EMT Ch 37: Hazardous Materials, Multiple-Casualty Incidents, and Incident Management

You are on the scene of a​ mass-casualty incident in which the grandstand at a race track has collapsed. As the triage​ officer, you have encountered a​ 14-year-old male whose leg has been amputated above the knee. He is responsive to verbal​ stimuli, and he has an open​ airway, shallow rapid​ breathing, and a​ weak, rapid carotid pulse. This patient would be classified as a Priority​ ________ for treatment and transport. A. 1 B. 4 C. 3 D. 2

A. 1

Which of the following is required on the exterior of a tanker truck that is carrying hazardous​ cargo? A. A DOT hazard placard B. An NFPA 704 placard C. A cargo manifest D. A safety data sheet

A. A DOT hazard placard

Which of the following is the BEST description of a safety data sheet​ (SDS)? A. Papers that must accompany hazardous materials during transport B. Papers kept on site with hazardous chemicals C. A placard that must be attached to a fixed container of hazardous materials D. A resource book published by the U.S. Department of Transportation for referencing hazardous materials

B. Papers kept on site with hazardous chemicals

Using START triage​ guidelines, a patient on the scene of a​ mass-causality incident who is not breathing​ initially, but begins breathing when the airway is​ open, is deemed a​ ________ patient. A. Priority 0 B. Priority 1 C. Priority 2 D. Priority 3

B. Priority 1

Which warning placard is​ diamond-shaped and divided into four smaller​ diamonds? A. DOT hazard label B. Material data safety sheet​ (MSDS) C. UN Globally Harmonized System D. NFPA 704 System

D. NFPA 704 System

What is the number of patients that generally serves as the lowest possible threshold for a​ multiple-casualty incident? A. 2 B. 15 C. 3 D. 10

C. 3

Which of the following statements regarding a disaster plan is​ FALSE? A. A disaster plan should be​ well-publicized. B. A disaster plan should be rehearsed. C. A disaster plan should be written to address any conceivable incident. D. A disaster plan should be realistic.

C. A disaster plan should be written to address any conceivable incident.

Which of the following must be assessed on a hazmat team member before he or she enters the hot​ zone? A. Task assignment B. Allergies C. Baseline vitals D. Height and weight

C. Baseline vitals

At​ 0330, you responded to the scene of an overturned tanker truck. What organization could you contact to obtain information about the liquid the truck is​ carrying? A. Environmental Protection Agency​ (EPA) B. Regional poison control center C. CHEMTREC D. OSHA

C. CHEMTREC

At a hazardous materials​ incident, which of the following areas is used for triaging​ patients, performing necessary​ treatment, and stabilizing patients before​ transport? A. Warm zone B. Hot zone C. Cold zone D. Decon zone

C. Cold zone

Which of the following is NOT a responsibility of an EMT at the scene of a hazardous materials​ emergency? A. Rehabilitating the hazmat team B. Staying in the cold zone C. Decontaminating injured victims D. Treating injured patients

C. Decontaminating injured victims

Field decontamination takes place in​ the: A. cold zone. B. hot zone. C. warm zone. D. safe zone.

C. warm zone.

Simple Triage and Rapid Treatment​ (START) is a system that relies on some simple commands and what three physiologic​ parameters? A. ​Circulation, sensory, and motor status B. ​Respiration, pain, and mental status C. ​Respiration, pulse, and mental status D. ​Respiration, sensory, and motor status

C. ​Respiration, pulse, and mental status

Which of the following is NOT a mechanism of decontamination from hazardous​ materials? A. Disposing B. Emulsifying C. Disinfecting D. Deodorizing

D. Deodorizing

You are called to a local hardware store for a male patient complaining of difficulty breathing. As you pull into the parking​ lot, you notice several people in front of the building coughing and in obvious distress. What would be the BEST course of action at this​ point? A. Locate the patient for whom you were requested and begin treatment while another ambulance is en route for the other patients. B. Request a hazardous materials incident response and begin treating all patients displaying respiratory difficulties. C. Move the people with respiratory difficulties to a distant corner of the parking lot and set up a treatment sector. D. Evaluate the scene further for indications of a hazardous environment and request a hazardous materials response.

