Chapter 37- Hazardous Materiaals, 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.

1

ICS systems recognize that the manageable span of control​ is:

6 people.

Which of the following statements regarding a disaster plan is​ FALSE?

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

Who should receive psychological first​ aid?

A stable patient who has become overwhelmed by the horror of the scene

Which of the following settings should MOST make the EMT consider the likelihood of a hazardous materials​ incident?

A warehouse

Which of the following must be assessed on a hazmat team member before he or she enters the hot​ zone?

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?

CHEMTREC

Which of the following is a​ 24-hour resource operated by the American Chemistry​ Council?

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.

CHEMTREC

Flammable​ solids, substances that are dangerous when​ wet, and spontaneously combustible materials​ are:

Class 4 materials.

In which of the following areas at a hazmat incident are normal​ triage, stabilization, and treatment​ performed?

Cold zone

In which of the following zones is the EMT expected to be staged at the scene of a hazardous materials​ incident?

Cold zone

Which of the following is NOT an acceptable way of attempting to identify a hazardous​ material?

Collecting a sample of the material for laboratory analysis

Which of the following is a principle of effective Incident​ Command?

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

While other patients are waiting for​ triage, what is an appropriate treatment measure that can be performed during the ongoing triage​ process?

Controlling severe bleeding

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.

First Responder Awareness

No minimum training hours are required for which level of​ training?

First Responder Awareness

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.

First Responder Operations

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.

Hazardous Materials Specialist

To command activities at a hazardous materials incident​ site, the minimum level of training necessary​ is:

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.

Hazardous Materials Technician

Which of the following should NOT be considered during the scene​ size-up of a hazardous materials​ emergency?

How quickly the materials may be cleaned up

It is characteristic of a disaster plan to be all of the following EXCEPT which​ one?

Impractical

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?

Incident Commander of the scene

If an EMS unit is the first to respond to a​ multiple-casualty incident, which role does the most senior EMT​ assume?

Incident commander

Which of the following is NOT a desirable characteristic of the rehabilitation sector of a hazardous materials​ incident?

It is located in the warm zone.

The characteristics of a rehab area include all of the following EXCEPT which​ one?

Large enough to accommodate a single crew

What should responders do with any clothing that is worn in the warm or hot zones of a hazardous​ incident?

Leave it at the scene.

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?

Make a sweep to determine what needs must be met.

What is the MOST likely reason a garden center could become the site of a hazardous materials​ incident?

Many​ fertilizers, pesticides, and other chemicals are sold there.

Which of the following is the MOST common type of​ multiple-casualty incident that EMS providers will respond​ to?

Motor vehicle collisions

Which warning placard is​ diamond-shaped and divided into four smaller​ diamonds?

NFPA 704 System

What does the triage mnemonic START stand​ for?

Simple triage and rapid treatment

You have been assigned to the transport unit at an MCI. In what area will you wait while awaiting your assigned​ patient?

Staging

You are assigned to the triage unit at an​ MCI, and you are going from patient to​ patient, assigning triage categories. Which of the following interventions is acceptable in this phase of the​ process?

Opening the airway

What source will provide first aid information about hazardous materials for employees at a work​ site?

Safety data sheets

Which of the following is LEAST likely an effect of a hazardous​ material?

Scalds if heated too high

Which of the following must be identified in hazardous materials shipping​ papers?

The origin of the shipment

If you do not have specialized training in hazardous​ materials, which of the following statements is​ TRUE?

You are a layperson when it comes to hazardous materials.

Which of the following statements about primary triage when resources are limited is​ TRUE?

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

Priority 3 patients are also known​ as:

walking wounded.

A decontamination corridor would be established in​ the:

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?

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

Simple Triage and Rapid Treatment​ (START) is a system that relies on some simple commands and what three physiologic​ parameters?

​Respiration, pulse, and mental status

Which of the following are desirable characteristics of the safe or​ "cold" zone in a hazardous materials​ incident?

​Upwind, on the same level as the spill

Psychological first aid​ involves:

​caring, honest engagement with patients in emotional distress.

When seeking expert advice on how to proceed at a hazardous materials​ incident, which of the following information is important to​ provide?

Amount of the substance involved

What constitutes a​ multiple-casualty incident​ (MCI)?

An event involving multiple patients that places a great demand on EMS equipment and personnel resources

Which of the following statements BEST describes primary​ triage?

An initial determination of each​ patient's priority for treatment and transport

Which of the following is NOT a responsibility of an EMT at the scene of a hazardous materials​ emergency?

