eprc
JKO Emergency Preparedness Response Course (Operator, 8 hour) answers, verified line by line against the doctrinal handbooks: USAMRICD chemical casualties (nerve agents, vesicants, pulmonary agents, cyanide, triage categories, ICAM, decontamination zones), USAMRIID's Blue Book (plague, anthrax, Q fever, tularemia, smallpox, ricin, SEB, botulinum, VHF), AFRRI radiological casualties (acute radiation syndrome, cell radiosensitivity, beta burns, potassium iodide), FEMA ICS, 29 CFR 1910.120 and JP 3-41 CBRN response phases. Every answer carries a citation; cards the handbooks could not confirm were left out rather than guessed.
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01Which agent blocks aerobic metabolism by interfering with the cell's use of oxygen?
Cyanide. It halts oxidative phosphorylation by binding cytochrome a3, so cells cannot use the oxygen the blood is still delivering — which is why the casualty can look pink yet be dying of cellular hypoxia.
VERIFIED AGAINST THE SOURCE
“The fact that cyanide inhibits cellular utilization of oxygen would lead to the expectation that supplemental oxygen would not be of use in cyanide poisoning.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗02Which class of chemical agent is considered a fast-effect agent?
Nerve agents (GA, GB, GD, GF, VX). Vapor effects begin within seconds and a large exposure can kill in minutes, so antidote must be given at the point of exposure rather than at a treatment facility.
VERIFIED AGAINST THE SOURCE
“Nerve agents are the most toxic of the known chemical agents. They are hazards in their liquid and vapor states and can cause death within minutes after exposure.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗03How is a lung-damaging (pulmonary) agent casualty who develops respiratory distress less than 4 hours after exposure triaged?
Expectant. Dyspnea within the first 4 hours means pulmonary edema is already progressing rapidly and survival is unlikely; onset after 4 hours carries a good prognosis with intensive pulmonary care.
VERIFIED AGAINST THE SOURCE
“Survival is less likely for a casualty who becomes dyspneic within the first 4 hours after exposure, because pulmonary edema is already rapidly occurring.”
— Borden Institute, Field Management of Chemical and Biological Casualties Handbook, 5th Edition (2016), US Army Medical Department Center and School ↗04A group of people present with a delayed onset of blisters and a dry cough that later turns productive. What is the likely agent?
Sulfur mustard (HD/H). Mustard has an asymptomatic latent period of hours, then erythema and blisters on skin plus airway injury that starts as mild upper-respiratory irritation and progresses.
VERIFIED AGAINST THE SOURCE
“Signs and Symptoms: Asymptomatic latent period (hours). Erythema and blisters on the skin; irritation, conjunctivitis, corneal opacity, and damage in the eyes; mild upper respiratory signs to marked airway damage; also gastrointestinal (GI) effects and bone marrow stem cell suppression.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗05The immediate concern after chlorine exposure is the effect on what?
The airway and lungs. Chlorine converts to hydrochloric acid on contact with airway moisture and burns the tissue, acting on both the central and peripheral airway compartments.
VERIFIED AGAINST THE SOURCE
“Chlorine turns to hydrochloric acid when it contacts the moisture of the airway; it then causes chemical burns to the tissue.”
— Borden Institute, Field Management of Chemical and Biological Casualties Handbook, 5th Edition (2016), US Army Medical Department Center and School ↗06Which device detects and discriminates between nerve and mustard vapors and can be used to sort contaminated from clean personnel during decontamination?
The Improved Chemical Agent Monitor (ICAM). It reads vapor only and displays results in a G mode for nerve agents and an H mode for blister agents.
VERIFIED AGAINST THE SOURCE
“The ICAM, which is used to detect nerve and blister agents as vapors only, uses a 10-mCi nickel-63 (Ni63) beta-particle radiation source to ionize airborne agent molecules that have been drawn into the unit by a pump.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗07Which hazard control zone is the area immediately surrounding a hazardous material incident, extending far enough to protect personnel outside the zone from contamination?
The hot zone (also called the exclusion, red, or restricted zone). It is the primary area of contamination and its size is set by the incident commander.
VERIFIED AGAINST THE SOURCE
“The hot zone is an area immediately surrounding a hazardous material incident which extends far enough to prevent adverse effects from released contamination to personnel outside the zone.”
