Welcome, Nevada Nurse.
This interactive hub translates the 10-module Bioterrorism Preparedness course into an actionable, explorable tool. Instead of static chapters, this application is built around your core tasks: identifying threats, executing a clinical response, and understanding the systems you operate in. Use the navigation to explore filterable agent data, review response protocols, and understand Nevada's emergency frameworks.
Course Content Focus
The curriculum focuses on three core domains of preparedness.
Threat Agents Database
Explore the agents of concern from Module 2, 5, 6, and 7. Use the filters and search bar to quickly locate detailed clinical information, treatment, and required PPE.
Clinical Response Protocols
This section consolidates the key nursing actions from Module 3: Triage, Personal Protective Equipment (PPE), and Decontamination. Use the tabs below to review each critical response protocol.
Personal Protective Equipment (PPE)
Based on Module 3, PPE selection is critical and depends on the agent's transmission route. Review the standard transmission precautions and specific PPE for Category A threats.
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Airborne Precautions (e.g., Smallpox, TB)
Gear: N95 Respirator or PAPR.
Room: Airborne Infection Isolation Room (AIIR) / Negative Pressure.
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Droplet Precautions (e.g., Pneumonic Plague)
Gear: Surgical Mask worn within 6 feet of patient.
Room: Private room or cohort with other plague patients.
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Contact Precautions (e.g., VHFs - Ebola, Marburg)
Gear: Gown and gloves. For VHFs, strict fluid-impermeable suit, double gloves, eye protection, and PAPR are often required due to high risk from bodily fluids.
Key Action: Meticulous donning and *especially* doffing procedures with a trained observer.
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Chemical Exposure (e.g., Sarin, VX)
Gear: Requires specialized chemical-resistant suits (Levels A, B, or C) with respiratory protection. Standard hospital PPE is inadequate for vapor or liquid chemical hazards.
Key Action: Decontamination *must* occur *before* patient enters the ED.
Mass Casualty Triage (START Algorithm)
In a mass casualty incident (Module 3), nurses must shift from individual care to population-based triage. The START (Simple Triage and Rapid Treatment) algorithm is the standard.
The algorithm is a sequential assessment:
Step 1: "Can you walk?"
YES: Tag MINOR (Green). Direct to a safe area.
Step 2: (If NOT walking) Check Respirations.
NOT Breathing: Open airway. Still not breathing? Tag DECEASED (Black).
Breathing > 30/min: Tag IMMEDIATE (Red).
Breathing < 30/min: Proceed to Step 3.
Step 3: Check Perfusion (Capillary Refill).
Cap Refill > 2 sec or no radial pulse: Control bleeding. Tag IMMEDIATE (Red).
Cap Refill < 2 sec: Proceed to Step 4.
Step 4: Check Mental Status.
CANNOT follow simple commands: Tag IMMEDIATE (Red).
CAN follow simple commands: Tag DELAYED (Yellow).
Decontamination Protocols
Decontamination (Module 3, 5, 6) is critical to prevent secondary contamination of staff and the facility. The protocol differs for chemical vs. radiological agents.
CHEMICAL Decon (e.g., Sarin, VX)
Goal: Immediate removal to stop absorption and off-gassing. This is a life-saving intervention.
- Location: "Hot Zone" *outside* the hospital.
- Step 1: Remove all clothing immediately (cuts off 80-90% of agent).
- Step 2: Flush with copious amounts of water (low pressure).
- Step 3: Wash with soap and water.
- Wounds: Gently flush wounds with saline; avoid scrubbing.
RADIOLOGICAL Decon (e.g., Dirty Bomb)
Goal: Remove contaminants to prevent internal absorption and limit facility spread. This is urgent, but secondary to life-saving trauma care.
- Location: Controlled area, often outside the ED.
- Step 1: Remove all clothing and bag in labeled containers.
- Step 2: Survey patient with a Geiger counter to find "hot spots".
- Step 3: Wash with soap and water, containing run-off if possible.
- Wounds: Flush and gently debride contaminated wounds first.
Systems & Frameworks
A successful response relies on organized systems (Module 4), legal/ethical guidelines (Module 9), and communication (Module 8 & 10). Explore the key frameworks for Nevada nurses.
Hospital Incident Command System (HICS)
HICS (Module 4) is the standardized framework hospitals use to manage emergencies. It provides a clear chain of command and role definition. Click a role to see its description.
Click a role to see its description.
Legal & Ethical Framework (Module 9)
Your actions are guided by legal and ethical mandates. As a Nevada nurse, you must be aware of your specific obligations under the Nevada Administrative Code (NAC).
Nevada Administrative Code (NAC)
NAC 632.340 (Reporting): Mandates that a nurse who knows of any circumstances that may render a person unable to practice nursing with reasonable skill must report this. In a bioterrorism context, this extends to the duty to report unusual disease clusters or suspected exposures to the state/local health authority as a public health threat.
NAC 632.355 (Competency): Requires nurses to maintain the competency necessary for their practice. This includes seeking education and training for emergency preparedness and response appropriate to their role.
Isolation vs. Quarantine
Isolation: The separation of *symptomatic* (sick) individuals who are contagious from those who are not.
Quarantine: The separation and restriction of movement of *asymptomatic* (healthy) individuals who were exposed to a contagious disease.
Ethical Triage
In a resource-scarce crisis, the guiding principle shifts from individual good to: Utility (doing the greatest good for the greatest number). This means prioritizing resources (like ventilators or countermeasures) for those with the highest chance of survival.
Communication & Support (Module 8 & 10)
Clear communication and psychological support are essential. You must know how to receive official alerts and how to support patients and colleagues.
Health Alert Network (HAN)
The CDC's primary system for sharing urgent health information with state/local health departments and clinicians.
- Health Alert: Highest urgency. Warrants immediate action for a major threat.
- Health Advisory: Provides important information for a specific action.
- Health Update: Provides new information on a developing situation.
Your Role: Immediately read, acknowledge, and disseminate HAN messages per facility protocol.
Psychological First Aid (PFA)
A compassionate, non-intrusive approach to help individuals in distress. Remember the 3 L's:
- Look: Assess for safety and identify those with obvious urgent needs.
- Listen: Approach people, ask about their needs, and listen actively without pressure.
- Link: Connect people to practical support, accurate information, and their loved ones.