MHhAwQt60n

15.Complete the statement:

-In case of asphyxia (bites, stings, burns, near-drowning, fainting, fractures and joint injuries, frostbite, heat exhaustion, heatstroke, poisoning, severe bleeding, shock, wound) to render first aid means ...

16.Have you ever had to render first aid?

yes no

What did you do? What would you do if you had to render first aid?

17.Make up a dialogue between a journalist and a life-saver.

II. Fill in the gaps with the following words:

injured bandaging victim syringe charcoal saving unconscious

1.The essentials of first aid treatment also include the correct _____ of a wound.

2.Prevent movement of _____ parts until splint is applied

3.Activated _____ absorbs poison.

4.The _____ of the accident was taken to the hospital at once.

5.Proper early measures may be instrumental in _____ life.

6.The man was _____.

7.Have you got a _____ to make an injection?

III. Find the correct alternative:

Emergency (1) _____ control describes the steps or actions taken to control bleeding from a patient who has suffered a (2) _____ injury or who has a medical condition which has led to bleeding. Many bleeding control techniques are taught as part of first (3) _____ throughout the world, although some more advanced techniques such as tourniquets, are often taught as being reserved for

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use by health professionals, or as an absolute last resort, in order to minimize the risks associated with them, such as potential loss of (4)_____. In order to manage bleeding effectively, it is important to be able to readily identify both types of (5)

_____ and types of bleeding.

IV. Make up sentences with the words:

1.burns, Chemical, should, washed, quantity, with, be, large, water, of.

2.wound, was, The, deep, eighteen, needed, and, stitches.

3.should, burns, be, All, with, sterile, covered, dressings.

4.used, bandages, be, for, Elastic, immobilization, may.

5.body, The, position, be, adjusted, should, the, according, to, injuries, victim's.

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IV. Terrorism

Safety Pocket Guide

Pocket guide – карманное руководство To confirm – подтверждать

To project – проектировать; прогнозировать Nuclear medicine – медицинская радиология Physician – врач; терапевт

Blood count / blood test – анализ крови

Exposure – облучение, (внешнее) воздействие To swab – брать мазок

Nares – ноздри

To contaminate – заражать External – внешний

To irradiate – облучать

Facility – оборудование

Universal precautions – всеобщие меры предосторожности

Life-threatening – опасный для жизни

Thyroid gland – щитовидная железа

Potassium iodide – иодид калия Suspicion – подозрение Substantial – значительный Nausea – тошнота

Vomiting – рвота

Lesion – повреждение, поражение Marrow – костный мозг Clandestine – тайный, скрытый To emit – испускать, выделять

Intermittent – скачкообразный, прерывистый Source – источник

To absorb – поглощать, впитывать To inhale – вдыхать; заглатывать To ingest – проглатывать

Fallout shelter – противорадиационное убежище To dim – потускнеть, затуманивать(ся)

Blurred – нерезкий, расплывчатый

Volatility – летучесть, испаряемость; изменчивость Solubility – растворяемость

Mucosa – слизистая оболочка Lung – лёгкое (анат.) Support – поддержка, помощь

In-house – внутренний, местный

Disease – болезнь

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To alert – предупреждать (об опасности); поднимать тревогу Fever – жар, лихорадка

Rash – сыпь

Irritation – раздражение; недовольство Anthrax – сибирская язва

Plague – чума Smallpox – оспа

Precautions – меры предосторожности

1. Complete the sentences. Use the previous list of words. Use the words in an appropriate form.

a)Have your ______ done.

b)My worst ______ were ______ .

c)He never reveals his ______ of information.

d)Certain chemicals are easily ______ into the bloodstream, while others are

not.

e)My ______ told me to stop smoking and go on a diet.

f)The injury is not ______.

g)The parks in the city and outskirts are called “the ______ of London”.

h)All ______ staff had to be present at the meeting.

i)If you had taken that medicine it would have prevented the ______ .

j)We must ______ the public to the danger.

k)They took all necessary ______ against terrorism.