— Joint Publication 3-41, Chemical, Biological, Radiological, and Nuclear Consequence Management (21 June 2012) ↗08How is a vesicant (blister agent) casualty with skin burns over less than 5 percent of body surface area and minor eye irritation triaged?
Minimal. Small non-critical skin lesions and minor eye irritation can be treated symptomatically, and many of these casualties return to duty.
VERIFIED AGAINST THE SOURCE
“Patients with skin lesions covering a small percentage of BSA (under 5%) when the lesions are not in vital areas (a burn on the face might prevent mask donning) are triaged as minimal.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗09Which level of decontamination is carried out by a unit to reduce contamination to natural background or the lowest possible level?
Thorough decontamination. It permits partial or total removal of individual protective equipment while keeping the unit operating with minimum degradation.
VERIFIED AGAINST THE SOURCE
“thorough decontamination. Decontamination carried out by a unit to reduce contamination on personnel, equipment, materiel, and/or working areas equal to natural background or to the lowest possible levels, to permit the partial or total removal of individual protective equipment and to maintain operations with minimum degradation.”
— Joint Publication 3-11, Operations in Chemical, Biological, Radiological, and Nuclear (CBRN) Environments ↗10What level of civilian chemical protective equipment do healthcare providers wear when giving initial medical treatment on the contaminated side of a patient decontamination station?
Level C — air-purifying respirator plus chemical protective clothing. Military doctrine equates the MOPP Level IV worn by all warm-side staff, including the triage and emergency treatment areas, with OSHA Level C.
VERIFIED AGAINST THE SOURCE
“Protection. All staff on this side of the PDS wear MOPP Level IV, roughly equivalent to OSHA Level C.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗11Which of these is NOT a recognized risk of wearing personal protective equipment: heat stress, psychological stress, impaired vision and mobility, or hyperactivity?
Hyperactivity. OSHA lists heat stress, physical and psychological stress, and impaired vision, mobility and communication as the hazards PPE itself creates — hyperactivity is not among them.
VERIFIED AGAINST THE SOURCE
“The use of PPE can itself create significant worker hazards, such as heat stress, physical and psychological stress, and impaired vision, mobility, and communication.”
— 29 CFR 1910.120 Appendix B, General Description and Discussion of the Levels of Protection and Protective Gear ↗12How is a nerve agent casualty who presents with convulsions triaged?
Immediate. A convulsing or post-ictal casualty who still has intact circulation will survive with prompt antidote and ventilation, so immediate therapy is life-saving.
VERIFIED AGAINST THE SOURCE
“A severe nerve agent casualty who is unconscious, convulsing or post-ictal, breathing with difficulty or apneic, and possibly flaccid will survive with appropriate, immediate therapy, including ventilation, if he still has an intact circulation.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗13Which agent blocks an enzyme and produces a cholinergic crisis?
Nerve agent. It inhibits acetylcholinesterase, so acetylcholine accumulates and target cells fire uncontrollably — the syndrome treated with atropine, pralidoxime chloride and diazepam.
VERIFIED AGAINST THE SOURCE
“Nerve agent produces cholinergic crisis by inhibiting AChE and thus prolonging the action of ACh.”
— Borden Institute, Field Management of Chemical and Biological Casualties Handbook, 5th Edition (2016), US Army Medical Department Center and School ↗14Which drug class is a cyanide antidote?
A nitrite — amyl nitrite by inhalation or IV sodium nitrite, given with sodium thiosulfate. The nitrite forms methemoglobin, which pulls cyanide off cytochrome a3.
VERIFIED AGAINST THE SOURCE
“Management: Antidote: intravenous (IV) sodium nitrite and sodium thiosulfate. Supportive: oxygen, correct acidosis.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗15What term describes the deposit or absorption of radioactive material or of biological or chemical agents on personnel, structures or objects?
Contamination. It covers agent deposited on or absorbed by people, areas and objects, and it is what decontamination and the hazard control zones are built around.
VERIFIED AGAINST THE SOURCE
“contamination. 1. The deposit, absorption, or adsorption of radioactive material, or of biological or chemical agents on or by structures, areas, personnel, or objects.”
