Learning Hub | Nevada Bioterrorism Preparedness for Nurses

NEW: Interactive Experience

Bioterrorism Response Simulator

Test your clinical judgment in realistic bioterrorism scenarios. Make critical decisions under pressure. Face real consequences. Learn advanced concepts beyond the modules.

9 Complete Scenarios covering all Nevada regions
Branching storylines with real consequences
Advanced teaching content not in modules
Patient vital signs respond to your decisions

Launch Simulator

Quick Reference Guide

Nerve Agent

SLUDGEM: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis, Miosis

Key: Pinpoint pupils (miosis)

Anthrax

Hallmark: Widened mediastinum on CXR

NOT person-to-person. Standard precautions.

Smallpox

Rash: Centrifugal, all same stage, palms/soles involved

AIRBORNE + Contact precautions!

Botulism

4 D's: Diplopia, Dysarthria, Dysphagia, Descending paralysis

Alert patient, NO fever

Dirty Bomb

Priority: TREAT TRAUMA FIRST! Radiation is secondary.

Clothing removal = 80-90% decon

Ebola/VHF

PPE: Enhanced barrier + TRAINED OBSERVER for doffing

Doffing is highest risk moment!

Pneumonic Plague

Signs: Fulminant pneumonia + hemoptysis + rodent exposure

DROPLET precautions - person-to-person!

START Triage

Colors: Red (Immediate), Yellow (Delayed), Green (Minor), Black (Expectant)

Can walk? → GREEN

Course Modules

0 of 10 complete

Module 1

Introduction to Bioterrorism

Definitions, history, Nevada framework, nurse's role

Module 2

Biological Agents

Category A agents: Anthrax, Smallpox, Plague, Botulism

Module 3

Clinical Recognition

PPE selection, START Triage, decontamination

Module 4

Emergency Response

HICS, ICS structure, Strategic National Stockpile

Module 5

Radiation & Nuclear

RDD, Acute Radiation Syndrome, countermeasures

Module 6

Chemical: Nerve Agents

Sarin, VX, SLUDGEM, Atropine + 2-PAM

Module 7

Viral Hemorrhagic Fevers

Ebola, Marburg, enhanced PPE, trained observer

Module 8

Health Alert Network

HAN messages, reporting, surveillance

Module 9

Ethical & Legal

Triage ethics, isolation vs quarantine, resilience

Module 10

Communication & Leadership

CDC CERC, Psychological First Aid, burnout

Nevada Emergency Contacts

Nevada Poison Control

1-800-222-1222

24/7 Emergency Line

Nevada Division of Public Health

775-684-4200

State Health Department

CDC Emergency Operations

770-488-7100

24/7 - Antitoxin requests

REAC/TS Radiation

865-576-1005

24/7 Radiation Emergency

Your Path to Certification

1

Complete Modules

Study all 10 modules

2

Practice in Simulator

Test your knowledge

3

Pass Assessment

Score 70% or higher

4

Pay Fee & Certify

$10 for 4.0 CE hours

Take the Assessment

Download PDF Modules

Prefer offline study? Download printable PDF versions of all modules.

Module 1 Module 2 Module 3 Module 4 Module 5 Module 6 Module 7 Module 8 Module 9 Module 10

Systems and Frameworks

Key frameworks for Nevada nurses: HICS, Legal/Ethical, and Communication.

Hospital Incident Command System (HICS)

HICS provides a clear chain of command. Click a role to see its description.

Legal and Ethical Frameworks

Isolation vs. Quarantine

Isolation: Separates SICK people with a contagious disease from those who are healthy.

Quarantine: Separates and restricts movement of people who were EXPOSED but not yet sick.

Nevada Legal Authority

State Health Officer has authority for quarantine/isolation orders
NRS 441A governs communicable disease control
Governor can declare state of emergency
Medical volunteers protected under Good Samaritan laws

Crisis Standards of Care

When resources are scarce, ethical allocation frameworks guide decisions:

• Fairness: Equitable distribution regardless of status
• Duty to Care: Professional obligation continues
• Stewardship: Maximize overall benefit
• Transparency: Clear communication of decisions

Nurse Legal Protections

PREP Act liability protection during declared emergencies
Good faith actions within scope protected
Right to refuse unsafe assignments (with proper reporting)
Workers' compensation for occupational exposure

Crisis Communication Frameworks

CDC CERC Principles

Crisis and Emergency Risk Communication

1 Be First - Get information out quickly

2 Be Right - Accuracy builds trust

3 Be Credible - Honesty, even about unknowns

4 Express Empathy - Acknowledge fear

5 Promote Action - Give people things to do

6 Show Respect - Treat public as partners

Psychological First Aid (PFA)

RAPID Model for crisis intervention

R

Rapport & Reflective Listening

Build trust through active listening

A

Assessment of Needs

Identify immediate concerns

P

Prioritization

Triage psychological needs

I

Intervention

Stabilize and support

D

Disposition

Connect to resources and follow-up

SBAR Communication

Structured handoff and reporting for critical information

S

Situation

What's happening now?

B

Background

What's the context?

A

Assessment

What do you think?

R

Recommendation

What do you need?

Memory Aids & Mnemonics

SLUDGEM

Nerve Agent / Organophosphate Toxicity

S - Salivation
L - Lacrimation
U - Urination
D - Defecation
G - GI upset
E - Emesis
M - Miosis (pinpoint pupils)

The 4 D's of Botulism

Recognizing Botulinum Toxicity

Diplopia (double vision)
Dysarthria (slurred speech)
Dysphagia (difficulty swallowing)
Descending paralysis

+ NO fever, patient is ALERT

START Triage Colors

Mass Casualty Prioritization

RED - Immediate (life-threatening, salvageable)
YELLOW - Delayed (serious, can wait)
GREEN - Minor (walking wounded)
BLACK - Expectant (deceased/unsurvivable)

Smallpox vs Chickenpox

Critical Differentiation

Distribution: Centrifugal (smallpox) vs Centripetal
Lesions: ALL same stage (smallpox) vs Multiple stages
Palms/Soles: Involved (smallpox) vs Rarely
Fever: BEFORE rash (smallpox) vs With rash

Radiation Countermeasures

Match Agent to Antidote

Iodine-131: Potassium Iodide (KI)
Cesium-137: Prussian Blue
Plutonium: DTPA chelation

KI is NOT universal - only for radioiodine!

CDC CERC Principles

Crisis Communication

Be First
Be Right
Be Credible
Express Empathy
Promote Action
Show Respect