Decontaminating injured victims

Which of the following tasks must be accomplished before a patient can leave the warm​ zone?

Decontamination

Which of the following is NOT a mechanism of decontamination from hazardous​ materials?

Deodorizing

What is the process that removes the biological​ (etiological) contamination​ hazards, as it destroys microorganisms and their​ toxins?

Disinfection

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?

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

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?

EMS sector officer

Which of the following is a resource for specific actions to be taken by personnel dealing with a hazardous materials​ incident?

Emergency Response Guidebook

Which of the following should immediately increase your suspicion of a hazardous materials​ incident?

Emergency site at a factory

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?

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

Which of the following is the BEST description of a safety data sheet​ (SDS)?

Papers kept on site with hazardous chemicals

Using START triage​ guidelines, a patient on the scene of a​ mass-causality incident who has no pulse is deemed a​ ________ patient.

Priority 0

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.

Priority 1

Which of the following statements about decisions made by the transportation unit at an MCI is​ TRUE?

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

Where is the decon corridor located where​ patients, personnel, and equipment are​ decontaminated?

Warm zone

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.

Priority 3

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:

Priority 3 walking wounded.

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.

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.

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 an​ 8-year-old male patient with respirations 10 and pulse 102 who is ambulatory with an alert mental status and warm dry skin.

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​ 17-year-old male patient with the following vital​ signs: respirations​ 18; pulse​ 104; alert,​ crying, and wanting his​ mother; ambulatory.

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.

Priority​ 4, black tag

Which of the following has the HIGHEST priority at a hazardous materials​ incident?

Protecting the safety of all rescuers and patients

Which of the following is NOT a function of the rehabilitation sector in a hazardous materials​ incident?

Providing a decontamination corridor from the hot zone

Which of the following hazards is represented by the yellow area on an NFPA​ placard?

Reactivity

Which of the following is needed for effective response to an​ MCI?

Requesting and managing necessary resources

Which of the following is NOT the role of the first arriving EMT at the scene of a possible hazardous materials​ emergency?

Rescue any victims still in the area of the spill.

Which statement regarding the​ diamond-shaped placards involved in the transportation of dangerous goods is​ FALSE?

These placards are always carefully vetted and accurate.

Which of the following BEST describes the roles of Hazardous Materials​ Specialists?

They provide command and support activities at the site of a hazardous materials incident.

Which of the following BEST describes the use of secondary​ triage?

To reevaluate the treatment priorities designated during primary triage

When transporting patients from the scene of a​ mass-casualty incident, who should be responsible for contacting the receiving​ hospital?

Transportation supervisor

Who is the person that is in charge of tracking the​ patient's final​ destination?

Transportation supervisor

Which of the following personal protective items must be used by EMS personnel caring for patients in a hazardous materials​ emergency?

Tyvek or other chemical impermeable coveralls

You are on the scene of a riot following a decision in a controversial court case. A large group of people have set fire to​ vehicles, broken​ windows, and assaulted people in the area. Which of the following would be the BEST method of incident​ command?

Unified command

Surge capacity refers​ to:

a measurable representation of ability to manage a sudden influx of patients.

Disaster plans are a predefined set of instructions that should be written to address the events that are conceivable​ for:

a particular location.

A command organization in which a single agency controls all resources and operations​ is:

a single incident command.

Hazardous material​ is:

any material that poses an unreasonable risk to​ life, health, or property.

A​ multiple-casualty incident​ is:

any medical or trauma incident involving multiple patients.

Identification of chemical hazards starts​ with:

awareness and knowledge of what exists in the community.

As it pertains to hazardous​ materials, the Occupational Safety and Health Administration requires employers​ to:

document the appropriate level of training for each employee.

Emotionally incapacitated​ EMTs:

may not return to duty even after they have rested.

To be classified as​ "walking wounded" in primary​ triage, a​ patient:

must have only minor musculoskeletal or​ soft-tissue injuries.

An EMT trained at a First Responder Awareness level would be able​ to:

recognize a hazardous materials incident and initiate a response from the proper organizations.

Gross decontamination is​ the:

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:

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:

safe zone.

The plan for a​ large-scale MCI:

should be a logical extension of the plan for a​ small-scale MCI.

If arriving units are not needed right​ away, they should wait in​ the:

staging area.

A​ large-scale MCI creates a situation​ that:

tests the capabilities of even the​ best-trained EMTs.

To identify the exact substance an overturned chemical truck was​ carrying, the EMT would​ consult:

the bill of lading. (the truck)

EMS providers who become emotionally incapacitated during an MCI should​ be:

treated as patients.