— Joint Publication 3-11, Operations in Chemical, Biological, Radiological, and Nuclear (CBRN) Environments ↗16When conducting the initial medical assessment of a chemical casualty, what status is checked first?
Respiratory status — airway then breathing. Chemical casualty care runs on the ABCDDs: Airway, Breathing, Circulation, Decontamination, Drugs.
VERIFIED AGAINST THE SOURCE
“A: Airway attention should be focused on establishing an airway (by positioning or by procedures) if needed, and maintaining the airway. No matter what else is done to try to save a casualty, death will be guaranteed if the airway is lost.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗17Which form of detection provides warning in time to implement protective measures before exposure to the agent?
Detect (detection) to warn — sensing the agent before it reaches the target so personnel can mask and don protective equipment. It is contrasted with detection to treat, which is medical surveillance after the fact.
VERIFIED AGAINST THE SOURCE
“Once an agent has been dispersed, detecting the bio-agent before its arrival over the target (and in time for personnel to don protective equipment), is referred to as "detect to warn".”
— USAMRIID, Medical Management of Biological Casualties Handbook ("Blue Book"), 9th Edition ↗18Which agent are the eyes most vulnerable to because of their thin, moist, warm mucosa?
Sulfur mustard. The eye is the body part most sensitive to mustard's corrosive effects, and even mild vapor exposure produces conjunctivitis and lid edema within 1 to 2 hours.
VERIFIED AGAINST THE SOURCE
“The eye is the body part most sensitive to mustard's corrosive effects.”
— Borden Institute, Field Management of Chemical and Biological Casualties Handbook, 5th Edition (2016), US Army Medical Department Center and School ↗19Chlorine casualties who require immediate treatment are most likely to be suffering from what?
Laryngospasm — sudden closure of the larynx, which makes the victim choke and collapse and is an immediate airway emergency.
VERIFIED AGAINST THE SOURCE
“can cause a sudden closure of the larynx (laryngospasm), causing the victim to choke and collapse.”
— Borden Institute, Field Management of Chemical and Biological Casualties Handbook, 5th Edition (2016), US Army Medical Department Center and School ↗20Decontamination is conducted in which hazard control zone?
The warm zone. Immediate, patient operational and patient thorough decontamination all take place there, between the hot zone and the clean cold zone.
VERIFIED AGAINST THE SOURCE
“Warm Zone. This is an area where low levels of dry, liquid, and vapor contamination can be expected once contaminated individuals enter this area.”
— USAMRICD, Medical Management of Chemical Casualties Handbook, 4th Edition (February 2007) ↗21A patient has fever, cough, dyspnea, prominent gastrointestinal symptoms and no buboes. Which form of plague is this?
Pneumonic plague — the form expected after a deliberate aerosol release. Absence of buboes rules out the bubonic form, and GI symptoms are common in primary pneumonic disease.
VERIFIED AGAINST THE SOURCE
“Primary pneumonic plague (the expected form following a bio-agent attack) begins with a sudden onset of symptoms after an incubation period of 1 to 6 days. These include high fever, chills, headache, malaise, followed by cough (often producing blood), progressing rapidly to dyspnea, stridor, cyanosis, and death. GI symptoms are often present.”
— USAMRIID, Medical Management of Biological Casualties Handbook ("Blue Book"), 9th Edition ↗22Twenty co-workers develop cough, pulmonary edema and dyspnea; chest films show bilateral infiltrates and bronchial aspirates are rich in protein. Several die. What is the likely agent?
Ricin by inhalation. Protein-rich bronchial aspirate with bilateral infiltrates is the signature of high-permeability pulmonary edema, and unlike SEB (which is rarely fatal) inhaled ricin kills.
VERIFIED AGAINST THE SOURCE
“Additional supportive clinical or diagnostic features after aerosol exposure to ricin include the following: bilateral infiltrates on CXR, arterial hypoxemia, neutrophilic leukocytosis, and a bronchial aspirate rich in protein compared to plasma, which is characteristic of high-permeability pulmonary edema.”
— USAMRIID, Medical Management of Biological Casualties Handbook ("Blue Book"), 9th Edition ↗23Processed foods and temperature-abused foods are most commonly associated with poisoning by which toxin?