D. Evaluate the scene further for indications of a hazardous environment and request a hazardous materials response.

Soraya is an EMT who volunteers for a local fire department. On the scene of a hazardous materials​ incident, she helps prevent the incident from becoming larger and ensures bystanders remain safe.​ Soraya's level of hazardous materials training is at the​ ________ level. A. Hazardous Materials Technician B. Hazardous Materials Specialist C. First Responder Awareness D. First Responder Operations

D. First Responder Operations

Which of the following hazmat training levels requires at least eight hours of​ training? A. Hazardous Materials Specialist B. Hazardous Materials Technician C. First Responder Awareness D. First Responder Operations

D. First Responder Operations

If an EMS unit is the first to respond to a​ multiple-casualty incident, which role does the most senior EMT​ assume? A. Scene leader B. Ground chief C. Section coordinator D. Incident commander

D. Incident commander

At what point should transport of the injured begin at an​ MCI? A. After triage has identified​ "immediate" category patients and transport has been coordinated through the treatment and transport units B. After all​ "minor" patients have been directed to a treatment area to relieve congestion at the scene C. After all patients have been triaged D. As soon as the first ambulance arrives

A. After triage has identified​ "immediate" category patients and transport has been coordinated through the treatment and transport units

In which of the following zones is the EMT expected to be staged at the scene of a hazardous materials​ incident? A. Cold zone B. Warm zone C. Ground zero D. Hot zone

A. Cold zone

Which of the following is a principle of effective Incident​ Command? A. Command is most effective when one person is responsible for not more than 6 other people. B. ​Police, fire, and EMS must establish separate command locations. C. The command location must not be revealed to anyone on the scene. D. Anyone on the scene should report directly to Incident Command.

A. Command is most effective when one person is responsible for not more than 6 other people.

You are an EMT on the scene of a​ mass-casualty incident in which there are 50 patients from a bus rollover. Incident Command has been established and​ EMS, law​ enforcement, and rescue sectors are established. You have just discovered that one of the bus passengers was carrying a suspicious package that is now leaking a white powdery substance. Which of the following entities should you contact about​ this? A. EMS sector officer B. Medical direction C. Incident Commander D. Dispatch

A. EMS sector officer

Johnny is an EMT with a local ambulance service. As part of his​ job, he is trained to recognize the existence of a potentially dangerous scene involving hazardous materials and know when to request a hazmat response.​ Johnny's level of hazardous materials training is at the​ ________ level. A. First Responder Awareness B. Hazardous Materials Specialist C. First Responder Operations D. Hazardous Materials Technician

A. First Responder Awareness

Andrea is an EMS supervisor with a combined​ EMS/Fire department. On the scene of a hazardous materials​ incident, she uses her knowledge of hazardous materials to support the activities of other responders and manage the scene.​ Andrea's level of hazardous materials training is at the​ ________ level. A. Hazardous Materials Specialist B. First Responder Awareness C. First Responder Operations D. Hazardous Materials Technician

A. Hazardous Materials Specialist

To command activities at a hazardous materials incident​ site, the minimum level of training necessary​ is: A. Hazardous Materials Specialist. B. First Responder Operations. C. First Responder Awareness. D. Hazardous Materials Technician.

A. Hazardous Materials Specialist.

Eduardo is an EMT with a major metropolitan fire department. He is assigned to a station within an industrial complex. On the scene of a hazardous materials​ incident, Eduardo functions on a team where he plugs a leaking drum.​ Eduardo's level of hazardous materials training is at the​ ________ level. A. Hazardous Materials Technician B. First Responder Awareness C. Hazardous Materials Specialist D. First Responder Operations

A. Hazardous Materials Technician

When you call an emergency response hotline regarding hazardous​ materials, which information is LEAST​ relevant? A. How long ago you believe the incident might have begun B. Nature and location of the problem C. Injuries and exposures D. Estimate of the quantity of material transported and released

A. How long ago you believe the incident might have begun

The senior EMT on the first vehicle that arrived on a scene with multiple patients should assume which of the following roles until relieved by a senior​ official? A. Incident Commander of the scene B. Staging supervisor C. Transport sector supervisor D. Triage sector supervisor

