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Terrorism/Casualty
| Question | Answer |
|---|---|
| What is an Incident Command System? (ICS) | a local organization that coordinates personnel, facilities, equipment, and communication; it is federally mandated; it is the center of operations; one person is the incident commander |
| What is the Hospital Incident Command System? (HICS) | It's a clear chain of command with specific responsibilities within the hospital during an incident of mass casualty |
| What positions does the HICS include? | Incident Commander, Public Information Commander, Safety & Security Office, Liaison Officers, Specialty Personnel as needed |
| What are the focused areas of HICS? | Planning, Logistics, Finance, Operations |
| How does non-disaster situations get prioritized? | Highest priority and most resources go to the most critically ill. |
| How does triage prioritize disaster situations? | Decision is based on likelihood of survival gets treated first. |
| Who is #1 priority during mass casualty? | Immediate-Red: life threatening injuries but survivable with minimal intervention |
| What are examples of the red category? | Sucking chest wound, open fx of long bone, tension pneumothorax |
| What is #2 priority during mass casualty? | Delayed-Yellow: significant injuries but can wait hours without threat to life or limb |
| What is #3 priority during mass casualty? | Minimal-Green: injuries are minor and treatment can be delayed by hours to days; should be moved away from main triage area |
| What is #4 priority during mass casualty? | Expectant-Black: injuries are extensive and chances of survival are unlikely; comfort measures should be provided |
| Examples of "Black" Injury | penetrating head wounds, high SCI, 2nd and 3rd degree burns, profound shock, agonal respirations, pupils fixed dilated |
| How do you start triage? | send all who can walk to a specific location, separate green victims. |
| What is the 2nd step of triage? | Assess respirations: if greater then 30/min then triage as red and move to next patient, if less then 30/min continue assessing |
| What is the 3rd step in triage? | Assess perfusion: if cap refill is >2 sec then triage as red and continue to next pt, if <2 sec then continue assess pt |
| What is 4th step in triage? | Assess mental status: if can't follow simple commands then triage as red, if they can follow commands then triage as yellow |
| What are exceptions to the triage system? | Pregnant women, children & fellow rescuers |
| What is a level A PPE? | self-containing breathing apparatus (SCBA), vapor tight chemical resistant suit, gloves, and boots |
| What is Level B PPE? | high level of respiratory protection (SCBA) but lesser skin and eye protection; chemical resistant suit |
| What is Level C PPE? | air purified respirator, coverall with splash hood, chemical resistant gloves and hood |
| What is Level D PPE? | Typical work uniform |
| What are the steps of decontamination? | remove all of patient's clothing and jewelry and rinse with water; thorough soap and water wash and rinse |
| What are primary injuries due to blast? | due to direct effect of increases in atmospheric pressure that cause barotrauma: ruptured ear drums, pneumothorax, hemorrhage, DIC and ARDS |
| What are secondary injuries due to blast? | as a result of flying debris: minor lacerations, contusions; dust or smoke inhalation |
| What are tertiary injuries due to blast? | as a result of being thrown through the air by the blast and hitting another object |
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