Emergency Care For Hazardous Materials Exposure 0801678137, 9780801678134

Table of contents :
Cover
THE SHIP’S MEDICINE CHEST AND MEDICAL AID AT SEA
Dedicated to American Merchant Mariners and others who risk their lives at sea.
Disclaimer
Table of Contents
Historical Background
Editorial Board and Other Contributors
Foreword
Introduction and How to Use This Book
SMC-1 History, Physical Examination and Basic Supportive Care
Introduction
Creating the Sickbay Environment
Communication
Initial Assessment
Problem - Focused Health History
Physical Examination
The pulse
Respiratory rate
Skin:
Head and Neck:
Ears, Nose and Throat:
mouth and throat
Eyes:
Chest and Lungs:
Heart:
Abdomen:
Musculoskeletal system:
Neurological:
Genitalia:
Assessment Summary:
Fluid Therapy
Dehydration
Treatment of Dehydration
Hypothermia and Hyperthermia
Hypothermia
Hyperthermia
Stages of Hyperthermia:
Heat Exposure:
Heat Cramps:
Heat Exhaustion:
Heat Stroke:
Pain
Assessment of Pain
Interventions
Medication Administration
Equipment for Parenteral Injections:
Preparation of Medication:
Subcutaneous Injections
Intramuscular Injections
Intravenous Infusions or Injections
Recording
Checking the IV for Complications
Wound Care
Universal Precautions
Assessment
Control of Bleeding
Principles of Bandaging.
Splinting
Compression Bandages
Kinds of Wounds
Infection Control
Methods Of Wound Closure
Record Keeping/Flow Charting
SMC-2 Communicable Disease Prevention
Introduction
Communicable Diseases
Infectious Agents
Disease Incidence (Occurrence)
Chain of Transmission
Reservoirs or Sources of Infection
Portals of Entry and Exit
Modes Of Transmission
Host Immunity and Resistance
Prevention of Communicable Diseases
Vaccination
Reservoir Eradication
Interrupting Disease Transmission
Inactivating Infectious Agent
Personal Hygiene
Safe Food Practices
SMC-3 Ship Sanitation
Introduction
Food Sanitation
The Food Handler
Food Service Facilities, Equipment, and Utensils
Food Selection and Procurement
Food Storage
Food Preparation and Handling
Sanitation of Equipment, Utensils and Food Preparation Areas
Potable Water
Potable Water Tanks
Potable Water Hoses
Pest Management
Pesticides
Rodents
Flies
Mosquitoes
Roaches
Lice, Bedbugs, and Fleas
Pests in Stored Products
Garbage
Laundry
Barbershops
Habitability
Thermal Stress
Hazardous Materials
Respiratory Protection
Confined/Enclosed Spaces
Recommended References
SMC-4 Substance Abuse
CHAPTER 4 SUBSTA N C E A B U S E
INTRODUCTION
THE ALCOHOLS
ALCOHOL IN THE BODY
MANAGEMENT OF PATIENTS WITH ALCOHOL-INDUCED DISORDERS
ALCOHOL INTOXICATION
ALCOHOL WITHDRAWAL
ALCOHOL DEPENDENCE AND ALCOHOL ABUSE
DRUGS OF ABUSE
OPIOID-RELATED DRUGS
Treatment of Opioid Intoxication and Dependence
SEDATIVE-, HYPNOTIC- AND ANXIOLYTIC- RELATED DRUGS
AMPHETAMINE-RELATED DRUGS
HALLUCINOGENS
CANNABIS
COCAINE
INHALANTS
SUMMARY
SMC-5 Dental Care and Emergencies
CHAPTER 5 DENTAL C A R E A N D E M E R G E N C I E S
INTRODUCTION
DENTAL DISEASES THAT MAY PRESENT AS DENTAL EMERGENCIES
ACUTE NECROTIZING ULCERATIVE GINGIVITIS
ALVEOLAR OSTEITIS ("DRY SOCKET")
APHTHOUS ULCER
AVULSED TOOTH / DISPLACED TOOTH
DISPLACED TOOTH
CARIES
FRACTURED TOOTH OR CROWN
GINGIVITIS (ACUTE PAINFUL)
PERIAPICAL ABSCESS
PERICORONITIS
PERIODONTAL ABSCESS
PULPITIS
SUGGESTED DENTAL MATERIALS TO HAVE STOCKED IN YOUR SICKBAY
SUGGESTED MEDICATIONS TO HAVE STOCKED IN YOUR SICKBAY:
SMC-6 Personal Preventive Practices
CHAPTER 6 PERSONAL P R E V E N T I V E P R A C T I C E S
INTRODUCTION
HABITS FOR HEALTH
HABIT 1: QUIT SMOKING
HABIT 2: THINK ACTIVE!
