EMT Chapter 38

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A system implementing to manage disasters and mass casualty incidents in which section chiefs, including finance, logistics, operations, and planning, report to the incident commander

Incident command system (ICS)

The overall leader of the incident command system to whom commanders or leaders of incident command system divisions report.

Incident commander (IC)

Shipping and storage vessels that can be either pressurized or non pressurized

Intermodal tanks

An area designated by the incident commander, or a designee, in which public information officers from multiple agencies disseminate information about the incident

Joint information center

A sorting system for pediatric patients younger than 8 years or weighing less than 100 lbs.

JumpSTART triage

The process of directing responders to return to their facilities when work at a disaster or mass casualty incident has finished, at least for those particular responders

Demobilization

In incident command, the person who relays information, concerns, and requests among responding agencies

Liaison officer

A widespread event that disrupts community resources and functions, in turn threatening public safety, citizen's lives, and property

Disaster

Barrel-like containers used to store a wide variety of substances, including food-grade materials, corrosives, flammable liquids, and grease.

Drums

Which of the following statements regarding trench rescue is correct?

Ground vibration is a primary cause of secondary collapse.

In incident command, the position that helps procure and stockpile equipment and supplies during an incident

Logistics

An emergency situation involving three or more patients that can place great demand on the equipment or personnel of the EMS system or has the potential to produce multiple casualties.

Mass casualty incident (MCI)

A branch of operations in a unified command system, whose three designated sector positions are triage, treatment, and transport

Medical incident command

In incident command, the person who works with area medical examiners, coroners, and law enforcement agencies to coordinate the disposition of dead victims

Morgue supervisor

An agreement between neighboring EMS systems to respond to mass casualty incidents or disasters in each others region when local resources are insufficient to handle the response.

Mutual aid response

You are dispatched to the scene of a building explosion. Upon arrival, you see people frantically fleeing the building, screaming, "Everyone is passing out!" You should:

carefully assess the situation and ensure your own safety.

An engineered method to control spilled or released product if the main containment vessel fails

Secondary containment

A type of patient sorting used in the treatment sector that involves retriage of patients

Secondary triage

Upon arriving at the scene of a possible hazardous materials (HazMat) incident involving several patients, you should:

carefully assess the situation.

If a technical rescue team is required at the scene, but is not present when you arrive you should:

check with the incident commander to ensure that the team is en route.

The process of removing dirt, dust, blood, or other visible contaminants from a surface or equipment is called:

cleaning.

Historically, the weak point at most major incidents has been:

communication.

During the transport phase of an ambulance call, it is MOST important to:

converse with the patient and provide reassurance.

Most terrorist attacks are:

covert.

If the incident command system (ICS) is already established at the scene of a WMD or terrorist attack, the EMT should:

locate the medical staging officer to obtain his or her assignment.

The FIRST step in the START triage system is to:

move all walking patients to a designated area.

At a very large incident, the _________ section is responsible for managing the tactical operations usually handled by the IC on routine EMS calls.

operations

Nerve agents, a class of chemicals called organophosphates, were first discovered while in search of a superior:

pesticide.

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

place deceleration straps over the patient's shoulders.

The development of an incident action plan is the responsibility of the:

planning section.

You and your partner are standing by at the scene of a residential fire when you hear the incident commander state "we have located a victim" over the radio. You should:

remain with the ambulance and wait for fire personnel to bring the victim to you.

Disentanglement involves:

removing a patient from a dangerous position.

Signs and symptoms of exposure to a nerve agent include:

salivation, pinpoint pupils, and diarrhea

Which of the following terrorist groups poses the LEAST threat to a person's physical safety?

technology terrorists.

Which of the following statements regarding storage containers and hazardous materials is correct?

In most cases, there is no correlation between the color of the container and the possible contents.

An oral or written plan stating general objectives reflecting the overall strategy for managing an incident

Incident action plan

Which of the following statements regarding the rapid extrication technique is correct?

The rapid extrication technique is indicated if the scene is unsafe and the patient is not entrapped in his or her vehicle.

