during the rescue effort should be handled as an ____ priority and be transported off the site as soon as possible.
    immediate
  59. Hazardous materials (HazMat) and weapons of mass destruction incidents force the HazMat team to identify patients as ____ or ____ before the regular triage process.
    contaminated or decontaminated
  60. A ____ is a widespread event that disrupts the functions and resources of a community and threatens lives and property.
    disaster
  61. Any material that poses an unreasonable risk of damage or injury to persons, property, or the environment if it is not properly controlled.
    hazardous material
  62. The senses that can be safely used during a hazardous material incident are those of:
    sight and sound.
  63. One way to distinguish containers is to divide them into two categories based on their capacity:
    • bulk
    • nonbulk
  64. In general, ____ storage containers are found in buildings that rely on and need to store large quantities of a particular chemical.
    bulk
  65. ____ have capacities ranging from 119 gallons to 703 gallons.
    Totes
  66. ____ ____ are both shipping and storage vessels, hold between 5,000 and 6,000 gallons of product, and can be pressurized or nonpressurized.
    Intermodal tanks
  67. Four types of nonbulk containers:
    • drums
    • bags
    • carboys
    • cylinders
  68. -Transport and store corrosives and other types of chemicals
    -Glass, plastic, or steel container that holds 5 to 15 gallons of product
    Carboys
  69. Diamond-shaped indicators that are placed on all four sides of highway transport vehicles, railroad tank cars, and other forms of transportation carrying hazardous materials.
    Placards
  70. Smaller versions of placards, placed on the four sides of individual boxes and smaller packages being transported.
    Labels
  71. -Offers a certain amount of guidance for responders operating at a HazMat incident
    -Updated every 3 to 4 years
    -Provides information on approximately 4,000 chemicals
    The Emergency Response Guidebook
  72. The area immediately surrounding the release, which is also the most contaminated area.
    hot zone
  73. The ____ ____ is where personnel and equipment transition into and out of the hot zone.  It contains control points for access to the hot zone as well as the decontamination area.
    warm zone
  74. The process of removing or neutralizing and properly disposing of hazardous materials from equipment, patients, and rescue personnel.
    Decontamination
  75. Safe area where personnel do not need to wear any special protective clothing for safe operation.
    cold zone
  76. The National Fire Protection Association (NFPA) 704 Hazardous Materials Classification standard classifies hazardous materials according to (four things):
    • Health hazard or toxicity levels
    • Fire hazard
    • Chemical reactive hazard
    • Special hazards
  77. Toxicity levels measure the health risk that a substance poses to someone who comes into contact with it.  There are five levels from __ to __.
    0 to 4
  78. All health hazard levels, with the exception of __, require respiratory and chemical protective gear that is not standard on most ambulances and specialized training.
    0
  79. What level PPE?  The most hazardous, requires fully encapsulated, chemical-resistant protective clothing that provides full-body protection, as well as SCBA and special, sealed equipment.
    Level A
  80. What level PPE?  Requires nonencapsulated protective clothing or clothing that is designed to protect against a particular hazard.  Also requires breathing devices that contain their own air supply, such as SCBA, and eye protection.
    Level B
  81. What level PPE?  Requires the use of nonpermeable clothing and eye protection.  In addition, face masks that filter all inhaled outside air must be used.
    Level C
  82. What level PPE?  Requires a work uniform, such as coveralls, that affords minimal protection.
    Level D
  83. What do all levels of PPE require?
    Two pairs of gloves
  84. A blistering agent that has a rapid onset of symptoms and produces immediate, intense pain and discomfort on contact.
    phosgene oxime (CX)
  85. A nerve agent that is one of the G agents; a highly volatile colorless and odorless liquid that turns from liquid to gas within seconds to minutes at room temperature.
    sarin (GB)
  86. An agent that affects the body's ability to use oxygen.  It is a colorless gas that has an odor similar to almonds.  The effects begin on the cellular level and are very rapidly seen at the organ and system levels.
    cyanide
  87. Early never agents that were developed by German scientists in the period after WWI and into WWII.  There are three such agents: sarin, soman, and tabun.