Staphylococcal enterotoxin B (SEB). Naturally it is the classic food-poisoning toxin from improperly handled and held food; weaponized as an aerosol it incapacitates rather than kills.
VERIFIED AGAINST THE SOURCE
“These accidental intoxications often occur in a group setting such as a church picnic or other community event, and are due to improperly handled food and temperature holding, combined with ingestion of a common contaminated food source.”
— USAMRIID, Medical Management of Biological Casualties Handbook ("Blue Book"), 9th Edition ↗24Which bacterial (rickettsial) disease produces a non-specific illness that can cause prolonged disability but is rarely fatal?
Q fever (Coxiella burnetii). It looks like a viral illness or atypical pneumonia, patients are not usually critically ill, and it is generally self-limited — which is exactly why it was weaponized as an incapacitating agent.
VERIFIED AGAINST THE SOURCE
“Q fever is not a clinically distinct illness and may resemble a viral illness or other types of atypical pneumonia.”
— USAMRIID's Medical Management of Biological Casualties Handbook, 4th Edition (February 2001) ↗25Which statement does NOT describe the spores of Bacillus anthracis: highly stable, viable for years in soil, resistant to disinfectants, or sensitive to UV light?
"Sensitive to UV light" is false. Anthrax spores are highly resistant to sunlight, heat and disinfectants, which is precisely what makes them attractive as a weapon.
VERIFIED AGAINST THE SOURCE
“Moreover, the spores are highly resistant to sunlight, heat and disinfectants - properties which could be advantageous when choosing a bacterial weapon.”
— USAMRIID's Medical Management of Biological Casualties Handbook, 4th Edition (February 2001) ↗26A patient back from safari in Africa has high fever, mild hypotension, flushing, conjunctival injection and a bleeding rash. What class of viral infection is suspected?
Viral hemorrhagic fever (VHF). The exam findings of conjunctival injection, mild hypotension, flushing and petechial hemorrhage on top of fever and prostration are the classic VHF picture.
VERIFIED AGAINST THE SOURCE
“Physical examination may reveal only conjunctival injection, mild hypotension, flushing, and petechial hemorrhages.”
— USAMRIID's Medical Management of Biological Casualties Handbook, 4th Edition (February 2001) ↗27Which biological toxin is derived from the bean of the castor plant?
Ricin. It is a protein cytotoxin extracted from Ricinus communis; the waste mash from castor-oil production is about 5% ricin by weight, which is why it is so widely available.
VERIFIED AGAINST THE SOURCE
“Ricin is a potent protein cytotoxin derived from the beans of the castor plant (Ricinus communis).”
— USAMRIID's Medical Management of Biological Casualties Handbook, 4th Edition (February 2001) ↗28Which bacterial disease is contagious from person to person?
Pneumonic plague. It spreads by respiratory droplets between people, which is why suspected cases need droplet precautions in addition to antibiotics.
VERIFIED AGAINST THE SOURCE
“The contagious nature of pneumonic plague, whether through zoonotic or person-to-person transmission, makes it particularly concerning as a biological weapon.”
— USAMRIID, Medical Management of Biological Casualties Handbook ("Blue Book"), 9th Edition ↗29Which bacterial disease produces an ulcer on the skin with regional lymphadenopathy?
Tularemia — the ulceroglandular form of Francisella tularensis infection, which follows inoculation through the skin.
VERIFIED AGAINST THE SOURCE
“Signs and Symptoms: Ulceroglandular tularemia presents with a local ulcer and regional lymphadenopathy, fever, chills, headache and malaise.”
— USAMRIID's Medical Management of Biological Casualties Handbook, 4th Edition (February 2001) ↗30A patient has 5-day-old lesions concentrated on the face, arms and hands, with fever that began several days before the rash. Chickenpox or smallpox?
Smallpox. The rash is centrifugal — more abundant on the extremities and face than the trunk — and unlike varicella the lesions on any one body segment are all at the same stage.
VERIFIED AGAINST THE SOURCE
“Lesions are more abundant on the extremities and face, and this "centrifugal" distribution is an important diagnostic feature. In distinct contrast to varicella, lesions on various segments of the body remain generally synchronous in their stages of development.”