The area in a mass casualty incident where ambulances and crews are organizing to transport patients from the treatment area to receiving hospitals.

Transportation area

The individual in charge of the transportation sector in a mass casualty incident who assigns patients from the treatment area to awaiting ambulances in the transportation area.

Transportation supervisor

The location in a mass casualty incident where patients are brought after being triaged and assigned a priority, where they are reassessed, treated, and monitored until transport to the hospital.

Treatment area

The individual, usually a physician who is in charge of and directs EMS personnel at the treatment area in a mass casualty incident

Treatment supervisor

The process of sorting patients on the severity of injury and medical need to establish treatment and transportation priorities.

Triage

The individual in charge of the incident command triage sector who directs the sorting of patients into triage categories in a mass casualty incident

Triage supervisor

A command system used in larger incidents in which there is a multiagency response or multiple jurisdictions are involved

Unified command system

The area located between the hot zone and the cold zone at a hazardous materials incident.

Warm zone

Which of the following situations would require the use of a specialized rescue team?

a patient trapped in a cave or a confined space.

Botulinum is:

a potent bacterial neurotoxin.

Continual reassessment of the scene at a suspected terrorist or WMD incident is MOST important because:

a secondary explosive device may detonate.

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

100' past the scene on the same side of the road.

Typically medevac helicopters fly between:

130 and 150 mph.

Portable, compressed gas containers used to hold liquids and gases. Uninsulated compressed gas cylinders are used to store substances such as nitrogen, argon, helium, and oxygen. They have a range of sizes and internal pressures.

Cylinders

The designated area in a hazardous materials incident where all patients and rescuers must be decontaminated before going to another area

Decontamination area

Shipping papers used for transport of chemicals over roads and highways. Also referred to as freight bills

Bills of lading

Glass, plastic, or steel containers ranging in volume from 5 to 15 gallons

Carboys

An area set up by physicians, nurses, and other hospital staff near a major disaster scene where patients can receive further triage and medical care

Casualty collection area

The agency that assists emergency personnel in identifying and handling hazardous materials transport incidents.

Chemical Transportation Emergency Center (CHEMTREC)

A safe area at a hazardous materials incident for the agencies involved in the operations.

Cold zone

In incident command, the position that oversees the incident, establishes the objectives and priorities, and from there develops a response plan.

Command

The location of the incident commander at the scene of an emergency and where command, coordination, control, and communication are centralized.

Command post

Any vessel or receptacle that holds material, including storage vessels, pipelines, and packaging

Container

Areas at a hazardous materials incident that are designated as hot, warm, or cold, based on safety issues and the degree of hazard found there

Control zones

An area where individuals can be exposed to electrical hazards such as sharp metal edges, broken glass, toxic substances, lethal rays, or ignition or explosion of hazardous materials.

Danger zone (hot zone)

The process of removing or neutralizing and properly disposing of hazardous materials from equipment, patients, and rescue personnel.

Decontamination

A dept of homeland security system designed to enable federal, state, and local governments and private-sector and nongovernmental organizations to effectively and efficiently prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, including acts of catastrophic terrorism

National Incident Management System (NIMS)

Any container other than bulk storage containers such as drums, bags, compressed gas cylinders, and cryogenic containers, which hold commonly used commercial and industrial chemicals such as solvents, industrial cleaners, and compounds

Nonbulk storage vessels

In incident command, the position that carries out the orders of the commander to help resolve the incident

Operations

Measures of the amount and type of protective equipment that an individual needs to avoid injury during contact with a hazardous materials

Personal protective equipment (PPE) levels

Signage required to be placed on all four side of highway transport vehicles, railroad tank cars, and other forms of hazardous materials transportation.

Placards

In incident command, the position that ultimately produces a plan to resolve any incident

Planning

A type of patient sorting used to rapidly categorize patients; the focus is on speed in locating all patients and determining an initial priority as their conditions warrant

Primary triage

In incident command, the person who keeps the public informed and relates any information to the press

Public information officer (PIO)

The area that provides protection and treatment to fire fighters and other personnel working at an emergency.