    G agents
  88. Small suitcase-sized nuclear weapons that were designed to destroy individual targets, such as important buildings, bridges, tunnels, and large ships.
    Special Atomic Demolition Munitions (SADMs)
  89. A nerve agent that is one of the G agents; twice as persistent as sarin and five times as lethal; it has a fruity odor, as a result of the type of alcohol used in the agent, and is a contact and inhalation hazard that can enter the body through skin absorption and through the respiratory tract.
    soman (GD)
  90. A pulmonary agent that is a product of combustion, such as might be produced in a fire at a textile factory or house or from metalwork or burning Freon.  It is a very potent agent that has a delayed onset of symptoms, usually hours.
    phosgene
  91. A nerve agent that is one of the G agents; is 36 times more persistent than sarin and approximately half as lethal; has a fruity smell and is unique because the components used to manufacture the agent are easy to acquire and the agent is easy to manufacture.
    tabun (GA)
  92. A neurotoxin derived from mash that is left from the castor bean; causes pulmonary edema and respiratory and circulatory failure leading to death.
    ricin
  93. A vesicant; it is a brownish, yellowish oily substance that is generally considered very persistent; it has the distinct smell of garlic or mustard and, when released, is quickly absorbed into the skin and/or mucous membranes and begins an irreversible process of damaging the cells.
    sulfur mustard (H)
  94. A class of chemical agents called organophosphates; they function by blocking an essential enzyme in the nervous system, which causes the body's organs to become overstimulated and burn out.
    nerve agents
  95. A nerve agent antidote kit containing atropine and pralidoxime chloride; delivered as a single dose through one needle.
    DuoDote Auto-Injector
  96. Blister agents; the primary route of entry is through the skin.
    vesicants
  97. The process by which the temporary bond between the organophosphate and acytlcholineesterase undergoes hydrolysis, resulting in a permanent covalent bond.
    aging
  98. A nerve agent antidote kit containing two auto-injectors containing atropine and pralidoxime chloride.
    Mark 1 Nerve Agent Antidote Kit (NAAK)
  99. A blistering agent that has a rapid onset of symptoms and produces immediate, intense pain and discomfort on contact.
    Lewisite (L)
  100. Excessively constricted pupil; often bilateral after exposure to nerve agents.
    miosis
  101. Existing facilities that are established in a time of need for the mass distribution of antibiotics, antidotes, vaccinations, and other medications and supplies.
    points of distribution (PODs)
  102. A lung infection, also known as plague pneumonia, that is the result of inhalation of plague-causing bacteria.
    pneumonic plague
  103. Biologic agents that are the most deadly substances know to humans; they include botulinum toxin and ricin.
    neurotoxins
  104. The monitoring, usually by local or state health departments, or patients presenting to emergency departments and alternative care facilities, the recording of EMS call volume, and the use of over-the-counter medications.
    syndromic surveillance
  105. One of the G agents; it is a clear, oily agent that has no odor and looks like baby oil; more than 100 times more lethal than sarin and is extremely persistent.
    V agent (VX)
  106. Which of the following is considered a priority when determining "what needs to be done" during the scene size-up?
    A. Rescue operations
    B. Notifying hospitals
    C. Establishing operations
    D. Incident stabilization
    D. Incident stabilization
    (this multiple choice question has been scrambled)
  107. A pediatric patient who is breathing 12 breaths per minute should be categorized as:
    immediate
  108. What is the jumpSTART requirement in terms of respirations for an immediate categorization?
    less than 15 and more than 45 breaths per minute
  109. During a motor vehicle collision involving multiple patients, the IC would MOST likely:
    A. delegate all of the command functions to the appropriate personnel.
    B. relinquish command when a senior EMS provider arrives at the scene.
    C. designate a safety officer, but retain other command functions.
    D. maintain responsibility for all of the command functions.
    C. designate a safety officer, but retain other command functions.
    (this multiple choice question has been scrambled)
  110. According to the JumpSTART triage system, if a pediatric patient is not breathing, you should:
    A. immediately check for a pulse.
    B. open the airway and reassess breathing.
    C. triage him or her as expectant.
    D. give five rescue breaths and reassess.
    A. immediately check for a pulse.
    (this multiple choice question has been scrambled)
  111. An agreement between neighboring EMS systems to response to mass-casualty incidents in each others region when local resources are insufficient to handle the response.
