EMS 1020 - Chapter 11: Scene Size-Up
[Chapter 11: Post-test] How far does the danger zone extend out when downed wires are involved? A. A full span beyond the first intact pole. B. There is no specific danger zone to establish. C. No more than 50 feet is needed in any direction. D. Half the distance that the severed wires can reach.
A
[Chapter 11: Post-test] The U.S. Department of Transportation publishes a book that should be carried in every emergency vehicle to assist in the identification of hazardous materials. This book is called: A. the Emergency Response Guidebook. B. the CHEMTREC Handbook. C. the Hazardous Materials Handbook. D. the Responders' Book of Hazardous Materials.
A
[Chapter 11: Post-test] Which of the following Standard Precautions should be employed on every scene? A. Gloves B. Boots C. Face mask D. Gown
A
[Chapter 11: Post-test] You arrive on scene and discover a methamphetamine lab. Besides law enforcement, what specific resource should you request? A. A hazmat team B. The power company C. Additional EMS assistance D. Social services
A
[11.4] Which of the following would represent the next best location to park if you could not park upwind or uphill from a scene of a gasoline spill? A. Behind a barrier B. Downwind from the spill C. Downhill from the spill D. In the drainage ditch
A If a liquid is flowing, park behind a barrier if possible. Parking downhill or downwind would put you at risk for exposure to the liquid or fumes. Drainage ditches also pose the risk of exposing you to runoff from the spill.
[11.7] Why is it important to make observations during the scene size-up of the mechanism of injury in a car collision (i.e., rollover, frontal, rear end, or lateral crash)? A. It increases the index of suspicion. B. It helps in determining the time of the incident. C. It will help the police to investigate the collision. D. It helps to determine the cause of the crash.
A The MOI helps to increase the index of suspicion, which is anticipation that certain types of accidents and mechanisms will produce specific types of injuries. Although it can also help to determine other factors associated with the collision, the index of suspicion would be the most immediately important.
[11.4] What is the purpose for establishing a danger zone while working at a motor vehicle crash scene? A. To designate the area where special safety precautions should be taken B. To establish the area where the fire department will be operating C. To require additional equipment to be dispatched to the scene D. To ensure that the traffic will be rerouted around the wreckage
A The area around the wreckage at a collision is designated a danger zone so that special precautions (e.g., special PPE) will be taken here to avoid injury. Although the fire department often operates in this area, it is not limited to their personnel. Traffic will likely be rerouted around the area, but that is not the key purpose for its establishment.
[11.2] The purpose of a thorough scene assessment by EMTs is to ensure their own well-being as well as those of patients and: A. bystanders. B. property. C. criminals. D. law enforcement.
A The first rule is to protect your own safety. After this, focus your attention on your partner and any bystanders who are in immediate harm's way. Once their safety has been ensured, you can focus on the patient and the patient's safety and care.
[11.2] Which of the following would be considered one of the three basic goals of the scene size-up? A. Determining what led to your being called to the scene B. Determining the patient's chief complaint C. Determining whether the patient is breathing D. Determining the patient's medical history
A The scene size-up is the initial evaluation of a scene to which an EMT has been called. The EMT has three basic goals during scene size-up: (1) Identify possible hazards at the scene, and ensure the safety of yourself and other members of your EMS crew, the patient, and the bystanders. (2) Identify what led to your being called to the scene-long dash—either an injury or a medical problem. (3) Determine whether any factors, such as the number of patients or unusual characteristics of the scene, might require a call for additional assistance. Determining a chief complaint and breathing assessment are completed in the primary assessment. A medical history is obtained in the secondary assessment.
[11.7] The type of medical condition or complaint a patient is suffering from is referred to as the: A. nature of illness. B. mechanism of injury. C. index of suspicion. D. history of the present illness.
A The type of medical condition or complaint a patient is suffering from is referred to as the nature of illness. The mechanism of injury is the cause of a traumatic problem. The index of suspicion is the level of concern or probability that you assign to a specific situation. The history of the present illness refers to the recent events that have led up to the call for EMS.