Rehabilitation area

In incident command, the person who establishes an area that provides protection for responders from the elements and the situation.

Rehabilitation supervisor

In incident command, the person appointed to determine the type of equipment and resources needed for a situation involving extrication or special rescue.

Rescue supervisor

In incident command, the person who gives the 'go ahead' to a plan or who may stop an operation when rescuer safety is an issue

Safety officer

You are assessing a 30-year-old female who presents with respiratory distress and tachycardia after she opened a package that was delivered to her home. The patient tells you that there was a fine white powder on the package, but she did not think it was important. This patient has MOST likely been exposed to"

anthrax.

Points of distribution (PODs) are strategically placed facilities where:

antidotes, antibiotics, and vaccines are distributed.

A disease vector is defined as:

any agent that acts as a carrier or transporter.

A weapon of mass destruction (WMD) is MOST accurately defined as:

any agent used to bring about mass death, casualties, or massive infrastructural damage.

You are attempting to gain access to a patient who was injured when his truck struck another vehicle from behind. The patient is conscious and alert, but is screaming in pain. You try to open the door, but it is locked. You should:

ask the patient if he can unlock the door.

According to the JumpSTART triage system, if a pediatric patient has a respiratory rate of 40 breaths/min, you should:

assess for a distal pulse.

Regardless of where portable and mounted oxygen cylinders are stored in the ambulance, they must:

be capable of delivering oxygen at 1 to 15 L/min.

When transporting a patient to the hospital, you should:

be safe and get the patient to the hospital in the shortest practical time.

Following proper decontamination, a 30 year old male is brought to you. He is semiconscious and has rapid, shallow respirations. A quick visual assessment reveals no obvious bleeding. You should:

begin some form of positive-pressure ventilation.

A 49-year-old man has been removed from his overturned tanker, which was carrying a hazardous material. The tank ruptured and he was exposed to the material. When rescue personnel bring him to the decontamination area, they note that he is unconscious and has slow, shallow breathing. They should:

cut away all of the patients clothing and do a rapid rinse to remove as much of the contaminating matter as they can.

A 19-year-old female has just been extricated from her severely damaged car. She is on a long backboard and has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unconscious, has slow and shallow respirations, and has bilaterally closed femur deformities. You should:

direct your partner to begin ventilator assistance.

Symptoms of both inhaled and ingested ricin include:

fever and headache.

The term used when individual units or different organizations make independent and often inefficient decisions regarding an incident is called:

freelancing.

As the first arriving emergency responder at the scene of a suspected terrorist or WMD incident, you should request addition resources as needed and then:

function as the incident commander until additional personnel arrive.

Placards and labels on a storage container are intended to:

give a general idea of the hazard inside that particular container.

According to the JumpSTART triage system, if a pediatric patient is not breathing, you should:

immediately check for a pulse.

Maintaining a cushion of safety when operating an ambulance means:

keeping a safe distance between your ambulance and the vehicles in front of you and remaining aware of vehicles potentially hiding in your mirror's blind spots.

When arriving at the scene of an overturned tractor-trailer rig, you note that a green cloud is being emitted from the crashed vehicle. The driver is still in the truck; he is conscious but bleeding profusely from the head. After notifying the hazardous materials team, you should:

position the ambulance upwind.

Pulmonary hemorrhage and inner ear damage are examples of ________ blast injuries.

primary.

Which of the following is a typical function of the rescue team?

providing safe entry and access to patients.

Which of your sense can be safely used to identify a HazMat incident?

sight and sound.

The _________ area is where incoming ambulances meet and await further instructions at the scene of a mass-casualty incident.

staging

A critical function of the safety officer is to:

stop an emergency operation whenever a rescuer is in danger.

The reasons for rescue failure can be referred to by the mnemonic FAILURE. According to this mnemonic, the "U" stands for:

underestimating the logistics of the incident.

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.


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