HABIT 3: EAT FOR NUTRITION
HABIT 4: MAINTAIN MENTAL HEALTH AND MINIMIZE CHRONIC STRESS
HABIT 5: MAXIMIZE PERSONAL SAFETY
HABIT 6: MANAGE SUFFICIENT, RESTFUL SLEEP
HABIT 7: GET PROFESSIONAL PREVENTIVE CARE WHEN ASHORE
SMC-7 Ship's Women Health
CHAPTER 7 WOMEN’S HEALT H
INTRODUCTION
Heart Health
Cancer Screening
Breast Self-Examination
INFORMATION ON DISEASES, SYMPTOMS AND CONDITIONS
Vaginal Discharge and/or Itching
Tampon Safety
Bleeding Between Menstrual Periods
Missed Periods
Difficult Menstrual Periods
Menopause
Osteoporosis
Management of Recurrent Urinary Tract Infection
SEXUAL CONTACT
VIOLENCE AGAINST WOMEN
NUTRITION AND WOMEN’S SPECIAL NEEDS
Calcium
Iron
Calories and Weight Control
Eating Disorders
PREVENTIVE HEALTH CARE: YOUR ROLE
SMC-8 Responding to Potential Bioterrorism
CHAPTER 8 R E S P O N D I N G TO P O T E N T I A L B I O L O G I C A L , C H E M I C A L A N D N U C L E A R / R A D I O L O G I C A L T E R R O R I S M A G E N T S
INTRODUCTION
HISTORY OF BIOLOGICAL AGENTS
BIOLOGICAL AGENTS
DISTINGUISHING BETWEEN NATURAL AND INTENTIONAL DISEASE OUTBREAKS
BACTERIAL AGENTS
ANTHRAX (INHALLATION)
BRUCELLOSIS
GLANDERS AND MELIOIDOSIS
PLAGUE
Q FEVER
TULAREMIA
VIRAL AGENTS
SMALLPOX
VENEZUELAN EQUINE ENCEPHALITIS (VEE)
VIRAL HEMORRHAGIC FEVERS (VHF)
BIOLOGICAL TOXINS
BOTULINUM
RICIN
STAPHYLOCOCCAL ENTEROTOXIN B (SEB)
T-2 MYCOTOXINS
CHEMICAL AGENTS
MUSTARD
NERVE AGENTS
CYANIDE
DETECTION
DECONTAMINATION
PATIENT ISOLATION PRECAUTIONS
Standard Precautions
Airborne Precautions
Droplet Precautions
Contact Precautions
NUCLEAR RADIATION
TYPES OF RADIATION
Alpha Particles
Beta Particles
Gamma Rays
X-Rays
Neutron Particles
LIMITING EXPOSURE
MEDICAL TREATMENT
PERSONAL PROTECTIVE EQUIPMENT (PPE) AND RADIATION
EFFECTS OF EXPOSURE
GLOSSARY OF MEDICAL TERMS
SUMMARY
FIGURE 1. SOURCES OF INFORMATION ON NATURAL AND MANMADE DISASTERS
SMC-9 Legal Issues of Shipboard Medicine
CHAPTER 9 - LEGAL I S S U E S O F S H I P B O A R D M E D I C I N E
INTRODUCTION
DUTIES OF THE OWNER OF THE VESSEL
DUTIES OF THE MASTER OF THE SHIP
SMC-10 Immersion Hypothermia, Near-Drowning and Water Survival
CHAPTER 10_I M M E R S I O N H Y P O T H E R M I A , N E A R - DROWNING AND WAT E R S U RVI VAL
INTRODUCTION
PHYSIOLOGICAL RESPONSES TO COLD-WATER IMMERSION
Normal:
Mild hypothermia:
Moderate hypothermia:
Severe hypothermia:
Stage 1: Initial Immersion: the Cold Shock Response:
Stage 2: Short-Term Immersion: Impaired Performance:
Stage 3: Long-term immersion: hypothermia:
RESCUE AND MANAGEMENT OF HYPOTHERMIA
Near-Drowning
Water Survival
REFERENCES:
App. A - STCW Code
APPENDIX A - S TA N D A R D S O F T R A I N I N G, C E R T I F I C AT I O N A N D WAT C H K E E P I N G F O R S E A FA R E R S ( S T C W C O D E )
INTRODUCTION
OCCUPATIONAL SAFETY, MEDICAL CARE AND SURVIVAL
IMPLEMENTATION
NMC Policy Letter 9-99
COMPETENCY IN ELEMENTARY FIRST AID
COMPETENCY AS MEDICAL FIRST AID PROVIDER
COMPETENCY AS A PERSON IN CHARGE OF MEDICAL CARE
COMPETENCY AT THE MANAGEMENT LEVEL
App. B - Elementary First Aid
APPENDIX B - S TA N D A R D S O F C O M P E T E N C E F O R SEAFA R E R S D E S I G N AT E D TO P R O V I D E ELEMENTARY F I R S T A I D
STANDARDS – SECTION A-VI/1-3 OF STCW CODE
STANDARD OF COMPETENCE FOR SEAFARERS DESIGNATED TO PROVIDE ELEMENTARY FIRST AID
Coast Guard Assessment Guidelines for TABLE A-VI/1-3 Specification for minimum standard of competency in Elementary First Aid
App. C - Medical First Aid
APPENDIX C - S TA N D A R D O F C O M P E T E N C E F O R P E R S O N S D E S I G N AT E D TO P R O V I D E M E D I C A L F I R S T A I D
STANDARDS - SECTION A-VI/4-1 OF STCW CODE
TABLE A-VI/4-1 of STCW CODE STANDARD OF COMPETENCE FOR SEAFARERS DESIGNATED TO DESIGNATED TO PROVIDE MEDICAL FIRST AID
TABLE A-VI/4-1 SPECIFICATION OF MINIMUM STANDARD OF COMPETENCE FOR PERSONS DESIGNATED TO PROVIDE MEDICAL FIRST AID sterile techniques.