[11.5] Which of the following scenes would require you to be extra vigilant? A. An unusually quiet scene B. A noisy scene room in a factory C. Police on scene motioning you in D. A large crowd at a daycare
A Vigilance should be increased any time the situation does not match your expectation. An unusually quiet scene would require an EMT to be extra vigilant. A large crowd can also be cause for concern, but in the context of a daycare, it would seem to be less concerning. Police presence can lessen your need for vigilance but does not eliminate it entirely. Noise can also require vigilance, but in a factory, noise would be expected and not unusual.
[11.1] Which of the following is associated with a scene size-up and is used in assessing a patient who has received a traumatic injury? A. Mechanism of injury B. Index of suspicion C. Nature of illness D. Index of injury
A When arriving on the scene of a suspected trauma, you will be looking for the mechanism of injury (MOI). Mechanism of injury refers to how the patient was injured. It includes the strength, direction, and nature of the forces that caused the injury. The mechanism of injury is the basis for your index of suspicion. Nature of illness is generally associated with a medical complaint.
[Chapter 11: Post-test] Mechanism of injury refers to: A. injuries specifically caused by machinery or industrial equipment. B. how the patient was injured. C. the degree of your anticipation that the patient has received an injury. D. the specific injury that the patient has received.
B
[Chapter 11: Post-test] Your unit arrives first at the scene of a car and bus accident. A bystander approaches your vehicle and states that multiple children are injured. You should first: A. initiate patient care. B. request additional units. C. review the mechanism of injury. D. begin primary triage.
B
[11.1] Which of the following is the area around the wreckage of a vehicle or other potentially unsafe incident within which special safety precautions must be taken? A. Injury area B. Danger zone C. Access area D. Zone of safety
B Although all these choices could be used as informal warnings, the specific and formal term is danger zone.
[11.9] An injury that is caused by a blow that strikes the body but does not penetrate the skin or other body tissues is known as: A. penetrating trauma. B. blunt force trauma. C. whiplash injury. D. indirect trauma.
B An injury that is caused by a blow that strikes the body but does not penetrate the skin or other body tissues is known as blunt force trauma. Penetrating trauma implies that the skin has been penetrated. Indirect trauma occurs when an injury occurs in an area that is not in contact with the source of the traumatic energy. A whiplash injury occurs when the head is forced in a different direction than the body, such as in a rear-end collision.
[11.5] You are caring for a 19-year-old male who was shot during a gang confrontation. The police have secured the scene and requested you to treat the patient. In addition to patient care, you should: A. assist law enforcement in searching the scene for clues. B. have one EMT constantly watch bystanders and the surrounding area. C. ask the patient about the crime so that you can report the answers to law enforcement. D. refuse to treat any patient at this crime scene.
B Be alert to the possibility that the patient at the crime scene may be not simply a victim but also a perpetrator or that a bystander at the scene may also include the perpetrator. Be prepared for the possibility that such a patient may suddenly reach for a weapon. If possible, have one EMT keep a constant watch on the bystanders and the surrounding area while you work on the patientlong dash—to alert you if a scene begins to turn dangerous. Although documenting patient statements and assisting law enforcement may be helpful, they are not your prime responsibility.
[11.8] A 39-year-old male complains of respiratory distress, cough, and a fever. The patient weighs 400 pounds and lives on the second floor of a small house. You determine that transport is indicated. You should next: A. have the patient walk down to the first floor. B. request additional lifting assistance. C. get medical direction orders to treat and release. D. manage the best you can with your partner.
B Because of the large weight load, you should request additional lifting assistance. Attempting to lift beyond your capabilities puts you at risk for both acute and chronic injuries. The patient does require transport and should not be asked to walk down stairs, as that act could exacerbate his respiratory condition.
[11.6] You have been asked to climb inside the wreckage at a motor vehicle crash to provide patient care. What personal protective equipment will you don before entering the vehicle? A. Examination gloves B. Bunker gear C. HEPA mask D. Shoe covers
B Bunker gear would protect you from the hazards to sharp objects and fire and should be donned before entering the vehicle. Although examination gloves would be appropriate to protect against bloodborne hazards, they would not be sufficient protection in that environment. Shoe covers and a HEPA mask would not apply to this situation.