A. Incident Commander of the scene

Using START triage​ guidelines, a patient on the scene of a​ mass-causality incident who has no pulse is deemed a​ ________ patient. A. Priority 0 B. Priority 2 C. Priority 1 D. Priority 3

A. Priority 0

Which of the following statements about decisions made by the transportation unit at an MCI is​ TRUE? A. Priority 1 patients should be transported​ first, immediately after treatment. B. Each ambulance should radio the receiving hospital with a detailed patient report. C. Ambulatory patients may be sent to a hospital on a bus without EMS personnel. D. ​High-priority patients should all be transported to the same hospital.

A. Priority 1 patients should be transported​ first, immediately after treatment.

You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you only have 5 patients. Your closest unit is 30 minutes away. Using START triage​ criteria, triage an​ 8-year-old male patient with respirations 10 and pulse 102 who is ambulatory with an alert mental status and warm dry skin. A. Priority​ 3, green tag B. Priority​ 1, red tag C. Priority​ 4, black tag D. Priority​ 2, yellow tag

A. Priority​ 3, green tag

Which of the following is NOT a function of the rehabilitation sector in a hazardous materials​ incident? A. Providing a decontamination corridor from the hot zone B. Performing medical assessment of rescue crews C. Providing for hydration of rescue crews D. Taking baseline vital signs before rescuers enter the operations area

A. Providing a decontamination corridor from the hot zone

What is the purpose of secondary​ triage? A. To reevaluate each​ patient's priority for treatment and transport B. To conduct a comprehensive examination of all patients C. To assess patients who were not immediately found in the initial response D. To perform START triage

A. To reevaluate each​ patient's priority for treatment and transport

When involved in a​ multiple-casualty incident, staging refers to which of the​ following? A. Waiting in a designated location until called upon by the designated sector officer B. Setting up a triage center from the back of your ambulance C. Keeping a log of all patients transported D. Staying on station until called upon to receive a patient

A. Waiting in a designated location until called upon by the designated sector officer

An example of psychological first aid for a patient at an MCI​ is: A. assuring the patient that everything he feels is normal and that responders are doing everything they can. B. directing the patient to begin providing care to less critical patients. C. telling the patient that despite how it​ looks, everyone at the scene will be okay. D. asking the patient to consider the possibility he is in denial.

A. assuring the patient that everything he feels is normal and that responders are doing everything they can.

Emotionally incapacitated​ EMTs: A. may not return to duty even after they have rested. B. may rest until they are ready to return to duty. C. must leave the​ area, clock​ out, and go home. D. must observe on scene without providing treatment.

A. may not return to duty even after they have rested.

Which of the following are desirable characteristics of the safe or​ "cold" zone in a hazardous materials​ incident? A. ​Upwind, on the same level as the spill B. ​Downwind, uphill from the spill C. ​Upwind, uphill from the spill D. ​Downwind, downhill from the spill

A. ​Upwind, on the same level as the spill

When seeking expert advice on how to proceed at a hazardous materials​ incident, which of the following information is important to​ provide? A. Your background in chemistry B. Amount of the substance involved C. Your level of EMS certification D. Your suspicions as to cause

B. Amount of the substance involved

Which of the following is a​ 24-hour resource operated by the American Chemistry​ Council? A. HAZTECH B. CHEMTREC C. MSDS D. CHEMTRANS

B. CHEMTREC

________ is the response​ agency, established in​ Washington, DC, as a service of the American Chemistry​ Council, that can provide either you or your dispatcher with information about the hazardous material and contact the shipper to provide you with information about the material. A. EPA B. CHEMTREC C. HAZMART D. OSHA

B. CHEMTREC

In which of the following areas at a hazmat incident are normal​ triage, stabilization, and treatment​ performed? A. Command post B. Cold zone C. Temperate zone D. Warm zone

B. Cold zone

Which of the following is NOT an acceptable way of attempting to identify a hazardous​ material? A. Checking the material safety data sheet B. Collecting a sample of the material for laboratory analysis C. Asking the driver of the​ tractor-trailer truck involved in the incident D. Using binoculars to obtain information from the placard on a container