— USAMRIID, Medical Management of Biological Casualties Handbook ("Blue Book"), 9th Edition ↗31A patient has nausea, vomiting, trouble with eye movement, dry mouth, dysphagia, no gag reflex and extreme weakness, yet is alert and oriented. What toxin, and how is it treated?
Botulinum toxin — treated with supportive care (up to and including mechanical ventilation) plus early botulinum antitoxin. Cranial nerve palsies with a clear sensorium and descending flaccid paralysis are the giveaway.
VERIFIED AGAINST THE SOURCE
“Usually begins with cranial nerve palsies, including ptosis, blurred vision, diplopia, dry mouth and throat, dysphagia, and dysphonia. This is followed by symmetrical descending flaccid paralysis, with generalized weakness and progression to respiratory failure.”
— USAMRIID's Medical Management of Biological Casualties Handbook, 4th Edition (February 2001) ↗32High doses of which form of ionizing radiation cause the delayed, irreversible skin changes known as radiation (beta) burns?
Beta particles. Beta emitters deposited on the skin damage the basal layer and cause radiation burns; washing the contaminant off promptly prevents them.
VERIFIED AGAINST THE SOURCE
“Large quantities of beta emitters deposited on the skin can damage the basal layer and cause radiation burns.”
— AFRRI (Armed Forces Radiobiology Research Institute), Medical Management of Radiological Casualties, 5th Edition (February 2022) ↗33After a nuclear detonation, casualties with survivable injuries may also be contaminated. What is the correct course of action?
Treat all life-threatening injuries first. Surgical priorities for acute or life-threatening injury precede any treatment for the radiation injury — decontamination follows resuscitation.
VERIFIED AGAINST THE SOURCE
“Immediate treatment should focus on the trauma rather than radiation effects. Surgical priorities for acute or life-threatening injury must precede any treatment priority for associated radiation injury.”
— AFRRI (Armed Forces Radiobiology Research Institute), Medical Management of Radiological Casualties, 5th Edition (February 2022) ↗34Which cells are most sensitive to radiation damage?
Cells that are actively dividing. Hematopoietic progenitors in the bone marrow turn over rapidly and are among the most radiation-sensitive cells in mammals, which is why the marrow fails first.
VERIFIED AGAINST THE SOURCE
“Because of their rapid cell turnover, hematopoietic cells in the bone marrow are among the most radiation-sensitive cells in mammals.”
— AFRRI (Armed Forces Radiobiology Research Institute), Medical Management of Radiological Casualties, 5th Edition (February 2022) ↗35Which sub-syndrome of Acute Radiation Syndrome appears at the lower end of the exposure range?
The hematopoietic syndrome, above roughly 2 Gy. GI syndrome follows above about 6 Gy and neurovascular syndrome above about 12 Gy.
VERIFIED AGAINST THE SOURCE
“• Hematopoietic syndrome ( > 2 Gy) • GI syndrome (> 6 Gy) • Neurovascular syndrome (> 12 Gy)”
— AFRRI (Armed Forces Radiobiology Research Institute), Medical Management of Radiological Casualties, 5th Edition (February 2022) ↗36Which sub-syndrome of Acute Radiation Syndrome appears at the higher end of the exposure range?
The neurovascular syndrome, above roughly 12 Gy. Nausea and vomiting come within minutes, followed by hyperpyrexia, hypotension, ataxia and confusion; death is inevitable, usually within 24 to 48 hours.
VERIFIED AGAINST THE SOURCE
“Neurovascular syndrome occurs when a patient has been exposed to radiation greater than 12 Gy.”
— AFRRI (Armed Forces Radiobiology Research Institute), Medical Management of Radiological Casualties, 5th Edition (February 2022) ↗37Which form of ionizing radiation penetrates deeply into body tissue?
Photons — gamma rays (and x-rays). Their high penetrability means a photon source produces whole-body exposure and damage to deep organs, unlike alpha or beta particles.
VERIFIED AGAINST THE SOURCE
“Gamma rays: photons emitted during a nuclear detonation, and in many instances of radioactive decay. They are highly energetic and pass through matter easily. Because of high penetrability, gamma radiation can result in whole-body exposure and damage to deep organs.”