    mutual aid response
  112. A command system used in larger incidents in which there is a multiagency response or multiple jurisdictions are involved.
    unified command system
  113. An area set up by physicians, nurses, and other hospital staff near a major disaster scene where patients can receive further triage and medical care.
    casualty collection area
  114. An area designated by the incident commander, or a designee, in which public information officers from multiple agencies disseminate information about the incident.
    joint information center
  115. Four types of terrorist:
    • Violent religious groups/doomsday cults
    • Extremist political groups
    • Technology terrorists
    • Single-issue groups
  116. Terrorist groups that may participate in apocalyptic violence.
    Violent religious groups/doomsday cults
  117. Terrorist groups that include violent separatist groups and those who seek political, religious, economic, and social freedom.
    Extremist political groups
  118. Terrorist groups who attack a population’s technological infrastructure as a means to draw attention to their cause; cyberterrorists.
    Technology terrorists
  119. Terrorist groups that include antiabortion groups, animal rights groups, anarchists, racists, and even ecoterrorists.
    Single-issue groups
  120. ____ and ____ are mnemonics to remember the kinds of weapons of mass destruction.
    • B-NICE
    • CBRNE
  121. BNICE:
    • Biologic
    • Nuclear
    • Incendiary
    • Chemical
    • Explosive
  122. CBRNE:
    • Chemical
    • Biologic
    • Radiologic
    • Nuclear
    • Explosive
  123. To date, the preferred WMD for terrorists has been:
    explosive devices.
  124. Four types of chemical agent:
    • Vesicants (blister agents)
    • Respiratory agents (choking agents)
    • Nerve agents
    • Metabolic agents (cyanides)
  125. Three types of biologic agent:
    • Viruses
    • Bacteria
    • Toxins
  126. The public safety community generally has no prior knowledge of the time, location, or nature of the attack.
    covert
  127. System that alerts responders to the potential for a terrorist attack, although the specifics of the current threat will not be given.
    Homeland Security Advisory System
  128. Severe risk of terrorist attacks.
    Severe (red)
  129. High risk of terrorist attacks
    High (orange)
  130. Significant risk of terrorist attacks
    Elevated (yellow)
  131. General risk of terrorist attacks
    Guarded (blue)
  132. Low risk of terrorist attacks
    Low (green)
  133. Occurs when you come into contact with a contaminated person who has not yet been decontaminated.
    Cross-contamination
  134. -Terrorists have been known to plant additional explosives that are set to explode after the initial bomb.
    -This type of secondary device is intended primarily to injure responders and to secure media coverage.
    -May include various types of electronic equipment such as cell phones or pagers.
    Secondary device
  135. Agents with a ____ hazard enter the body through the respiratory tract in the form of vapors.
    vapor
  136. Agents with a ____ hazard (or skin hazard) give off very little vapor or no vapors and enter the body through the skin.
    contact
  137. The primary route of exposure of blister agents, or vesicants, is the ____.  However, if vesicants are left on the skin or clothing long enough, they produce vapors that can enter the respiratory tract.
    skin
  138. Vesicants cause burnlike ____ to form on the victim’s skin and in the respiratory tract.
    blisters
  139. Three vesicant agents:
    • Sulfur mustard (H)
    • Lewisite (L)
    • Phosgene oxime (CX)
  140. ____ agents usually cause the most damage to damp or moist areas of the body, such as the armpits, groin, and respiratory tract.
