EMT Chapter 39: Incident Management

You are triaging victims of a train derailment. Patient A has significant bleeding from an abdominal injury. Patient B has several simple fractures of the femur and ulna. Patient C is conscious and complaining of head and neck pain. Patient D is in cardiac arrest. How would you prioritize these patients?

A-red; B-green; C-yellow; D-black

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:

A. begin some form of positive-pressure ventilation. Correct

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

A. freelancing. Correct

Placards and labels on a storage container are intended to:

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

The FIRST step in the START triage system is to:

A. move all walking patients to a designated area. Correct

Unlike a multiple-casualty incident, a natural disaster:

A. often requires personnel to remain on scene for several days. Correct

The JumpSTART triage system is intended to be used for children younger than _____ years or who appear to weigh less than _____.

B. 8; 100 lb Correct

Which of the following is probably NOT a multiple-casualty incident?

B. A motor vehicle crash with two critically injured patients and two ambulances Correct

You are approaching an overturned tanker truck to assess the driver, who appears to be unresponsive. As you get closer to the vehicle, you note the smell of noxious fumes and find that you are in the midst of a vapor cloud. What should you do?

B. Exit the area immediately and gather information for the HazMat team. Correct

While triaging patients at the scene of a building collapse, you encounter a young child who is conscious, alert, and breathing; has bilateral radial pulses; and has a severely angulated leg, which is not bleeding. According to the JumpSTART triage system, you should:

B. assign him a delayed (yellow) category and continue triaging the other patients. Correct

A supervisor who has more than seven people reporting to him or her:

B. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person. Correct

After primary triage, the triage supervisor should communicate all of the following information to the medical branch officer, EXCEPT:

B. the recommended transport destination for each patient. Correct

Which level of PPE do you need to wear when dealing with a Level 1 or 2 toxicity level?

C

In preparing for a disaster, EMS systems should have enough supplies for at least a ______ period of self-sufficiency.

C. 72-hour Correct

You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following patients should be assigned the highest (red) triage category?

C. A 49-year-old female with diabetes and difficulty breathing Correct

According to the START triage system, what should you do if a patient is found to have a respiratory rate of 24 breaths/min?

C. Assess for bilateral radial pulses. Correct

Which of the following duties or responsibilities does NOT fall within the realm of the medical branch of the incident command system?

C. Extrication Correct

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

C. Sight and sound Correct

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

C. carefully assess the situation. Correct

As a triage supervisor, you:

D. must not begin treatment until all patients have been triaged. Correct

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

D. planning section. Correct

The function of the National Incident Management System (NIMS) is to:

D. prepare for, prevent, respond to, and recover from domestic incidents. Correct

The two important underlying principles of the NIMS are standardization and what?

Flexibility

Which of the following statements regarding transport of patients from a multiple-casualty incident or disaster site is correct?

Immediate-priority patients should be transported two at a time.

Which toxicity level includes materials that are extremely hazardous to health?

Level 4

What is the primary difference between a disaster and an MCI?

MCIs are usually short term and disasters are long term.

According to the START triage system, what should you do if you encounter an unresponsive patient who is not breathing?

Open the airway and reassess breathing status.

Which type of drum is used for the storage of corrosives such as acids, bases, or oxidizers?

Polyethylene

Which of the following is a member of the command staff?

Public information officer

During triage, how should you tag a child who is breathing fewer than 15 breaths/min?

Red

Which of the following is a requirement when labeling pesticide bags?

The EPA establishment number

In which control zone would you find the decontamination area?

Warm zone

Interoperability, an important feature of the NIMS, refers to the ability of:

agencies of different types or from different jurisdictions to communicate with each other.

A carboy is a container that would MOST likely be used to store and transport:

corrosives.

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 patient's clothing and do a rapid rinse to remove as much of the contaminating matter as they can.

You and your partner are the first to arrive at the scene of a motor vehicle accident. As you approach the scene, you can see multiple patients, some walking and others who are still in their vehicles. You should:

declare a mass-casualty incident and request additional resources.

The process of removing or neutralizing and properly disposing of a hazardous material is called:

decontamination

Which of the following is NOT a common role of the EMT at the scene of a HazMat incident?

decontamination

During a motor vehicle collision involving multiple patients, the incident commander would MOST likely:

designate a safety officer, but retain other command functions.

The purpose of the incident command system (ICS) is to:

ensure responder and public safety, achieve incident management goals, and ensure the effective use of resources.

As the first-arriving senior EMT at the scene of an incident, you should perform a scene size-up and then:

establish command.

Injuries or conditions that would be classified as first priority (red tag; immediate) include all of the following, EXCEPT:

fractures of multiple long bones.

General principles for approaching a potential HazMat incident include:

maintaining a safe distance and viewing the scene with binoculars.

You and your partner arrive at the scene where a truck has crashed into a small building, injuring eight people. You immediately request additional ambulances and begin the triage process. The first patient that you triage is a young female who is unconscious and apneic. She has an open head injury and her pulse is weak and thready. You should:

place a red tag on her and continue triaging

Which of the following is NOT a responsibility of the treatment supervisor?

primary assessment

You have a critically injured patient in the back of your ambulance, ready to be transported. There are other injured patients at the scene and it will be approximately 10 minutes before other ambulances will arrive. Law enforcement personnel are at the scene. You should:

remain at the scene until at least one other ambulance arrives.

A Level 4 hazardous material:

requires specialized gear designed for protection against that particular hazard.

According to the JumpSTART triage system, infants or children not developed enough to walk or follow commands, including children with special needs:

should be taken to the treatment area for immediate secondary

The reference used as a base for your initial actions at a HazMat incident is:

the Emergency Response Guidebook.

The MOST appropriate location to park your ambulance at a HazMat incident is:

upwind at least 100′ from the incident.