Ch. 39 – EMS Response to Terrorism – Flashcards
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            Terrorism is defined as
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        the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population or any segment thereof, in furtherance of political or social objectives
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            2 types of terrorism in US are:
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        domestic & international
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            Domestic terrorism involves
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        groups/individuals whose terrorist activities are directed at their own government/population without foreign direction
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            International terrorism involves
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        groups/individuals whose terrorist activities are purely foreign based and/or directed by countries/groups outside the targeted country or whose activities cross national boundaries
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            In addition to armed attacks, incidents of terrorism may involve CBRNE agents:
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        Chemical, Biological, Radiological, Nuclear, Explosive
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            Weapons of mass destruction (WMBD) are
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        weapons, devices, or agents intended to cause widespread harm and/or fear among a population
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            The EMT should recognize that any terrorist event in the US is considered
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        a crime scene
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            Two additional terrorism related factors that all responders will have to take into account are:
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        deliberate targeting of responders and crime scene considerations
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            A secondary device is those used to
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        injure first responders
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            Clues such as the OTTO signs will help recognizing suspicious incidents:
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        Occupancy or location  Type of event  Timing of the event  On-scene warning signs
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            Types of harm to which you can be exposed TRACEM-P are:
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        Thermal harm  Radiological harm  Asphyxiation  Chemical harm  Etiological harm (causes of disease like bacteria/virus/toxin)  Mechanical harm  Psychological harm
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            Protection of the EMR is based on avoiding/minimizing exposure based on
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        Time: minimize time at a dangerous scene  Distance: maximize distance from hazard area  Shielding: to address specific hazards (PPE, buildings, vehicles)
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            Types of harm from chemical incidents:
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        Primary: C  Secondary: TAM-P
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            Biological incidents can be caused by
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        bacteria, viruses, or toxins
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            Exposure is
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        the dose or concentration of an agent multiplied by the time, or duration
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            Chemical doses are generally measured in
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        milligrams per kilogram of body weight
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            Biological doses are measured in
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        fractions of micrograms per kilogram of body weight
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            The concentration of an agent is measured in
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        parts per million
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            Infectious dose data are standardized and typically based on
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        a 150-pound male in good health
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            The four major routes of entry are:
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        Absorption (skin contact)  Ingestion (mouth)  Injection (needles/projectiles)  Inhalation (breathing)
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            Contamination is caused by
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        contact with or presence of a contaminant, a material that is present where it does not belong and is somehow harmful to persons/animals/environment
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            Exposure vs. Contamination
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        Exposure occurs when a substance is taken into the body through one of the routes of exposure while contamination occurs when a substance clings to surface areas of the body or clothing
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            Permeation is
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        the movement of a substance through a surface or, on a molecular level, through intact materials; mass penetration or spreading
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            The removal of _______ removes most of the contamination.
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        Clothing
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            Types of harm from biological incidents
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        Primary: E  Secondary: CM-P
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            Types of harm from radiological/nuclear incidents:
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        Primary: TRM  Secondary:C-P
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            Types of harm from explosive incidents:
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        Primary: TCM  Secondary: A-P
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            Dissemination is
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        spreading
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            The most effective and most common means of dissemination is to enable the material to enter through
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        the respiratory tract
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            Weaponization is
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        the packaging or producing a material so ti can be used as a weapon
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            Chemical agents with a ____ boiling point tend to be more persistent
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        high
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            SLUDGEM is a
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        mnemonic used to remember the signs and symptoms of nerve agent poisoning
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            SLUDGEM stands for
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        Salivation  Lacrimation (due to stimulation of the lacrimal glands)  Urination  Defecation  GI upset  Emesis (vomiting from GI system effects)  Miosis (abnormal contraction of the pupils)
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            Biological agents are
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        microorganisms or toxins that can cause disease processes
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            A zoonotic disease is
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        a disease that can move through the animal-human barrier; anthrax
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            Anthrax is a ______ bacterium and can survive
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        sporulating (spore-producing); the acids of the stomach
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            An RDD is a
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        radiological dispersal device (RDD) or "dirty bomb"
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            If a terrorist were to use a radiological material, the three body systems that would be most severely affected are:
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        Blood-forming system (specifically bone marrow)  GI system  CNS
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            Rem is the
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        roentgen equivalent man; a measure of radiation dosage
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            Strategies vs. Tactics
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        Broad general plans designed to achieve desired outcomes vs. specific operational actions to accomplish assigned tasks
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            Tasks for responders are:
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        Isolation  Notification  Identification  Protection
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            An EMT's protection responsibilities include:
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        Make an initial scene size-up to determine security threats  Request protection via radio  Establish vehicle staging & triage/treatment areas in protected locations  Advise EMS command about protection/security concerns  Immediately report suspicious people/activities
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            How to protect yourself in terrorist attacks:
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        Recognize a possible terrorist event with OTTO  don't rush in  Understand the TRACEM-P harms  Time, distance, and shielding
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            Injuries received during the secondary blast phase are caused? by
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        blast projectiles
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            ?"Blast lung" is a consequence? of
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        a high-energy overpressurization wave
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            Which type of weapon ignites certain elements that burn? rapidly, causing violent air? displacement?