3. Look through the text. Find all the examples of past participles.

Terrorism with ionizing. Radiation general guidance. Confirmation of Cases

•Contact radiation safety officer (RSO) for help

•For help in projecting clinical effects, contact

nuclear medicine physician

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Medical Radiological Advisory Team (MRAT) at Armed Forces Radiobiology Research Institute (AFRRI) 301-295-0530

•Obtain complete blood count

absolute lymphocyte count <1000 mm3 suggests moderate exposure

absolute lymphocyte count <500 mm3 suggests severe exposure

аcute, short-term rise in neutrophil count

•Swab both nares

•Collect 24 hour stool if GI contamination is possible

•Collect 24 hour urine if internal contamination with radionuclides is possible

Decontamination Considerations

•Externally irradiated patients (skin contamination with radioactive material) are not contaminated

•Treating contaminated patients before decontamination may contaminate the facility: plan for decontamination before arrival

•Exposure without contamination requires no decontamination (RSO measurement)

•Exposure with contamination requires Universal Precautions, removal of patient clothing, and decontamination with soap and water

•For internal contamination, contact the RSO and/or Nuclear Medicine Physician

•Patient with life-threatening condition: treat, then decontaminate Patient with non-life-threatening condition: decontaminate, then treat

Treatment Considerations

•If life-threatening conditions are present, treat them first

•If external radioactive contaminants are present, decontaminate

•If radioiodine (reactor accident) is present, consider protecting the thyroid gland with prophylactic potassium iodide if within first few hours only (ineffective later).

Institutional Reporting

•If reasonable suspicion of a radiation event, contact hospital leadership (Chief of Staff, Hospital Director, etc)

•Immediately discuss hospital emergency planning implications

Public Health Reporting

•Contact local public health office (city, county or State)

•If needed, contact the FBI (for location of nearest office, see http://www.fbi.gov/contact/fo/info.htm)

Diagnosis: Be Alert to the Following

•Acute radiation syndrome follows a predictable pattern after substantial exposure or catastrophic events

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•Victims may also present individually over a longer period of time after exposure to contaminated sources hidden in the community

•Specific syndromes of concern, especially with a 2-3 week prior history of nausea and vomiting, are

thermal burn-like skin lesions without documented heat exposure

immunological dysfunction with secondary infections

a tendency to bleed

marrow suppression

hair loss

Understanding Exposure

•Exposure may be known and recognized or clandestine through

large radiation exposures, such as a nuclear bomb or catastrophic damage to a nuclear power station

small radiation source emitting continuous gamma radiation producing chronic intermittent exposures (such as radiological sources from medical treatment or industrial devices.)

•Exposure to RADIATION may result from any one or combination of the following

external sources (such as radiation from an uncontrolled nuclear reaction or radioisotope outside the body)

skin contamination with radioactive material (“external contamination”)

internal radiation from absorbed, inhaled, or ingested radioactive material (“internal contamination”)

(Produced by the Employee Education System for the Office of Public

Health and Environmental Hazards, Department of Veterans Affairs. April 2002.)

4.Read the text once more and answer whether the statements are true or false:

−Complete blood tests help to confirm exposure.

−“External contamination” is not contagious.

−A patient who is near death must be decontaminated first.

−Potassium iodide is effective within first few hours only.

−Internal radiation is skin contamination with radioactive material.

−

5.Make a list of necessary actions under the threat of radioactive contamination.

6.Look at table 1 attached to the pocket guide. Compare subclinical, sublethal and lethal ranges of whole body radiation. These phrases and word combinations may be useful for you:

within the range, it takes 2 weeks to …, much higher, least of all, the highest level of …, there is no need in …, I can say it for sure…, it is likely to …, the percentage of ... is lower than that of … .

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Table 1: Acute radiation syndrome

1 Gray (Gy) = 100 rads 1 centiGray (cGy) = 1 rad

7. Read the text and change the form of the underlined words when it is necessary.

Chemical terrorism. Confirmation of Cases

•Contact your local poison control center

•Contact your local industrial hygiene or safety officer

•Department of Justice (DOJ) Domestic Preparedness National Response Hotline (800-424-8802)

•If you need further help in clinical diagnosis or management, call DOJ Chembio Help Line (800-368-6498)

•Review US Army Chemical Casualty Care handbook (go to http://ccc.apgea.army.mil/, then “training/ materials”, then “handbooks”)

Decontamination Considerations

• Chemical warfare agents usually require removal of clothing and contaminate of the patient with soap and water

•Treating contaminate patients in the emergency department before decontamination may contaminate the facility

Institutional Reporting

•If reasonable suspicion of chemical attack, contact your hospital leadership (Chief of Staff, Hospital Director, etc)

•Immediate discuss hospital emergency planning implications

Public Health Reporting

•Contact your local public health office (city, county, or State)

•If need, contact the FBI (for location of nearest office, see http://www.fbi.gov/contact/fo/info.htm)

Diagnosis: Be alert to following

•Groups of individuals becoming ill around the same time

•Any sudden increase in ill in previously healthy individuals

•Any sudden increase in the following non-specific syndromes

Sudden unexplained weak in previously healthy individuals

Dim or blurred vision

Hypersecretion syndromes (like drooling, tearing, and diarrhea)

Inhalation syndromes (eye, nose, throat, chest irritation; shortness of breath)

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Burn-like skin syndromes

•Usual temporal or geographic clustering of illness (for example, patients who attended the same public event, live in the same part of town, etc.).