[11.3] You are dispatched to the scene of a child who was bitten by a dog. What step of the scene size-up can you begin to perform before arrival? A. Instruct bystanders on bleeding control. B. Determine whether the animal has been secured. C. Place the trauma kit in close proximity. D. Establish the seriousness of the bite.
B Determination that the animal has been secured can be made by a crew member or dispatch before your arrival. Resources such as animal control or law enforcement can be notified. The seriousness of the injury and first aid are not part of scene size-up. Instructing bystanders on bleeding control can be accomplished before arrival, but it is not part of the scene size up.
[11.9] If your patient is suffering from a medical condition, during your scene size-up, you should determine the patient's: A. mechanism of injury. B. nature of illness. C. index of suspicion. D. SAMPLE history.
B In a patient who is not injured but is suffering from a medical condition, you will begin to determine the nature of illness (NOI) during scene size-up. The patient, relatives, bystanders, or physical evidence at the scene may provide you with clues to determine what the patient is suffering from. You are not attempting to diagnose the patient's illness. You are gathering information that will narrow down the nature of the patient's complaint. A mechanism of injury would be used for a trauma patient. An index of suspicion will be determined once you better understand the nature of illness. The SAMPLE history is obtained in the secondary assessment.
[11.5] You have been dispatched to 29 Park Avenue for a man having chest pain. As you approach the house, you hear loud voices and verbal threats coming from inside. You should: A. approach the scene quietly. B. NOT enter the scene. C. use the PA system to announce your arrival. D. direct everyone to move away from the patient.
B Loud voices and verbal threats are an indicator that the scene is potentially not safe. You should not enter. Law enforcement should be contacted to ensure safety before you announce your presence or enter the scene.
[11.9] Penetrating trauma associated with handguns and shotguns is generally considered to be: A. critical velocity. B. medium velocity. C. high velocity. D. low velocity.
B Medium-velocity wounds are usually caused by handguns and shotguns. Some forcefully propelled items such as an arrow launched from a compound bow or a ballistic knife will also have greater velocities than the same items propelled by hand. Low-velocity wounds are general non-mechanical in nature. High-velocity wounds are generally caused by rifles or explosive shrapnel.
[11.4] Which of the following would be the appropriate place to park an ambulance if you were responding to a hazardous materials scene that involved gases or fumes? A. Downwind from the scene B. Level with the scene C. Uphill from the scene D. Downhill from the scene
B Parking anywhere but on the same level could lead to exposure and therefore would be potentially dangerous.
[11.9] You should consider calling for advanced life support: A. for all patients with external bleeding. B. whenever your patient's airway is compromised. C. for patients who are receiving supplemental oxygen. D. for all patients.
B The EMT is limited in the types of airway maneuvers they can employ on a patient with a compromised airway. If the airway compromised, the EMT should call ALS for backup, as paramedics have additional airway techniques they can employ. Not all patients require ALS, and EMTs are quite capable of making this decision. EMTs can also treat bleeding and administer oxygen without necessarily needing ALS.
[11.9] Which of the following elements should be completed only after the EMT has finished the scene size-up? A. Determine the mechanism of injury or nature of illness. B. Identify and manage life-threatening conditions. C. Identify possible hazards. D. Assess the scene for additional resources that might be needed.
B The EMT should always remember that the purpose of the scene size-up is to determine how to best control the scene and ensure personal safety. Hazards, mechanism of injury or nature of illness, and need for additional resources will all be determined during the size-up. Management of life threats would be completed once the size-up is finished.
[11.2] EMTs should consider scene safety when responding to: A. motor vehicle crashes. B. all EMS responses. C. domestic violence calls. D. chest pain calls.
B The costs of failing to recognize the hazards of an unstable scene can be high for yourself, your partners, and your patients. It is imperative that you identify and pay close attention to the scene size-up characteristics on every call, not just the ones that sound bad. Doing so can save your life.
