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Chap 8
Terms to know
124
Medical
Undergraduate 1
07/15/2024

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Term
Emergency situations such as:
Definition
  • Difficulty breathing
  • Changes in skin color or vital signs
  • Open bleeding wounds or visible punctures not indicated on the patient's chart
  • Inability to move an extremity
  • Misshapen/misaligned body part
  • Disorientation or confusion
  •  Severe Cephalalgia (headache)
Term
First Priorities
Definition

Make sure to provide the patient an airway and check circulation status

2nd should be to maintain cardiovascular status or restore it to hemostasis

Term
For the first 2 priorities, treatment is provided for these conditions:
Definition
  • Chest injuries
  • Shock
  • Wound protection/closure
  • Fractures
  • Vital sign monitoring
  • Provision of reassurance and comfort for the patient
Term
Cardiopulmonary resuscitation (CPR) is:
Definition
Technique of manually providing chest compressions and ventilations to patients in cardiac arrest
Term
Why do we do CPR?
Definition
To provide oxygenated blood to the brain and vital organs and reverse the processes that lead to death
Term
SCA & VF
Definition

Sudden Cardiac Arrest, Ventricular fibrillation.

Both of these demand CPR

Term
4-6 minutes
Definition
The time it takes before brain cells start to deteriorate. Makes it imperative to start CPR as quickly as possible
Term
The best way for surgical techs to learn CPR
Definition
Obtain a certification in it or one in BLS
Term
How often should one recertify their CPR or BLS training?
Definition
Every 2 years
Term
BLS
Definition
Basic Life Support
Term
What are the warning signs of Cardiac Arrest?
Definition
  • Chest pain (in the awake patient)
  • Unstable blood pressure -Tachycardia
  • Cardiac dysrhythmias
  • Respiratory changes
  • Hypovolemia
  • Laryngospasm
Term
Hypovolemia
Definition
Low levels of fluid in the blood and in the body
Term
Laryngospasm
Definition
The vocal cords suddenly seize up or close when taking in a breath, blocking the flow of air into the lungs
Term
The Chain of Survival entails:
Definition
  • The ABC's and D
  • Successful resuscitation requirements
  • Early recognition of cardiac arrest and action from trained responders
  • Early CPR and Defibrillation
  • Early Advanced Cardiac Life Support (ACLS)
Term
Defibrillation
Definition
Electrical Shock to restore cardiac rhythm
Term
ACLS
Definition
Advanced Cardiac Life Support
Term
Chain of Survival ABCD's
Definition

A: Airway

B: Breathing

C: Circulation

D: Definitive Treatment

Term
Definitive Treatment involves:
Definition
  • Control of dysrhythmia by cardiac defibrillation
  • Use of IV drugs and post resuscitative care
  • Monitoring blood pressure and blood gases
  • Providing artificial respiration 
  • IV access, arterial pressure, blood gas monitoring
  • Airway management, respiratory and cardiac support
Term
Basic life support was changed from
Definition
ABC to CAB in 2010
Term
CAB
Definition
Chest compressions, Airway, Breathing. This is now the proper procedure for handling adults, adolescents and infants. not newborns though
Term
Look, listen and feel has been eliminated because:
Definition
Of the inconsistency in the performance of these steps and their time consumption, thus delaying the start of chest compressions
Term
When patient is unresponsive, check them by:
Definition
Tapping them on the shoulder and shouting "Are you alright"! Also, check their breathing
Term
Shaking the patient to check responsiveness is:
Definition
No longer the right way to recognize cardiac arrest
Term
What is needed for High Quality Compressions
Definition
Appropriate rate and depth which includes recoil after each compression
Term
 What should be avoided during compressions
Definition
Pauses, as well as excessive ventilation. Defibrillation must also not interrupt the compressions if put into play
Term
ROSC
Definition
Return of Spontaneous Circulation, which will terminate resuscitation needs.
Term
 The ratio of chest compressions to rescue breaths for infants, adolescents and adults is
Definition
30-2
Term
 Consistent depth of 2 inches
Definition
The minimum compression for adults we must achieve to do CPR correctly. Used to be 1.5-2 inches
Term
The recommended number of Compressions per minute
Definition
100
Term
Positioning the head helps with:
Definition
Creating a tight seal to perform mouth-to-mouth rescue
Term
Where and how should the HCP (Health-care-provider) position their hands to provide compressions?
Definition
The 1st hands' heel on the lower half of the sternum and the 2nd hand on top in a parallel fashion. Use of a backboard is recommended.
Term
How often should rescuers switch in the duties of compressing? How quick should the switch be?
Definition