    Vesicant
  141. Mustard is considered a ____, which means that it mutates, damages, and changes the structures of cells.
    mutagen
  142. ____ also attacks vulnerable cells within the bone marrow and depletes the body’s ability to reproduce white blood cells.
    Mustard
  143. Generally, ____ ____ are best equipped to handle the wounds and subsequent infections produced by vesicants.
    burn centers
  144. Two pulmonary (choking) agents:
    • chlorine (CL)
    • phosgene
  145. ____ was the first chemical agent ever used in warfare.  Initially it produces upper airway irritation and a choking sensation.  The patient may later experience shortness of breath, chest tightness, hoarseness and stridor, and gasping and coughing.
    Chlorine (CL)
  146. -Has been produced for chemical warfare and is a product of combustion such as might be produced in a fire at a textile factory
    -Very potent agent that has a delayed onset of symptoms, usually hours
    -The odor produced by the chemical is similar to that of freshly mown grass or hay.  The result is that much more of the gas is allowed to enter the body unnoticed.
    -Initially, a mild exposure may include nausea, chest tightness, severe cough, and dyspnea on exertiond.    
    -A severe exposure produces such large amounts of fluid in the lungs that the patient may actually become hypovolemic and subsequently hypotensive.
    Phosgene
  147. Are there any antidotes for vesicants and pulmonary agents carried by EMS?
    no
  148. Nerve agents can cause ____ ____ within seconds to minutes of exposure.
    cardiac arrest
  149. Nerve agents are a class of chemical called ____, which are found in household bug sprays, agricultural pesticides, and some industrial chemicals. ____ block an essential enzyme in the nervous system, causing the body’s organs to become overstimulated and burn out.
    organophosphates
  150. Four G agents:
    • sarin (GB)
    • soman (GD)
    • tabun (GA)
    • V agent (VX)
  151. A highly volatile colorless and odorless liquid.  Especially dangerous in enclosed environments.  When it comes in contact with the skin, it is quickly absorbed and evaporates.  When it is on clothing, it has the effect of off-gassing.
    Sarin (GB)
  152. Twice as persistent as sarin and five times as lethal.  This agent is a contact and an inhalation hazard.  A unique additive causes it to bind to the cells that it attacks faster than any other agent.
    Soman (GD)
  153. Approximately half as lethal as sarin and 36 times more persistent.  It is a contact and an inhalation hazard.
    Tabun (GA)
  154. A clear oily agent that has no odor and looks like baby oil.  It is more than 100 times more lethal than sarin and is extremely persistent.  It is easily absorbed into the skin, and the oily residue that remains is extremely difficult to decontaminate.
    V agent (VX)
  155. ____ agents all produce similar symptoms but have varying routes of entry.
    Nerve
  156. Mnemonics to describe symptoms of nerve agents:
    • SLUDGEM
    • DUMBELS
  157. SLUDGEM: symptoms of nerve agents.
    • Salivation, sweating
    • Lacrimation (excessive tearing)
    • Urination
    • Defecation, drooling, diarrhea
    • Gastric upset and cramps
    • Emesis (vomiting)
    • Muscle twitching/miosis (pinpoint pupils)
  158. DUMBELS: symptoms of nerve agents.
    • Diarrhea
    • Urination
    • Miosis
    • Bradycardia, bronchospasm
    • Emesis
    • Lacrimation
    • Seizures, salivation, sweating
  159. ____ is the most common symptom of nerve agent exposure and can remain for days to weeks.