[11.9] You are approaching a conscious victim of a motor vehicle accident who is still sitting in the car. You notice that the air bag never deployed and the steering wheel is bent. What is your first concern? A. The patient may have chest injuries of which he is not aware. B. The air bag may still deploy, injuring you or the patient. C. The patient may have a head injury. D. You should immediately fit a cervical collar.
B While all are important considerations, deployment of the air bag could easily result in a second victim (you) and one less rescuer. Regardless of what injuries the victim may currently have, your injury would be detrimental to his treatment.
[11.2] You arrive at the scene of an overturned vehicle. Your scene size-up identifies power lines lying across the road that you would use to approach the vehicle. You should: A. stay in the vehicle until you have cleared the downed lines. B. stage in place and await the power company. Your answer is correct. C. get out of the vehicle and jump over the lines as you approach. D. yell to the victim to self-evacuate.
B Your personal safety is the top priority at any emergency scene. Downed power lines are a significant safety hazard. You should stage in place and await the power company. Driving or jumping over downed lines would not be a safe practice. Asking the patient to self-extricate would put the patient in danger.
[11.9] The Centers for Disease Control and Prevention states that a fall of greater than how many feet for an adult is considered to be a severe fall for which transport to a trauma center is recommended? A. 30 B. 20 C. 40 D. 50
B The U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention state that a fall of greater than 20 feet for an adult or greater than 10 feet for a child under age 15, or more than two to three times the child's height, is considered to be a severe fall for which transport to a trauma center is recommended.
[Chapter 11: Post-test] A pickup truck blew a tire on a bridge, skidded, and is now overhanging the edge of the deck with the driver still inside. You arrive on scene before other responding units. You should first: A. immediately assist the driver out of the vehicle. B. call for assistance to stabilize the truck. C. have your partner stand in the truck bed while you assess the driver. D. park your ambulance right next to the pickup and assess the patient from your cab.
B.
[11.3] As you pull up on scene, you notice that there is gasoline leaking from the car. The danger zone should be at least: A. 75 feet in all directions. B. 100 feet in all directions. C. 50 feet all directions. D. 25 feet in all directions.
B. 100 feet in both directions
[Chapter 11: Post-test] The process of ensuring scene safety is: A. not the job of the EMT. B. completed at the beginning of the call. C. dynamic and ongoing. D. completed once patient care begins.
C
[Chapter 11: Post-test] When it is necessary to transfer scene management to an EMS provider with a higher level of training than yours, you should: A. be prepared to file an incident report. B. immediately go back into service for other calls. C. provide a brief report of what has been done so far. D. leave the scene as soon as possible.
C
[Chapter 11: Post-test] You are dispatched to a local factory for a patient with a headache and respiratory symptoms. Before you arrive, dispatch notifies you that two additional patients have been identified with the same symptoms. You should immediately consider that: A. the patients are making up the complaint. B. substance abuse is occurring. C. the environment is toxic. D. a contagious disease is present.
C
[Chapter 11: Post-test] Your patient has been involved in a head-on collision with a tree. Which of the following injuries would you most suspect on the basis of the mechanism of injury? A. Eye injury B. Hand injury C. Chest injury D. Mouth injury
C
[11.2] You are performing a scene size-up at a large motor vehicle crash scene. Which of the following elements should be assessed first? A. A general impression of the patient. B. The number of patients. C. Possible hazards to your safety. D. The need for additional resources.
C Although each of these elements would be included in a scene size-up, the most important priority would be to assess for safety hazards.
[11.9] You are dispatched for a 35-year-old male complaining of chest pain. You arrive on scene at a residential address in a very run-down section of town. You approach the scene carefully, and upon entering, you find that the patient has been shot in the chest. You should: A. provide treatment of immediate life threats only. B. call for law enforcement and then begin care. C. exit the scene and call for law enforcement. D. provide treatment of immediate life threats and then leave the scene.
C Assessment of the scene for safety issues is always a dynamic situation. In this case, the call came in as "chest pain" (which the patient certainly had), but the caller probably realized that if they said a person was shot, law enforcement almost certainly would be called by the EMS dispatcher. In this situation, the EMT should back out of the scene to a safe location and then summon law enforcement, as safety threats abound and the source of the violent act has not been identified.