Understanding Exposure

•Exposure may occur from vapor or liquid droplets and, less like, contamination of food or water

•Chemical effects are dependent on:

volatility and amount of a chemical

water solubility (higher solubility leads to more mucosal and little deep lung deposition and toxicity)

increased fat solubility and smaller molecular size increase skin absorp-tion

(Produced by the Employee Education System for the Office of Public Health and Environmental Hazards, Department of Veterans Affairs. April 2002.)

8. Read the text. Write out 7 unknown words you would like to remember, look them up in the dictionary and use the words in the sentences of your own. Work in twos and share your examples.

Chemical terrorism agents and syndromes (including biologic toxins):

I.Nerve agents:

1)Symptom onset:

−Vapor: seconds.

−Liquid: minutes to hours.

2)Symptoms:

−Moderate exposure: diffuse muscle cramping, runny nose, difficulty breathing, eye pain, dimming of vision, sweating, diarrhea.

−High exposure: the above plus sudden loss of consciousness, flaccid paralysis, seizures.

3)Signs: pinpoint pupils, muscle twitching & rippling under the skin, sweating, hyper-salivation, diarrhea, seizures, apnea.

4)Clinical diagnostic tests: red blood cell or serum cholinesterase (whole blood). Treatment based on signs and symptoms. Use lab tests only for later confirmation. Collect urine for later confirmation and dose estimation.

5)Decontamination: rapid disrobing, water wash with soap and shampoo.

6)Exposure route and treatment: inhalation & dermal absorption. Atropine 2

– 6 mg IV or IM 2-PAMCl 600–1800 mg injection or 1.0 g infusion over 20-30 minutes. Additional atropine 2 mg q 3-5 min to decreased secretions. One additional 2-PAMCI 600mg injection or 1.0 g infusion over 20-30 minutes at 1 hr if necessary. Diazepan or lorazepam to prevent seizures if >6 mg atropine given. Ventilation support.

7)Differential diagnostic considerations: pesticide poisoning from organophosphorous agents and carbamates cause virtually identical syndromes.

II. Cyanide:

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1)Symptom onset: seconds to minutes.

2)Symptoms:

−Moderate exposure: dizziness, nausea, headache, eye irritation.

−High exposure: loss of consciousness.

3)Signs:

−Moderate exposure: nonspecific findings.

−High exposure: convulsions, cessation of respiration.

4)Clinical diagnostic tests: cyanide or thiocyanate levels in lab. Treatment based on signs and symptoms. Use lab tests only for later confirmation.

5)Decontamination: clothing removal.

6)Exposure route and treatment: inhalation & dermal absorption oxygen (face mask); amyl nitrite; sodium nitrite (300mg IV) and sodium thiosulfate (12.5g IV).

7)Differential diagnostic considerations: similar CNS illness results from carbon monoxide (from gas or diesel engine exhaust fumes in closed spaces), H2S (sewer, waste, industrial sources).

III.Blister Agents (Sulfur mustard):

1)Symptom onset: 2 – 48 hours.

2)Symptoms: burning, itching, or red skin; mucosal irritation (prominent tearing, and burning and redness of eyes); shortness of breath; nausea and vomiting.

3)Signs: skin erythema, blistering, conjunctivitis and lid swelling, upper airways sloughing, pulmonary edema, marrow suppression with lymphocytopenia.

4)Clinical diagnostic tests: often smell of garlic, horseradish, and mustard on body; oily droplets on skin from ambient sources; no specific diagnostic tests.

5)Decontamination: clothing removal, large amounts of water.

6)Exposure route and treatment: inhalation, dermal absorption, & oral ingestion. Thermal burn type treatment. Supportive care for Lewisite and Lewisite / Mustard mixtures: British Anti-Lewisite (BAL or Dimercaprol).

7)Differential diagnostic considerations: diffuse skin exposure with irritants, such as caustics, sodium hydroxide ammonia, etc., may cause similar syndromes. Sodium hydroxide (NaOH) from trucking accidents.

IV. Pulmonary agents (phosgene etc.):

1)Symptom onset: 1 – 24 (rarely up to 72) hours.

2)Symptoms: shortness of breath, chest tightness, wheezing, mucosal and dermal irritation and redness.

3)Signs: pulmonary (non-cardiogenic) edema with some mucosal irritation (signs after symptoms).

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