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        Explosive
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            What penetrating power do alpha particles? have?
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        Alpha particles have little penetrating ability and can be stopped by paper or clothing
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            Thermal injury would MOST likely be due? to
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        an explosive event
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            Who is responsible for perimeter control at a terrorism? incident?
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        Law enforcement personnel
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            When treating thermal injuries at a terrorism? incident, the EMT? should
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        follow local protocols
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            For an ingested weapon to be? effective, it? would
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        have to survive in an acidic environment
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            Into what category of hazardous materials do weapons of mass destruction commonly? fall?
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        Toxic & flammable gases  NOT Flammable? solids, materials that are dangerous when? wet, or materials that are spontaneously combustible  NOT corrosives  NOT organic peroxides
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            What is a measure of radiation dosage?
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        Rem
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            Nerve agents are _______ agents
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        chemical
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            A type of harm that you may be exposed to as an EMT responding to a terrorist incident that is characterized by a resulting? post-traumatic stress disorder? (PSTD) is typically called? a(n)
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        psychological harm
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            An outbreak of _______ would be LEAST likely to occur naturally
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        anthrax
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            Two elements that differentiate a hazardous materials incident from a terrorist incident? are
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        crime scene considerations and targeting responders
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            The current trend in international terrorism is that it tends to be motivated by?
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        Religion
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            An oxygen level of? ________ is required for normal breathing.
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        19.5%
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            A terrorist incident may have features in common with
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        mass casualty, haz mat, and infectious disease incidents
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            Tertiary injuries from a blast? include
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        extremity fractures
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            Standard management of a chemical burn caused by a terrorist incident? includes
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        irrigating vigorously with cool water
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            What chemical agent prohibits the use of oxygen in the? cells?
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        Cyanide
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            Primary injuries from a blast? include
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        lung injuries
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            What method decontamination is NOT usually a prehospital activity during a terrorism? incident?
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        Neutralization
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            What methods of decontamination are usually a prehospital activity during a terrorism incident?
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        Dilution, Absorption, and Isolation
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            Anthrax can infect an individual through which of the following routes of? exposure?
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        Skin, inhalation, ingestion
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            What impacts the behavior of a chemical in an MCI?
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        Physical state of the agent, route of entry into the body, and volatility of the agent.   NOT whether it was an intentional or accidental exposure
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            Which of the following animals is the direct source of exposure of the bacterium that causes the plague to? humans?
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        Rats
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            Dangerous organisms that can grow in a variety of environments and are capable of producing toxic substances are known? as
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        bacteria
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            Concerning the threat of nuclear devices used in terrorist? attacks, which of the following is MOST likely to be used in such an? attack?
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        Sabotage of facilities for nuclear research
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            The formula dose multiplied by time represents which of the? following?
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        Exposure
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            You are on the scene of a probable terrorist attack with several other? agencies, both local and federal. In order to operate in an efficient? manner, all agencies should follow? the
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        Incident Command System (ICS)
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            Dangerous organisms that grow inside of living cells and reproduce are known? as
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        viruses
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            Vesicants are ______ and are a type of ________
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        blistering agents; chemical weapon
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            A biological event will likely lead to patients with
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        unexplained illness
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            Your patient has been exposed to a vesicant agent. His injuries will be caused? by:
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        Absorption