B. Collecting a sample of the material for laboratory analysis

What is the highest level of training for hazmat incidents under OSHA​ regulations? A. Material Safety Data Sheet Coordinator B. Hazardous Materials Specialist C. First Responder Operations D. Hazardous Materials Director

B. Hazardous Materials Specialist

In which type of incident would unified command be MOST​ appropriate? A. An incident that involves only​ fire/rescue B. Involvement of different branches of public safety C. An incident that involves only EMS D. More than three patients at a scene

B. Involvement of different branches of public safety

You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you have 5 patients. Your closest unit is 30 minutes away. Triage a​ 16-year-old female patient with respirations​ 38, pulse​ 132, and altered mental status with cool clammy skin using START triage criteria. A. Priority​ 3, green tag B. Priority​ 1, red tag C. Priority​ 2, yellow tag D. Priority​ 4, black tag

B. Priority​ 1, red tag

You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you only have 5 patients. Your closest unit is 30 minutes away. Using START triage​ criteria, triage a​ 13-year-old female with the following vital​ signs: respirations​ 8, pulse​ 124, and nonresponsive with blood from the ears and nose. A. Priority​ 2, yellow tag B. Priority​ 1, red tag C. Priority​ 4, black tag D. Priority​ 3, green tag

B. Priority​ 1, red tag

Which of the following sector officers or supervisors is responsible in​ large-scale incidents for the provision of restrooms and meals and rotation of​ crews? A. Command B. Staging C. Transportation D. Supply

B. Staging

Which statement regarding the​ diamond-shaped placards involved in the transportation of dangerous goods is​ FALSE? A. These placards may have a​ four-digit identification number for the material. B. These placards are always carefully vetted and accurate. C. These placards show the hazard class. D. These placards bear a division number for the material.

B. These placards are always carefully vetted and accurate.

When transporting patients from the scene of a​ mass-casualty incident, who should be responsible for contacting the receiving​ hospital? A. Transporting EMT B. Transportation supervisor C. Incident commander D. Triage supervisor

B. Transportation supervisor

Who is the person that is in charge of tracking the​ patient's final​ destination? A. Treatment officer B. Transportation supervisor C. Incident Commander D. Staging supervisor

B. Transportation supervisor

What should be done with an EMT who has become emotionally incapacitated at an​ MCI? A. Talk to the EMT with calm empathy until he feels better enough to return to duty. B. Treat the EMT as a patient and remove him to a place of rest. C. Review the​ EMT's performance to identify what went wrong. D. Direct the EMT to treat only Priority 3 patients.

B. Treat the EMT as a patient and remove him to a place of rest.

Where is the decon corridor located where​ patients, personnel, and equipment are​ decontaminated? A. Hot zone B. Warm zone C. Cool zone D. Cold zone

B. Warm zone

A​ multiple-casualty incident​ is: A. any medical or trauma incident that requires extensive rescue efforts. B. any medical or trauma incident involving multiple patients. C. any trauma incident involving a patient with multisystem injuries. D. any trauma incident involving five or more critically injured patients.

B. any medical or trauma incident involving multiple patients.

Organization for a smaller MCI would​ involve: A. aides to the triage supervisor. B. command and a triage supervisor. C. site operations. D. treatment and transportation supervisors.

B. command and a triage supervisor.

As it pertains to hazardous​ materials, the Occupational Safety and Health Administration requires employers​ to: A. train employees to handle any type of hazardous materials incident. B. document the appropriate level of training for each employee. C. ensure there is at least one person​ on-site trained at the technician level. D. have knowledge of all hazardous materials on the premises.

B. document the appropriate level of training for each employee.

You arrive at the scene of a potential hazardous materials incident and see several patients lying on the ground next to an overturned truck with what looks like chemicals leaking out of it in all directions. You​ should: A. approach cautiously. B. take a command position. C. immediately act to save the patients. D. call out to the patients to see if any can leave the area of the accident.

B. take a command position.

A hot zone​ is: A. immediately identifiable with placards. B. the area immediately surrounding a hazmat incident. C. an area where personnel and equipment are decontaminated. D. an area where the support functions for an incident response are located.