[11.9] You are dispatched to an auto accident. As you approach the scene, you notice that law enforcement is there and the fire department is close behind you. Four badly damaged vehicles are involved. You should next: A. position the ambulance to protect the scene. B. determine the number of victims. C. contact dispatch and request additional EMS units. D. begin treatment.
C If there is a probability that there are more patients than you can safely handle, you should call for assistance as soon as possible, preferably before making contact with the victims. As you proceed into a scene, more patients may become apparent, and you are less likely to call for help once you are involved with patient care. Triage and treatment are important, but obtaining resources is more time sensitive. Positioning the ambulance may also be important, but resources should be started first.
[11.7] Your patient is an elderly male who has paralysis of his right arm and leg. What is likely the nature of his illness? A. Renal failure B. Hypertension C. Stroke D. Heart attack
C Stroke commonly causes paralysis. Although hypertension can cause neurological symptoms, it would be far less likely to cause paralysis. Renal failure and heart attacks do not typically cause paralysis.
[11.1] Which of the following elements would be considered parts of the mechanism of injury? A. A specific injury such as a fractured femur B. The patient's chief complaint C. The speed of the vehicle that struck the patient D. A scene safety hazard such as an unstable vehicle
C The MOI (mechanism of injury) is the factors and forces that cause the traumatic injury. Although it can result in specific injuries or scene hazards, such as unstable vehicle, as a concept, it looks purely at the physics that cause trauma.
[11.8] You arrive on the scene of a terrace collapse involving an unknown number of people. Among your priorities, which of the following is initially most important? A. Investigating the cause of the collapse. B. Triage. C. Requesting additional resources. D. Treatment.
C The first priority is to request additional resources, as it is unlikely that your unit can manage a large number of patients. Triage and treatment will be conducted after your size-up is complete. Investigation of the cause can be conducted later.
[11.9] Which of the following is a step in the scene size-up? A. Airway assessment B. Patient treatment C. Determining the mechanism of injury D. Resource allocation
C The mechanism of injury is the combined strength, direction, and nature of forces that injured your patient. It is usually apparent through careful evaluation of the trauma scene and can help you to anticipate both the location and the seriousness of injuries. Determine the nature of illness from bystanders, family members, or the patient. Assessment and treatment would occur after the size-up is complete. Resources are requested during size-up but allocated once the resources arrive on scene later.
[11.6] Which of the following provides the best protection against bloodborne pathogens? A. Appropriate personal decontamination B. The use of HEPA respirators C. Standard Precautions D. Decontamination of common surfaces
C The most common bloodborne risks for health care workers include HIV and hepatitis B and C. Standard Precautions are a strategy that is designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection and to protect against the widest variety of potential threats. Although decontamination of surfaces, personal decontamination, and respirators are important, they do not protect as widely as Standard Precautions do.
[11.3] Your unit arrives first at the scene of a tractor-trailer motor vehicle crash. Your partner notes that he sees hazardous materials placards on the truck. You should first: A. immediately leave the scene. B. use your intercom to ask the driver to come to the ambulance. C. stage in place, uphill and upwind from the scene. D. approach the truck to identify the placard.
C The placards identify a possible hazardous material and a potential scene safety threat. You should stage uphill and upwind until the substance has been identified. Victims should not be asked to leave the scene, as they could be contaminated. You should not leave the scene.
[11.5] Your patient, who is a known black belt martial arts instructor, is in the middle of the street attacking cars. When is it safe to approach him? A. After dispatch clears you to enter B. After another crew arrives C. After the police have subdued him D. After he has calmed down
C You are faced with an emotionally unstable patient who can be a significant threat if his anger is directed toward you. You should not approach him, even with another crew, without law enforcement presence. Once the police have the patient subdued, it is safe to approach him.
[11.3] Your ambulance has been dispatched to a multiple-car motor vehicle crash. Dispatch has alerted you that fire and rescue units are en route. As you approach the scene, you should: A. don personal protective equipment. B. review the trauma triage criteria. C. look and listen for other emergency units approaching from side streets. D. remove your seat belt to allow easy exit of the ambulance.