    Miosis
  160. Nerve agent treatment
    Mark 1 NAAK
  161. Two metabolic agents (cyanides):
    • Hydrogen cyanide (AC)
    • Cyanogen chloride (CK)
  162. Hydrogen cyanide (AC) and cyanogen chloride (CK) are both agents that affect the body’s ability to use ____.
    oxygen
  163. Cyanide is a colorless gas with an odor like ____.
    almonds
  164. In low doses, these chemicals are associated with dizziness, light-headedness, headache, and vomiting.
    metabolic agents (cyanides)
  165. High doses will produce symptoms that include the following:
    -Shortness of breath and gasping respirations
    -Tachypnea
    -Flushed skin
    -Tachycardia
    -Altered mental status
    -Seizures
    -Coma
    -Apnea
    -Cardiac arrest
    metabolic agents (cyanides)
  166. Biologic agents are grouped as (three things):
    • viruses
    • bacteria
    • neurotoxins
  167. The means by which a terrorist will spread the agent.
    Dissemination
  168. A disease ____ is an animal that spreads disease, once infected, to another animal.
    vector
  169. How easily the disease is able to spread from one human to another human is called ____.
    communicability
  170. ____ describes the period of time between the person becoming exposed to the agent and symptoms beginning.
    Incubation
  171. -All the lesions are identical in their development.
    -Blisters begin on the face and extremities and eventually move toward the chest and abdomen.
    -The disease is in its most contagious phase when the blisters begin to form.
    smallpox
  172. Three viral hemorrhagic fevers (VHFs):
    • Ebola
    • Rift Valley
    • Yellow fever
  173. This group of viruses causes the blood in the body to seep out from the tissues and blood vessels.  Initially, the patient will have flulike symptoms, progressing to more serious symptoms such as internal and external hemorrhaging.
    Viral hemorrhagic fevers (VHFs)
  174. Unlike viruses, ____ do not require a host to multiply and live.  ____ are much more complex and larger and can grow up to 100 times larger than the largest virus.
    bacteria
  175. -Caused by a deadly bacterium that lays dormant in a spore
    -When exposed to the optimal temperature and moisture, the germ will be released from the spore
    -The routes of entry are inhalation, cutaneous, and gastrointestinal
    Anthrax
  176. The inhalation form, or pulmonary ____, is the most deadly and often presents as a severe cold.  Pulmonary ____ is associated with a 90% death rate if untreated.
    anthrax
  177. ____ can be used to treat anthrax successfully.
    Antibiotics
  178. The plague’s natural vectors are infected rodents and ____.
    fleas
  179. Bubonic plague infects the:
    lymphatic system.
  180. -Patient’s lymph nodes become infected and grow
    -Glands of the nodes will grow large and round, forming buboes
    -If left untreated, the infection may spread through the body, leading to sepsis and possibly death.
    Bubonic plague
  181. ____ plague is a lung infection, also known as plague pneumonia, that results from inhalation of plague bacteria.  This form of the disease is contagious and has a much higher death rate than the bubonic form.
    Pneumonic
  182. The most deadly substances known to humans.
    Neurotoxins
  183. Four things neurotoxins are produced from:
    • plants
    • marine animals
    • molds
    • bacteria
  184. The route of entry for neurotoxins is through (three things):
    • ingestion
    • inhalation from aerosols
    • injection
  185. Unlike viruses and bacteria, they are not contagious and have a faster onset of symptoms.
    neurotoxins
  186. The most potent neurotoxin is ____, which is produced by bacteria.
    botulinum
  187. -Produced by bacteria
    -When introduced into the body, the neurotoxin affects the nervous system’s ability to function
    -Voluntary muscle control diminishes as the toxin spreads
    -Eventually the toxin causes muscle paralysis, leading to respiratory arrest
    botulinum
  188. -Derived from mash that is left from the castor bean
    -When introduced into the body, causes pulmonary edema and respiratory and circulatory failure leading to death
    -The toxin is quite stable and extremely toxic by many routes of exposure, including inhalation
    Ricin
  189. Signs and symptoms of ____ ingestion are as follows:
    -Fever
    -Chills
    -Headache
    -Muscle aches
    -Nausea
    -Vomiting
    -Diarrhea
    -Severe abdominal cramping
    -Dehydration
    -Gastrointestinal bleeding
    -Necrosis of the liver, spleen, kidneys, and GI tract
    ricin
  190. Signs and symptoms of ____ inhalation are as follows:
    -Fever
    -Chills
    -Nausea
    -Local irritation of eyes, nose, and throat
    -Profuse sweating
    -Headache
    -Muscle aches
    -Nonproductive cough
    -Chest pain
    -Dyspnea
    -Pulmonary edema
    -Severe lung inflammation
    -Cyanosis
    -Seizures
    -Respiratory failure
    ricin
  191. -Monitoring of patients presenting to emergency departments and alternative care facilities
    -Recording of EMS call volume
    -Monitoring of the use of over-the-counter medications
    Syndromic surveillance
  192. During ____ ____, patients with signs and symptoms that resemble influenza are particularly important.  Quality assurance and dispatch operations need to be aware of an unusual number of calls from patients with “unexplainable flu” coming from a particular region or community.