Coast Guard Assessment Guidelines for TABLE A-VI/4-1 of STCW Code Specification for minimum standard of competency in Medical First Aid
App. D - Medical Care on Board Ship
APPENDIX D - S TA N D A R D O F C O M P E T E N C E F O R SEAFA R E R S D E S I G N AT E D TO TA K E C H A R G E O F M E D I C A L C A R E O N B O A R D S H I P
STANDARD - SECTION A-VI/4-2 OF STCW CODE
TABLE A-VI/4-2 STANDARD OF COMPETENCE FOR SEAFARERS DESIGNATED TO TAKE CHARGE OF MEDICAL CARE ON BOARD SHIP
TABLE A-VI/4-2 SPECIFICATION OF MINIMUM STANDARD OF COMPETENCE
Coast Guard Assessment Guidelines for TABLE A-VI/4-2 of STCW Code Specification Of Minimum Standard Of Competence For Persons In Charge Of Medical Care
App. E - Personal Safety and Social Resp
APPENDIX E - S TA N D A R D O F C O M P E T E N C E F O R SEAFA R E R S D E S I G N AT E D TO P R O V I D E PERSONAL S A F E T Y A N D S O C I A L R E S P O N S I B I L I T I E S
STANDARD - SECTION A-VI/1-4 OF STCW CODE
STANDARD OF COMPETENCE FOR SEAFARERS DESIGNATED TO PROVIDE PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES
Coast Guard Assessment Guidelines for TABLE A-VI/1-4 Specification for minimum standard of competency in Personal Safety and Social Responsibility
App. F - Additional Health Care Provider Capabilities
APPENDIX F - A D D I T I O N A L H E A LT H C A R E P R O V I D E R CAPA B I L I T I E S
INTRODUCTION
EMERGENCY INTERVENTION
PATIENT ASSESSMENT
BASIC LIFE SUPPORT AND VENTILATION:
VENTILATION EQUIPMENT AND OXYGEN THERAPY:
HEMORRHAGE AND GENERAL EMERGENCIES:
SHOCK:
GENERAL INJURIES:
FRACTURES, DISLOCATIONS AND SPRAINS:
HEAD INJURIES AND MEDICAL EMERGENCIES:
INJURIES TO THE EYE, EAR AND THROAT:
CHEST INJURIES AND MEDICAL EMERGENCIES:
ALLERGIES AND ANAPHYLACTIC REACTIONS:
ABDOMEN AND GENERAL EMERGENCIES:
HEART DISEASE:
ENVIRONMENTAL EMERGENCIES:
PSYCHIATRIC CONDITIONS:
SUBSTANCE ABUSE
CLINICAL SICKCALL
HEAD:
VISION:
EAR:
SINUS/NOSE:
THROAT:
NECK:
RESPIRATORY/THORAX/ CIRCULATORY:
SKIN CONDITIONS:
ABDOMEN/REPRODUCTIVE:
DIABETES:
MUSCULAR SKELETAL:
UPPER EXTREMITIES:
LOWER EXTREMITIES:
PSYCHOLOGICAL CONDITIONS:
WELLNESS
ADMINISTRATION
PATIENT AFFAIRS
SUPPLY AND FISCAL MANAGEMENT
BASIC INSTRUCTION
SAFETY AND ENVIRONMENTAL HEALTH
App. G - Sickbay and Medicine Chest
APPENDIX G - S I C K B AY A N D M E D I C I N E C H E S T
INTRODUCTION
MEDICAL EQUIPMENT
DIAGNOSTIC
FURNITURE
CONSUMABLE SUPPLIES
Bandages:
Sponges/Pads/Dressing:
Splints/Walking Aids:
Adhesive Tape:
Ear Plugs:
Miscellaneous:
MEDICAL/SURGICAL SUPPLIES/SETS
Scissors/Blades:
Gloves:
Catheters:
Intravenous Sets:
Syringe/Needle:
Medical/Surgical Sets:
Sutures:
Diagnostic Instruments:
Miscellaneous Medical/Surgical Instruments And Items:
Miscellaneous:
Patient Transport:
Linens:
EMS EQUIPMENT AND SUPPLIES
Thomas Aeromedical Pack Tt-890
Supplemental Equipment For Thomas Aeromedical Pack Tt-890
Obstetrics Kit, Small Portable
Oxygen/Resuscitation Equipment
Litters And Stretchers
First Aid Kit, Life Raft
First Aid Kit, Carry Bag
INJURY DRESSING STATIONS (IDS)
Injury Dressing Station Supplies
PORTABLE MEDICAL LOCKERS (PML).
