EMT Chapter 37 Transport Operations

When parking your ambulance at the scene of a motor vehicle crash, you should position the ambulance:

100 feet past the scene on the same side of the road

To ensure you have enough reaction time to avoid hitting a motorist who does not move over, you should drive, at minimum, how many seconds behind vehicles traveling at an average speed?

4

In general, medivac helicopters should be utilized when:

A patient has a time-dependent injury or illness and traffic conditions would cause a significant delay in definitive care

Characteristics of a safe ambulance operator include:

A positive attitude and tolerance of other drivers

When a helicopter must land on a grade (uneven ground), you should:

Approach the aircraft from the downhill side

If you arrive on the scene of a mass-casualty incident, what is the first thing you should do?

Ask for additional resources

Minimum staffing in the patient compartment of a basic life support (BLS) ambulance includes:

At least one EMT

When transporting a patient to the hospital, you should:

Be safe and get the patient to the hospital in the shortest practical time

You are treating a 45-year-old woman who has chest pain. Her blood pressure is 92/40 mm Hg; pulse rate 132 beats/min and irregular; and respirations 24 breaths/min and labored. Should you use lights and siren when transporting this patient?

Because lights and sirens can exacerbate anxiety, using them with a patient having chest pain is not always the best option. However, when weighing the risks versus the benefits for this patient, it may be in her best interest to transport her with lights and sirens to the closest, most appropriate facility depending on traffic, distance and road conditions. She is borderline hypotensive, complaining of severe pain, and tachycardic with an irregular pulse, and has labored respirations that are a little fast. All of these factors together create a potentially unstable patient who needs access to advanced care quickly. Consider consulting medical control for advice about use of lights and sirens on a particular call depending on your local protocol.

Other than personal safety equipment, which of the following should be the MOST readily accessible item in the back of an ambulance?

Bleeding control supplies

When using lights and siren, most state laws permit an ambulance to:

Carefully exceed the posted speed limit

Minimum airway and ventilation equipment that should be carried on every ambulance include all of the following, EXCEPT: Various sizes of oral and nasal airways Combitubes or laryngeal mask airways Mounted and portable suctioning units Adult and pediatric bag-valve masks

Combitubes or laryngeal mask airways

Keeping a safe distance between your vehicle and the one in front of you, checking for tailgaters behind your ambulance, and being aware of objects in your mirror's blind spots are considered maintaining a(n):

Cushion of safety

If you are on an emergency call with your warning lights and siren turned on, you may be allowed to do which of the following? Proceed through a red traffic light or stop sign without stopping Drive faster than the posted speed limit Drive against the flow of traffic on an interstate in the left lane Pass a stopped scool bus with the stop sign out

Drive faster than the posted speed limit

Phases of an ambulance call include all of the following activities, EXCEPT: Emergency care provided at the scene Transport of the patient to the hospital Checking equipment on the ambulance Transferring the patient to the ambulance

Emergency care provided at the scene

During the _____ phase of an ambulance call, the crew should review dispatch information about the nature of the call and the location of the patient.

En route

If you are in an unfamiliar area and do not know an alternate route, what are your options?

GPS is the best option Other option is to ask dispatch via radio for street by street directions or request a police escort as a last resort

Where do most serious ambulance crashes occur, and what should you do to help avoid a crash?

Intersection crashes are the most common and usually most serious. If you are operating in emergency mode and cannot wait for traffic lights to change, you should still come to a complete stop, look around for other motorists and pedestrians, and then cautiously proceed (same goes for approaching an intersection with stop signs)

Upon returning to your station following a run, you should disinfect the ambulance as needed. Disinfection is MOST accurately defined as:

Killing pathogenic agents with a chemical made for that purpose

The six-pointed Star of Life emblem identifies vehicles that:

Meet federal specifications as licensed or certified ambulances

What attributes should an emergency vehicle operator possess?

Must complete an EVOC before able to drive an ambulance in emergency mode Reasonable judgement Common sense Constant care and caution Positive attitude Tolerance of other motorists

What factors should you consider before responding to the scene?

Must know where you are going and notify dispatcher you are en route; if any confusion ask dispatcher for confirmation Choose shortest and least congested route, considering time of day Consider weather conditions Get to scene quickly and safely

The features found in a modern ambulance are defined by which of the following?