C You should always look and listen for other emergency vehicles as you approach the scene. Although personal protective equipment and the trauma triage criteria are important, the immediate risk is being struck by an oncoming vehicle. You should always consider safety first. You should never remove your seat belt in a moving vehicle.
[11.4] When there are no apparent hazards on the scene of an accident, how far away should the ambulance be parked? A. 25 feet B. 40 feet C. 20 feet D. 50 feet
D
[Chapter 11: Post-test] When arriving at the scene of a suspected trauma, you should try to identify how the patient was injured, which is also known as the: A. initial assessment. B. nature of illness. C. general impression. D. mechanism of injury.
D
[Chapter 11: Post-test] Which of the following is another term for Standard Precautions? A. Exposure response B. Full body coverage C. Level A protection D. Body substance isolation
D
[Chapter 11: Post-test] Which of the following patients is potentially the most unstable and dangerous to the EMT? A. A patient who had a couple of drinks three hours ago B. A patient who is a firearms instructor but is not armed C. A cordial and friendly patient offering a good history D. A patient with tense muscle tone and clenched fists
D
[Chapter 11: Post-test] Why is it important NOT to simply rush into a patient's house when you arrive on the scene? A. The photos on the walls in the patient's home will give you clues of what the patient likes to do. B. Because some calls do not require any equipment to be carried into the house. C. So that you can bring in the right stretcher. D. The scene should be sized up for threats and violence.
D
[Chapter 11: Post-test] You are dispatched to an accidental shooting at a residence. What would be your FIRST scene size-up act? A. Apply personal protective equipment. B. Secure the firearm. C. Verify the number of victims. D. Notify or confirm notification of law
D
[Chapter 11: Post-test] You were dispatched to treat a 41-year-old woman with unknown bleeding. You introduce yourself to the patient and identify that the bleeding was caused by a stab wound. The patient says that the perpetrator has left the premises. You should next: A. begin the primary assessment. B. leave the scene. C. identify the weapon. D. request law enforcement.
D
[Chapter 11: Post-test]When you respond to a private residence where multiple family members are complaining of headache and nausea, you should consider: A. whether they might have all been injured in a crash. B. whether they all go to the same school. C. whether the illness is related to their family. D. the possibility of CO poisoning and get everyone out of the house.
D
[11.8] An explosion has occurred at a local church. You are the first responding medical unit, and you note many patients lying in the street. After establishing incident command, you should next: A. return to the ambulance until additional resources arrive. B. begin caring for the closest patient. C. begin primary triage. D. call for additional resources and begin the scene size-up.
D Additional resources will absolutely be necessary, and so will a scene size-up. Although triage and treatment will be priorities, a size-up will help you to identify potential safety hazards before committing to the scene. You should not retreat to your ambulance unless you identify a safety hazard that would require this step.
[11.9] You are dispatched to a motor vehicle crash on a street in a residential neighborhood. As you pull up, you note that none of the houses along the street have lights on. You should suspect: A. that the residents are not yet home from work. B. a violent ambush. C. that the houses are not occupied. D. downed power lines.
D Homes that are blacked out along an specific area of a street suggest the possibility of downed power lines. Although violent ambush could be possible, downed lines are a much more plausible alternative. Houses may be unoccupied and residents may not be home, but neither of those are safety threats and should not be assumed before a dangerous possibility is ruled out.
[11.9] Which of the following findings at a motor vehicle crash would indicate that there may be more than one patient involved? A. The vehicle is an SUV. B. The car was overturned in a ditch. C. The vehicle has four doors. D. You find a woman's purse in the car, and a man was driving.
D If you arrive on scene and a male patient is driving but you find a woman's purse in the vehicle, it does not mean for certain that there is another patient somewhere, but it is important enough to ask the patient whether anyone else was with him in the car or to look around and ask bystanders whether they know of anyone else who was in the vehicle. Next Question
[11.8] A 77-year-old female complains of chest pain. When you arrive, her husband greets you at the front door. You note that he is out of breath, sweaty, and holding his chest. You should: A. immediately focus your attention only on him. B. assess his wife first but then return to him once you have confirmed that she is non-emergent. C. ask him where the patient is located. D. radio for an additional unit and have your partner assess him while you check on his wife.