DECONTAMINATION LOCKER.
ANTIDOTE LOCKER
PHARMACEUTICALS.
Analgesics:
Antibiotics / Anti-Infectives:
Anti-Inflammatory:
Asthma:
Cardiac / Antihypertensive:
Contraceptive / Gynecological:
Gastrointestinal:
Hormonal Products:
Immunizations:
Miscellaneous:
ITEMS LISTED BELOW ARE USED TO TREAT EXPOSURE TO NERVE AGENTS:
Ophthalmics:
Otics:
Psychotropics / Neurological:
Topicals:
Vitamins:
DENTAL SUPPLIES AND EQUIPMENT
ENVIRONMENTAL HEALTH
ENVIRONMENTAL HEALTH EQUIPMENT AND SUPPLIES.
App.H - Infectious Diseases
A P P E N D I X H I N F E C T I O U S D I S E A S E S
INTRODUCTION
BEHAVIOR AND INFECTIOUS DISEASE TRANSMISSION
SEXUALLY TRANSMITTED DISEASES
Urethral Discharge (Urethritis)
Painful Testicle (Epididymitis)
Genital Ulcer
Chancroid
Genital Warts
Lymphogranuloma Venereum (LGV)
Pruritus (Itching)
Vaginal Discharge
Lower Abdominal Pain
Counseling
Partner Notification
Referral
Sexual Practices
Exposed, but Asymptomatic, Individuals
Prevention
HUMAN IMMUNODEFICIENCY VIRUS INFECTION/ ACQUIRED IMMUNODEFICIENCY SYNDROME (HIV/AIDS)
SEXUAL ASSAULT AND RAPE
TATTOOING
ANTHRAX (CUTANEOUS)
CHICKENPOX (VARICELLA)
CHOLERA
DENGUE FEVER (BREAKBONE FEVER)
DIPHTHERIA
GASTROENTERITIS/DIARRHEAL ILLNESSES
HEPATITIS, VIRAL
HEPATITIS A (HAV)
HEPATITIS B (HBV)
DELTA HEPATITIS (HDV)
HEPATITIS C (HCV)
INFLUENZA (FLU)
LEGIONNAIRES’ DISEASE (LEGIONELLOSIS)
MALARIA
MEASLES (RUBEOLA)
MEASLES, GERMAN (RUBELLA)
MENINGOCOCCAL DISEASE
MONONUCLEOSIS, INFECTIOUS
MUMPS (EPIDEMIC PAROTITIS)
PLAGUE
BUBONIC PLAGUE
PNEUMONIC PLAGUE
SEPTICEMIC PLAGUE
POLIOMYELITIS
RABIES (HYDROPHOBIA)
RHEUMATIC FEVER
RELAPSING FEVER (TICK-AND LOUSE-BORNE RELAPSING FEVER)
SCARLET FEVER
SHINGLES
TETANUS (LOCKJAW)
TUBERCULOSIS
TYPHOID FEVER (ENTERIC FEVER)
TYPHUS FEVER
UNDULENT FEVER (BRUCELLOSIS, MALTA FEVER OR MEDITERRANEAN FEVER)
WHOOPING COUGH (PERTUSSIS)
YAWS
YELLOW FEVER
App I - Medical References
A P P E N D I X I M E D I C A L R E F E R E N C E RECOMMENDAT I O N S
INTRODUCTION
CLINICAL MEDICAL REFERENCES
PHARMACY REFERENCES
DENTAL REFERENCE
ENVIRONMENTAL HEALTH REFERENCES
WEBSITE RECOMMENDATIONS