National Research Council of the National Academy of Sciences

Common activities that occur while you and your partner are en route to the scene of an emergency call include all of the following, EXCEPT: Assigning tasks to each member of the response team Obtaining additional information from the dispatcher Apprising the medical director of the nature of the call Fastening your seatbelts before the ambulance departs

Obtaining additional information from the dispatcher

When transporting a patient who is secured to a backboard, it is important to:

Place deceleration straps over the patient's shoulders

When driving an ambulance on a multilane highway in emergency mode, you should:

Remain in the extreme left-hand lane

When working at the scene of a motor vehicle crash at night, you should NOT use:

Road flares

When traveling in emergency mode, how do you respond to a stopped school bus?

Special privileges are not given to emergency vehicles when driving through a school zone or approaching a stopped school bus that is loading or unloading children. Operator is required to obey the law like any other motorist. An emergency vehicle operator is not allowed to pass a school bus that has stopped to load or unload children and is displaying its red warning lights and extended "stop arm". Stop before you reach the bus and turn off siren. May only proceed past stopped school bus once the bus driver makes sure the children are safe, the bus door is closed, and its red warning lights are turned off

What should you consider when deciding whether it is appropriate to turn on the lights and siren to maneuver through traffic?

The transport mode, either emergency (lights and siren) or nonemergency (no lights and siren) is determined by the patient's present condition and his or her anticipated clinical outcome. Three guiding principles for use of warning lights and sirens on an ambulance: 1. The unit must be, to the best of your knowledge, on a true emergency call 2. Audible and visual warning devices must be used simultaneously 3. The unit must be operated with due regard for the safety of all others, on and off the roadway

Which of the following is a cause of fatigue? Family interaction Working during the day Sleeping only 6 hours Stress

Stress

It is 10:30 PM and you have requested air medical transport for a critically injured patient. When you arrive at the designated landing zone, you should:

Survey the area for power lines or other hazards

After assessing your patient, you determine that his condition is stable. You provide the appropriate treatment and then load him into the ambulance. While en route to the hospital, you should:

Turn your emergency lights off and obey all traffic laws

When responding to a scene where smoke or possible hazardous material are present it is best to park:

Uphill and upwind

Your unit and a fire department vehicle are responding to the scene of a patient in cardiac arrest. As you approach an intersection that is highly congested, you should:

Use a different siren tone than the fire department vehicle

As you leave the hospital and are en route back to your station, you should inform the dispatcher:

Whether you are back in service

You respond to a motor vehicle crash with massive damage to the front of the vehicle where it struck a tree head on. The only occupant is a young man, who is unrestrained, unresponsive, and entrapped. Fire rescue is on scene preparing for extrication, and a responding paramedic unit is attending to the patient. The supervisor informs you he has requested a helicopter to respond and he has asked you and your partner to prepare a landing zone. What should your considerations be when establishing a landing zone?

· The area should be a hard or grassy level surface that measures 100 feet × 100 feet (recommended) and no less than 60 feet × 60 feet. If the site is not level, the flight crew must be notified of the steepness and direction of the slope. · The area must be cleared of any loose debris that could become airborne and strike the helicopter or the patient and crew; this includes branches, trash bins, flares, caution tape, and medical equipment and supplies. · You must survey the immediate area for any overhead or tall hazards such as power lines or telephone cables, antennas, and tall or leaning trees. The presence of these must be relayed immediately to the flight crew because an alternative landing site may be required. The flight crew may request that the hazard be marked or illuminated by weighted cones or by positioning an emergency vehicle with its lights turned on next to or under the potential hazard. · To mark the landing site, use weighted cones or position emergency vehicles at the corners of the landing zone with headlights facing inward to form an X. This procedure is essential during night landings as well. Never use caution tape or ask people to mark the site. The use of flares is also not recommended, because not only can they become airborne, but they also have the potential to start a fire or cause an explosion. · Move all nonessential people and vehicles to a safe distance outside of the landing zone. · If the wind is strong, radio to the flight crew the direction of the wind. They may request that you create some form of wind directional device to aid their approach. A bed sheet tightly secured to a tree or pole may be used to help the crew determine wind direction and strength. Never use tape.