D In this situation, a second patient has emerged in an unanticipated fashion. You should radio for an additional unit and have your partner assess the husband while you check on the wife. It will be important to conduct simultaneous assessments, as he could be the more severe patient.
[11.9] The need for additional assistance to deal with issues such as heavy rescue, potential violence, or mass-casualty incidents comes under which of the following phases of the scene size-up? A. Rescue operations B. Environmental hazards C. Personal protective equipment D. Resource determination
D Resource determination is the phase of the scene size-up in which the EMT determines what, if any, assistance is required. This decision may include both quantity of responders and specific types of resources, such as hazmat or rescue.
[11.9] An accident scene involving a chemical spill would likely require the additional resources of what entity? A. Rescue B. CISD C. Water rescue D. Hazmat
D The EMT must be alert to the possible presence of toxic substances or areas of low oxygen during the scene size-up. Some scenes, such as an accident involving a tanker truck, will present obvious hazards. At other scenes, the hazard may not be as obvious. To ensure your safety, always utilize the hazmat resources in your area.
[11.7] Which of the following would be indicated by a patient found sitting in a tripod position? A. A stroke B. Trouble swallowing C. Abdominal pain D. Respiratory distress
D The physical position and condition of the patient may provide information about the illness. A tripod position (sitting up and leaning forward) may indicate respiratory distress or cardiac compromise. Patients with respiratory distress rarely lie flat unless they are completely exhausted. A patient lying very still with his legs drawn up to his chest is likely suffering from severe abdominal pain. A fruity odor emanating from the patient may indicate a diabetic condition. Look for loss of bowel or bladder control, which may have resulted from a seizure or stroke
[11.1] The EMT's initial evaluation of the scene is called the: A. hazard assessment. B. primary assessment. C. initial assessment. D. scene size-up.
D The scene size-up is the EMT's initial evaluation of a scene to which he has been called. The purpose is to primarily determine whether the scene is safe to enter, but after this, the EMT also needs to determine things such as the number of patients, whether additional resources are needed, and what the mechanism of injury or nature of illness is. Although this includes a hazard assessment, it is not limited to that task. The primary assessment, also known as the initial assessment, would be the first point of assessment of the patient.
[11.7] You have just determined there are two patients to care for at an accident scene and have requested an additional ambulance. During what component of assessment do these activities take place? A. Primary assessment B. Reassessment C. Patient history D. Scene size-up
D These activities take place during the scene size-up. The scene size-up includes scene safety, standard precautions, determining the MOI or NOI, determining number of patients, and requesting additional resources.
[11.6] A 68-year-old female complains of respiratory distress. She says that she has been sick for three days, and she has a history of COPD. You note that she is coughing forcefully into a napkin. Which of the following would be the most appropriate personal protective equipment for use on this scene? A. Mask and eye protection B. Gloves and gown C. Gloves and eye protection D. Gloves, eye protection, and mask
D This patient is exhibiting signs of a respiratory illness. You should employ droplet protection in the form of gloves, eye protection, and a mask. The mask would protect against direct inhalation of droplets, the eye protection would protect the mucous membrane of the eyes, and the gloves would prevent secondary infection from contact with infected surfaces.
[11.6] You suspect that your patient may have tuberculosis. Which of the following should be added to your personal protective equipment? A. Gown B. Simple face mask C. Shoe covers D. N-95 mask
D Tuberculosis is a respiratory illness that is not stopped by simple face masks. You should add an N-95 mask to best protect against its spread. A gown and shoe covers would not be necessary.
[11.2] When assessing scene safety, the FIRST priority is: A. hazards to the public. B. treating the patient. C. bystander safety. D. your personal safety.
D Your personal safety is the top priority at any emergency scene. You have no duty to act if there is a threat of injury to you or your crew. Although each of the other selections is important, there is no higher priority than keeping yourself safe.