When 2 or more are available, switch every 2 minutes

The switch should be made in less than 5 seconds

Term
ERS
Definition
Emergency response system
Term
As one HCP begins compressions, what should the other HCP do?
Definition
Activate the ERS and obtain an AED to use ASAP
Term
 Cardiac Arrests in neonatals still follows the ABC sequence because:
Definition
For them the cause is nearly always asphyxia
Term
 The ratio of Chest compressions for neonatals is _____ unless ______
Definition
3-1: the arrest is due to Cardiac etiology which would then bump it to 15-2
Term
Cardiac etiology
Definition
Caused by a disease or abnormality of the heart
Term
Cardiac arrest is usually caused by
Definition
Exsanguinations or a critical thoracic injury
Term
Exsanguinations
Definition
Severe loss of blood
Term
Don't use chest compressions or tilt the head to open the airway when:
Definition
There is any suspicion of cervical spine injury because these will not reverse cardiac arrest
Term
When there is suspicion of cervical spine injury the patient must:
Definition
Undergo a resuscitative thoracotomy to allow access to the heart and major vessels by hand. This is known as a Cardiac massage
Term
(MH) Malignant Hyperthermia signs include:
Definition
  • Rapid increase in body temp
  • Unexplained tachycardia
  • Unstable blood pressure
  • Muscle rigidity
  • Tachypnea (rapid and shallow breathing)
  • Cyanosis
Term
Cyanosis
Definition
A bluish color in the skin, lips, and nail beds caused by a shortage of oxygen in the blood
Term
MH is usually triggered by
Definition
An anesthetic agent such as halothane, enflurane, or isoflurane and may be triggered by muscle relaxants such as succinylcholine
Term
(DIC) Disseminated Intravascular Coagulation
Definition
A pathological process in the body that occurs when blood begins to coagulate within the body. this may result in clotting symptoms or, more often, in bleeding due to the depletion of the body's blood clotting mechanisms
Term
 To counteract DIC one must
Definition
Administer a transfusion of fresh-frozen plasma to replace the coagulation factors. Additionally, Heparin (used to prevent thrombosis) is sometimes prescribed in combination with replacement therapy
Term
What is an Anaphylactic Reaction?
Definition
An exaggerated allergic reaction to a substance or protein
Term
What are the most common causes of anaphylaxis?
Definition
Drugs such as local anesthetics, codeine, antibiotics, animal derived drugs such as insulin, contrast media, and latex
Term
What actions should be taken if a patient has an anaphylactic reaction?
Definition
Maintain the airway, to prevent cardiovascular collapse and shock. Then administer epinephrine and steroids
Term
⊗ All-Hazards Preparation
Definition
All-encompassing term refers to many different emergencies
Term
Emergencies
Definition
Those requiring the emergency response of outside assistance, which may be a the local, county, state, or federal levels
Term
⊗ Emergency preparedness
Definition
Action taken by individuals, governments, healthcare facilities, allied health professionals and systems to be prepared for an emergency
Term
If people are stuck on the road due to snow disasters
Definition
They can suffer Hypothermia and frostbit
Term
If the vehicle is left running for heat and the tail pipe becomes plugged
Definition
Carbon dioxide poisoning can occur
Term
Heat waves
Definition
Are extended periods of abnormally hot weather that may be accompanied by high humidity
Term
Why are heat waves dangerous
Definition
Because the heat taxes the human body beyond its normal abilities. Ones most at risk are infants, adolescents, elderly, the obese, and the chronically ill
Term
Heat index
Definition
Number of degrees Fahrenheit that tells how hot it feels when relative humidity is added to air temperature. Exposure to full sunshine can increase the heat by 15°
Term
Heat Cramps
Definition
Muscular pains and spasms due to activity; often first sign/reaction by the body to the heat
Term
Heat Exhaustion
Definition
Due to exercising or working for long periods of time in a hot, humid place, body fluids are lost at a great rate through sweating without replacement. Mild form of shock because the body increases the blood flow to the skin, thus reducing blood flow to vital organs
Term
 Heat Stroke
Definition
A life-threatening condition where patient's internal temperature control system stops working. The body temperature can rapidly increase, causing neurological damage as well as leading to death if not treated immediately
Term
Earthquake levels below 3.5 and between 3.5-5.4
Definition