    syndromic surveillance
  193. Existing facilities that are established in a time of need, for the mass distribution of antibiotics, antidotes, vaccinations, and other medications and supplies.
    Points of distribution (Strategic National Stockpile) - PODs
  194. Medications from PODs may be delivered in large containers known as:
    “push packs”
  195. Radioactive material is unstable, and it attempts to stabilize itself by changing its structure in a natural process called:
    decay
  196. -Any container that is designed to disperse radioactive material.
    Radiologic dispersal devices (RDDs)
  197. -Carries the potential to injure victims with not only the radioactive material, but also the explosive material used to deliver it
    -Destructive capability is limited to the explosives that are attached to it
    -Ineffective WMD
    dirty bomb
  198. Due to the collapse of the former Soviet Union, the whereabouts of many small nuclear devices is unknown.  These small suitcase-sized nuclear weapons are called:
    Special Atomic Demolition Munitions (SADMs).
  199. Being exposed to a radiation source does not make a patient:
    contaminated or radioactive.
  200. -Due solely to the direct effects of the pressure wave on the body
    -The injury is seen almost exclusively in the hollow organs of the body
    -An injury to the lungs causes the greatest morbidity and mortality
    Primary blast injury
  201. -Penetrating or nonpenetrating injury that results from being struck by flying debris
    -Objects are propelled by the force of the blast and strike the victim, causing injury
    Secondary blast injury
  202. -Results from whole body displacement and subsequent traumatic impact with environmental objects
    -Other indirect effects include crush injury from the collapse of structures and toxic effects from the inhalation of combustion gases
    Tertiary blast injury
  203. The ____ is the organ system most sensitive to blast injuries.
    ear
  204. Primary pulmonary blast injuries occur as:
    contusions and hemorrhages.
  205. The most common causes of death from blast injuries.
    Neurologic injuries and head trauma
  206. ____ and ____ are common after an intense pressure wave from an explosion.
    • Bradycardia
    • hypotension
  207. The is the least toxic route of exposure for ricin?
    oral
  208. While only a small percentage of individuals conduct terrorism to achieve their goals, terrorists are more likely to have an affiliation with:
    A. single-issue, political extremist, or apocalyptic religious groups.
    B. governments and the military.
    C. private corporations and business.
    D. private citizens and civic organizations.
    A. single-issue, political extremist, or apocalyptic religious groups.
    (this multiple choice question has been scrambled)
  209. What are the greatest threats to the EMT from weapons of mass destruction (WMDs)?
    A. entrapment and injury from structure collapse and explosion of secondary devices
    B. Panic and mass hysteria may lead to EMT injury as the victims attempt to flee.
    C. contamination and cross-contamination from direct contact with exposed individuals
    D. penetrating injury and barotrauma from close proximity to the blast zone
    C. contamination and cross-contamination from direct contact with exposed individuals
    (this multiple choice question has been scrambled)
  210. Symptoms of both inhaled and ingested ricin include:
    A. dehydration and convulsions.
    B. fever and headache.
    C. liver necrosis and diarrhea.
    D. joint pain and bradycardia.
    B. fever and headache.
    (this multiple choice question has been scrambled)

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