B. the area immediately surrounding a hazmat incident.

Flammable​ solids, substances that are dangerous when​ wet, and spontaneously combustible materials​ are: A. Class 1 materials. B. Class 2 materials. C. Class 3 materials. D. Class 4 materials.

D. Class 4 materials.

Which of the following actions may need to be taken by the EMT when treating and transporting a patient who was exposed​ to, and contaminated​ by, a hazardous​ material? A. Wear heavy cloth gloves. B. Place towels on the floor of the ambulance to soak up contaminated runoff water. C. Dispose of patient care equipment such as​ blood-pressure cuffs and backboards. D. Wear a​ gown, mask, and goggles to prevent secondary contamination.

C. Dispose of patient care equipment such as​ blood-pressure cuffs and backboards.

No minimum training hours are required for which level of​ training? A. First Responder Operations B. Hazardous Materials Specialist C. First Responder Awareness D. Hazardous Materials Technician

C. First Responder Awareness

Which of the following is represented by the blue area of the NFPA 704​ placard? A. Instability hazards B. Flammability hazards C. Health hazards D. Special hazards

C. Health hazards

Which of the following should NOT be considered during the scene​ size-up of a hazardous materials​ emergency? A. Identification of the substance B. The properties and potential dangers of the substance C. How quickly the materials may be cleaned up D. Potential for spread of the substance

C. How quickly the materials may be cleaned up

Which of the following is NOT a desirable characteristic of the rehabilitation sector of a hazardous materials​ incident? A. It allows for rapid reentry to the emergency operation. B. It is large enough to accommodate multiple rescue crews. C. It is located in the warm zone. D. It is protected from weather elements.

C. It is located in the warm zone.

The characteristics of a rehab area include all of the following EXCEPT which​ one? A. Located in the cold zone B. Easily accessible to EMS units C. Large enough to accommodate a single crew D. Free from exhaust fumes

C. Large enough to accommodate a single crew

If your crew is the first to arrive on the scene of a major​ MCI, what will be a major aspect of your scene​ size-up? A. Make an initial scene report to the communications center. B. Prevent uncoordinated or undirected activity at the scene. C. Make a sweep to determine what needs must be met. D. Control​ on-scene communication as help arrives.

C. Make a sweep to determine what needs must be met.

Which of the following BEST describes the required contents of shipping papers associated with hazardous​ materials? A. Health​ hazards, flammability​ hazards, explosion​ hazards, and special hazards B. Route of​ exposure, signs and​ symptoms, classification, and chemical structure C. Name of the​ substance, quantity,​ origin, and destination D. The levels of​ toxicity, flammability, and reactivity

C. Name of the​ substance, quantity,​ origin, and destination

With START​ triage, when you arrive on the​ scene, you ask all the patients who can walk to move to one area. These patients are categorized​ as: A. yellow tagged. B. red tagged. C. Priority 3 walking wounded. D. Priority 4 walking wounded.

C. Priority 3 walking wounded.

What source will provide first aid information about hazardous materials for employees at a work​ site? A. Shipping manifest B. Bill of lading C. Safety data sheets D. Placard

C. Safety data sheets

Identification of chemical hazards starts​ with: A. identification of hazardous materials placards. B. being alerted to the presence of hazardous materials by dispatch. C. awareness and knowledge of what exists in the community. D. seeing fumes in the air at the incident scene.

C. awareness and knowledge of what exists in the community.

ICS systems recognize that the manageable span of control​ is: A. 18 people. B. 12 people. C. 24 people. D. 6 people.