Earthquake may be felt, but not recorded by a seismograph

 

Earthquake felt: rarely causes damage

Term
Earthquake levels 5.4-6.0 and levels 6.1-6.9
Definition

Slight damage to well-designed, earthquake resistant buildings; major damage to poorly constructed buildings

 

Heavy damage and destruction up to 62 miles from the epicenter

Term
Earthquake levels 7.0-7.9 and levels 8.0 and greater
Definition

Major earthquake that causes heavy damage and destruction over a very large area

 

Strongest of earthquakes, with serious damage and destruction for hundreds of miles

Term
Underwater Eruptions of Volcanoes can cause
Definition
Tsunamis to form, and large plumes of superheated volcanic ash to blanket an area
Term
 The volcanic ash can cause what kind of complications
Definition
Respiratory complications as well as damage the lungs and cause serious burns
Term
 How can infectious diseases spread quickly?
Definition
If there is a large gathering of people, especially if they are in a shelter with poor sanitation infrastructure and access to health care services
Term
Epidemics and pandemics can quickly do what
Definition
Overwhelm the health-care systems and create a shortage HCP's who become sick themselves
Term
⊗ With limited supplies and having a few ventilator machines can lead to:
Definition
Diseases like influenza can be hard to treat and can easily lead to more complications like pneumonia
Term
⊗ Man-Made disasters
Definition
Transportation accidents and acts of terrorism or industrial incidents
Term
Chemical Release accidents
Definition
Life threatening events that can cause severe damage to the environment
Term
Radiological Injuries
Definition
Occur due to the detonation of an improvised nuclear device or radiological dispersal device referred to as a "Dirty Bomb" or because of a nuclear power plant accident
Term
 Injuries that can be sustained during an explosion
Definition
Blast injuries, Thermal/Flash burns, Flash blindness, and ionizing radiation injuries
Term
⊗ Scarring of the eyes, permanently altered vision, or blindness are the result of:
Definition
Retinal Blindness
Term
Radiation Exposure can cause
Definition
Mutations to occur in the cells of the body, resulting in various types of cancer
Term
Explosions have the potential to:
Definition
Injure all body parts, challenging HCP's in determining the injuries that require immediate treatment to preserve the life of the patient (Life over limb)
Term
Life over limb
Definition
The timely acceptance and transfer of patients with threatening conditions to an appropriate level of acute care services for interventions that would improve patient outcomes
Term
Injuries that are common to explosion victims are
Definition
Penetrating wounds, blast soft tissue injuries, fractures and burns
Term
Infrastructure incidents
Definition
Involve the collapse of roads, bridges and structures
Term
 Infrastructure incidents primarily cause
Definition
Crushing unjuries and severe lacerations
Term
Terrorism
Definition
The unlawful use of violence or threat of violence to instill fear and coerce governments or societies
Term
What motivates Terrorism
Definition
Religious, political, or other ideological beliefs and committed in the pursuit of goals that are usually political
Term
The first indication of a terrorist attack is
Definition
Having a large number of patients presenting with the same set of signs and symptoms
Term
Biological weapons can be absorbed through
Definition
The respiratory tract or can be absorbed through the mucous membranes, eyes, skin or open wounds
Term
The 2 most likely biological agents to be used as bioweapons are
Definition
Anthrax and smallpox
Term
 For preparation in case of emergencies families should
Definition
Research, identify, and familiarize themselves with the local and regional destructive events that could occur. After which, we must create a family emergency plan for each type of emergency and set aside supplies with an emergency contact numbers
Term
National Incident Management System
Definition
Governments, public health sector, private agencies & nongovernmental organizations
Term
Local Emergency Management Agencies
Definition
Fire Dept., EMS, Public health dept.
Term
Incident Command System
Definition
Ensures all responders know their roles and duties, and whom to report to
Term
 When a disaster happens, the Governor does what?
Definition
Forwards a request to the President To declare a disaster, which is called a Presidential Declaration
Term
Federal Assistance must be requested through
Definition
Formal channels by the local and state Governments bu it could take up to 3 days or longer
Term
The Federal Emergency Management does what?
Definition
They nationally declare the emergency and coordinate treatment to victims and food and shelter at the emergency scene
Term
National Response Framework
Definition
Guide for coordinating the disaster relief activities, when presidential declaration has been made
Term
National Disaster Medical System
Definition
Enacts the NRF; Responsible for sending medical equipment, supplies, teams to the disaster scene and patient transportation needs