— AFRRI (Armed Forces Radiobiology Research Institute), Medical Management of Radiological Casualties, 5th Edition (February 2022) ↗38What protective measures should a unit apply on arriving at a suspected radiological incident?
Time, distance and shielding — minimize the time spent near the source, maximize distance from it, and put mass such as walls or soil between personnel and the source.
VERIFIED AGAINST THE SOURCE
“Commanders should minimize the time that personnel are exposed to the radiation source; maximize the distance between personnel and the radiation source; and place as much shielding material, such as walls or soil, between personnel and the radiation source as possible.”
— Joint Publication 3-11, Operations in Chemical, Biological, Radiological, and Nuclear (CBRN) Environments ↗39Which compound is given to reduce absorption of radioiodine by the thyroid?
Potassium iodide (KI). It must be given within about 4 hours of exposure to block thyroid uptake; it protects nothing else and does not treat other radionuclides.
VERIFIED AGAINST THE SOURCE
“Blocking uptake to the organ of interest. Example: Within 4 hours of exposure, administer potassium iodide (KI) to block uptake of radioactive iodine by the thyroid.”
— AFRRI (Armed Forces Radiobiology Research Institute), Medical Management of Radiological Casualties, 5th Edition (February 2022) ↗40Besides fires, earthquakes, hurricanes and terrorism, what is another valid application of ICS — for example planning and running a city's annual Labor Day parade and fair?
Planned events. ICS is explicitly intended for planned events as well as natural disasters and acts of terrorism, and using it for routine events keeps the skills sharp for large incidents.
VERIFIED AGAINST THE SOURCE
“May be used for planned events, natural disasters, and acts of terrorism.”
— FEMA Emergency Management Institute, ICS Review Materials (IS-100 Incident Command System), p. 1 ↗41Who is responsible for directing the command and control of all incident operations?
The Incident Commander. The IC sets priorities and objectives, establishes the Incident Command Post and the ICS organization, approves the Incident Action Plan, and coordinates Command and General Staff activity.
VERIFIED AGAINST THE SOURCE
“The Incident Commander is responsible for: • Having clear authority and knowing agency policy. • Ensuring incident safety. • Establishing an Incident Command Post. • Setting priorities, and determining incident objectives and strategies to be followed.”
— FEMA Emergency Management Institute, ICS Review Document (extracted from E/L/G 0300 Intermediate ICS for Expanding Incidents, ICS-300), March 2018 ↗42Which command system is the widely used and accepted tool for command, control and coordination of a disaster response?
The Incident Command System (ICS) — a standardized management tool for small or large emergency and non-emergency situations, and a key feature of the National Incident Management System.
VERIFIED AGAINST THE SOURCE
“Is a standardized management tool for meeting the demands of small or large emergency or nonemergency situations.”
— FEMA Emergency Management Institute, ICS Review Materials (IS-100 Incident Command System), p. 1 ↗43What is the purpose of a secondary explosive device at an incident scene?
To injure or kill the first responders. Secondary devices are set to function after EOD and CBRN response personnel have arrived, so responders must assume one is present.
VERIFIED AGAINST THE SOURCE
“Consider the potential for secondary devices designed to explode or release a CBRN hazard after EOD or CBRN hazard response personnel have arrived.”
— Joint Publication 3-41, Chemical, Biological, Radiological, and Nuclear Consequence Management (21 June 2012) ↗44Defense support of civil authorities is provided only when the requested action meets six criteria — what is the first of them?
Legality — compliance with the law. The other five are lethality, risk, readiness, appropriateness and cost, all weighed before the Secretary of Defense approves a request for assistance.
VERIFIED AGAINST THE SOURCE
“evaluates the request against six criteria: legality (compliance with laws); lethality (potential use of lethal force by or against DOD forces); risk (safety of DOD forces); readiness (impact on the DOD ability to perform its primary mission); appropriateness (whether the requested mission is in the interest of DOD to conduct); and cost (who pays, impact on DOD budget).”
— Joint Publication 3-41, Chemical, Biological, Radiological, and Nuclear Consequence Management (21 June 2012) ↗45Which phase of CBRN response synchronizes planning and execution with the efforts of the supported civil authorities?
Phase III — Operate (Dominate). It begins when DOD or National Guard forces start executing mission assignments in the operational area.