D. 6 people.

Using START triage​ guidelines, a patient on the scene of a​ mass-causality incident who is alert with respirations less than 30 a minute and has a capillary refill time of less than 2 seconds is deemed a​ ________ patient. A. Priority 2 B. Priority 1 C. Priority 0 D. Priority 3

D. Priority 3

You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you only have 5 patients. Your closest unit is 30 minutes away. Using START triage​ criteria, triage a​ 17-year-old male patient with the following vital​ signs: respirations​ 18; pulse​ 104; alert,​ crying, and wanting his​ mother; ambulatory. A. Priority​ 2, yellow tag B. Priority​ 4, black tag C. Priority​ 1, red tag D. Priority​ 3, green tag

D. Priority​ 3, green tag

You arrive on the scene where a school bus has been hit by a train. The bus was in its early stages of picking up students and you only have 5 patients. Your closest unit is 30 minutes away. Using START triage​ criteria, triage a​ 38-year-old female patient with the following vital​ signs: respirations​ 0, pulse​ 0, and nonresponsive. A. Priority​ 2, yellow tag B. Priority​ 3, green tag C. Priority​ 1, red tag D. Priority​ 4, black tag

D. Priority​ 4, black tag

Which of the following has the HIGHEST priority at a hazardous materials​ incident? A. Decontaminating​ clothing, equipment, and the vehicle B. Providing patient care C. Immediately removing patients from a hazardous area D. Protecting the safety of all rescuers and patients

D. Protecting the safety of all rescuers and patients

Which of the following personal protective items must be used by EMS personnel caring for patients in a hazardous materials​ emergency? A. Chemical permeable gloves B. HEPA mask C. Structural firefighting gear D. Tyvek or other chemical impermeable coveralls

D. Tyvek or other chemical impermeable coveralls

Which of the following statements about primary triage when resources are limited is​ TRUE? A. It is inappropriate for EMTs to assign​ "walking wounded" patients to assist more seriously injured patients. B. CPR is begun on patients without breathing and a pulse if there are no injuries that are obviously incompatible with life. C. No interventions are performed during primary triage. D. You should open a​ patient's airway and control severe bleeding.

D. You should open a​ patient's airway and control severe bleeding.

Disaster plans are a predefined set of instructions that should be written to address the events that are conceivable​ for: A. the United States including Alaska and Hawaii. B. the contiguous United States. C. the North American continent. D. a particular location.

D. a particular location.

A command organization in which a single agency controls all resources and operations​ is: A. a unified command. B. an Incident Command System. C. an Incident Command. D. a single incident command.

D. a single incident command.

You are directed to establish a rehab area at a hazmat incident. You know that this area must​ be: A. established within the warm zone. B. away from the media and the public. C. at least a quarter of a mile from the hot zone. D. easily accessible to EMS units.

D. easily accessible to EMS units.

Gross decontamination is​ the: A. alteration or removal of most residual contamination. B. residual contamination that remains on a host following decontamination procedures. C. complete removal or neutralization of a contaminant. D. removal or chemical alteration of the majority of a contaminant.

D. removal or chemical alteration of the majority of a contaminant.

When an EMT becomes emotionally incapacitated on the scene of a​ large-scale MCI, you​ should: A. wave the EMT off the scene and tell him to return to the station. B. administer psychological first aid to the EMT until he feels capable of returning to duty. C. direct the EMT to the collection point for walking wounded triage patients. D. remove the EMT to a resting area and monitor him until a clinically competent provider can take over.

D. remove the EMT to a resting area and monitor him until a clinically competent provider can take over.

An area near a hazardous materials incident that is on the same level as the​ incident, but​ upwind, is the BEST location for​ the: A. danger zone. B. warm zone. C. hot zone. D. safe zone.

D. safe zone.

If arriving units are not needed right​ away, they should wait in​ the: A. triage area. B. treatment area. C. transportation area. D. staging area.

D. staging area.

A decontamination corridor would be established in​ the: A. cold zone. B. dead zone. C. hot zone. D. warm zone.

D. warm zone.

You are on the scene of a church bus rollover collision. There are 30 passengers involved. As triage​ officer, which one of the following patients should you assign the highest​ priority? A. ​35-year-old pregnant woman with a cut on her​ head, neck​ pain, and numbness and tingling in her arms B. Unresponsive​ 9-year-old male with an open skull fracture who is in cardiac arrest C. ​30-year-old man with multiple lower extremity fractures who is​ awake, has a strong radial​ pulse, and is complaining of severe pain D. ​70-year-old woman who is awake but having difficulty breathing and has absent lung sounds on the right side

D. ​70-year-old woman who is awake but having difficulty breathing and has absent lung sounds on the right side