Term
Disaster Medical Assistance Teams (DMATS)
Definition
Specialized teams that can be rapidly deployed to the emergency scene to assist in caring for victims
Term
 To be a surgical tech member of DMAT's they have to have
Definition
Completed additional training in first aid, starting IV lines, CPR/BLS and other emergency care that DMAT uses. It is the same if they want to perform Triage 
Term
 Disaster Mortuary Operations Response Team (DMORT)
Definition
Team members that include medical examiners, pathologists, radiographers, and dental assistants who aid in recording the identification of victims
Term
⊗ National Pharmacy Response Teams (NPRT's)
Definition
Team members who are pharmacists and pharmacy technicians who dispense drugs and provide vaccinations to the population within the disaster area
Term
Emergency Action Plan (EAP)
Definition
Follows state and Federal Guidelines the mitigate, prepare, respond, and recover before during and after disaster
Term
Mitigation
Definition
Identifies hazards and plans prevention
Term
Preparedness
Definition
Developing emergency action plan & establishes the emergency operations center
Term
Response
Definition
Preps before, during and after the event
Term
Recovery
Definition
Activities performed to aid the community in returning to as normal as possible
Term
 Hospital Incident Command System (HICS)
Definition
Chain of command that specifies the roles of HCPS. It allows the health care facility to work efficiently with other health facilities and responding agencies
Term
Knowing the Health care facilities signals and codes will
Definition
Help with efficiency especially in times of crisis
Term
Evacuation of patients involves
Definition
Moving the patients to an area of the facility that is the most safe and secure
Term
 Evacuation logistics factors
Definition
  • Medications
  • Blood and blood products
  • Availability of backup gas-powered generators
Term
 Evacuations other factors include
Definition
Communication and agreement to receive the patients in a safe location with a detailed list of those moved. CST's fill the role of positioning and transporting patients and medical records which is imperative
Term
Triage
Definition
A preliminary assessment of patients or casualties in order to determine the urgency of their need for treatment and the nature of treatment required
Term
During a Triage HCP should
Definition
Not enter the scene of a disaster without ensuring it's safe. They do, however, need to to create a safe zone as soon as possible
Term
Decontamination of patients is particularly important when it is:
Definition
A radiological or Chemical disaster
Term
 Radiological Decontamination Procedure involves
Definition
Removing the clothes ASAP because up to 90% of the contamination will be eliminated that way
Term
 How does the skin get treated during radiologic decontamination?
Definition
The skin and wounds are scrubbed with .5% sodium hypochlorite (Household bleach) and water then irrigated with normal saline. ⊗ Don't use on brain and spinal cord wounds, the eyes or the peritoneal cavity
Term
What type of PPE should be used during Triage
Definition
Disposable sponges, towels, gowns and other clothing should be available should be used. Stay clean and warm
Term
How should a triage area work
Definition
Patients are separated by severity close to the scene of the disaster. Patients should be tagged. There should be a separate ambulance loading area with a team assigned to it and one person who coordinates actions
Term
The Triage coordinator
Definition
Doesn't provide patient care but works in assessing them quickly. Some victims don't have life threatening injuries but do have a chance to prevent deterioration
Term
 The goal of providing quality patient care is difficult to reach for the Triage person because:
Definition
They have to decide quickly how to serve as many patients as possible while using medical supplies and manpower in an economic way
Term
A popular system of Triage is Simple Triage and Rapid Treatment (START)
Definition
This uses 4 main categories in which to place patients summed up with the acronym DIME
Term
DIME
Definition

D: Delayed

I: Immediate

M: Minimal

E: Expectant

Term
 Triage of Chemical/Nuclear disaster victims require
Definition
A separate system of triage in order to contain the contamination
Term
Victims of nuclear/chemical incidents are triaged into 3 categories
Definition

Hot zones

Warm zones

Cold zones

Term
Hot Zones are
Definition
The central area where the disaster occurred. patient is quickly assessed for airway patency and sever hemorrhage
Term
Warm Zone is located
Definition
300 feet or more from the hot zone. They are quickly triaged into the four categories
Term
Cold Zone
Definition
Triage zone near the warm zone where patients are evaluated for injuries secondary to severe injuries and transported to a facility
Term
Bronchodilator
Definition
Substance that relaxes the bronchi so that it opens more and allows the passage of air to the lungs
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