VERIFIED AGAINST THE SOURCE
“Phase III—Dominate (Operate). In phase III, planning and execution efforts are synchronized and integrated with the efforts of the supported civil authorities, as well as other military operations that may be occurring simultaneously (e.g., technical nuclear forensics sample collection) within the same operational area.”
— Joint Publication 3-41, Chemical, Biological, Radiological, and Nuclear Consequence Management (21 June 2012) ↗46Which phase of CBRN response focuses on prioritizing forces to deploy for mission tasks?
Phase II — Respond (Seize the Initiative). Forces that directly save lives and prevent further injury get the highest movement priority into the joint operations area.
VERIFIED AGAINST THE SOURCE
“Forces are prioritized to deploy for mission tasks that are directly involved in life saving and preventing further injury.”
— Joint Publication 3-41, Chemical, Biological, Radiological, and Nuclear Consequence Management (21 June 2012) ↗47What does START stand for in mass casualty triage?
Simple Triage and Rapid Treatment. Developed in 1983 by Hoag Hospital and the Newport Beach Fire Department, it is the most widely used mass-casualty triage system in the United States.
VERIFIED AGAINST THE SOURCE
“Simple triage and rapid treatment (START) is currently the most widely used triage system in the United States for mass casualty incidents.”
— Clarkson L, Williams M. EMS Mass Casualty Triage. StatPearls (NCBI Bookshelf), Clinical Significance ↗48Which post-disaster phase is characterized by optimism brought on by an infusion of resources?
The honeymoon phase — a week to months after the disaster, when government assistance and volunteers arrive and survivors feel a short-lived optimism. It gives way to the inventory and disillusionment phases.
VERIFIED AGAINST THE SOURCE
“During the honeymoon phase, which occurs a week to months following a disaster, governmental assistance becomes readily available. In addition, large numbers of volunteers offer help. Survivors experience a short-lived sense of optimism.”
— CDC Radiation Studies Branch / ORAU, Psychological First Aid in Radiation Disasters - Psychosocial Reactions: Phases of Disaster ↗49In which post-disaster phase do survivors accept responsibility for rebuilding their homes, businesses and lives?
The reconstruction, or recovery, phase — the final phase, in which individuals and communities rebuild physical property and recover emotional well-being. It can take years.
VERIFIED AGAINST THE SOURCE
“The final phase is reconstruction, or recovery. It is in this period that individuals and communities rebuild their physical property and recover their emotional well-being. This phase can take years.”
— CDC Radiation Studies Branch / ORAU, Psychological First Aid in Radiation Disasters - Psychosocial Reactions: Phases of Disaster ↗50Which is a common behavioral reaction to severe short-term traumatic stress?
Substance abuse. Survivors commonly reduce tension through self-medicating, compulsive, impulsive or self-injurious behaviors — substance use is the classic example.
VERIFIED AGAINST THE SOURCE
“Some people reduce tension or stress through avoidant, self-medicating (e.g., alcohol abuse), compulsive (e.g., overeating), impulsive (e.g., high-risk behaviors), and/or self-injurious behaviors.”
— SAMHSA, Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series No. 57 (2014), Chapter 3 ↗51Short-term stress reactions in disaster survivors fall into every category EXCEPT which one: emotional, physical, cognitive, behavioral, or intellectual?
Intellectual. The recognized domains are emotional, physical, cognitive, behavioral, social and developmental — "intellectual" is not one of them (thinking changes are captured under cognitive).
VERIFIED AGAINST THE SOURCE
“The following sections focus on some common reactions across domains (emotional, physical, cognitive, behavioral, social, and developmental) associated with singular, multiple, and enduring traumatic events.”
— SAMHSA, Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series No. 57 (2014), Chapter 3 ↗52What is the role of the Liaison Officer in the Hospital Incident Command System?
To function as the incident contact person in the Hospital Command Center for representatives from other agencies. The Liaison Officer reports directly to the Incident Commander.
VERIFIED AGAINST THE SOURCE
“Mission: Function as the incident contact person in the Hospital Command Center for representatives from other agencies.”
— California EMSA, Hospital Incident Command System (HICS) 2014, Job Action Sheet - Liaison Officer ↗Know questions we're missing?
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