EMS CH 37 HOMEWORK 78 TERMS
Which of the following is needed for effective response to an MCI?
Requesting and managing necessary resources Requesting and properly managing adequate resources are required for efficient response to an MCI.
What are the three criteria for assessing patients during triage?
Respiration, pulse, and mental status Three functions are checked to assign patients to triage categories, represented by the mnemonic RPM: respiration, pulse, and mental status.
Where is the safest zone to provide medical care of a patient who has been covered with a hazardous material?
. In the cold zone after the patient has been decontaminated The hot zone is the location of the danger, the warm zone is where the decontamination corridor is located, and the cold zone is a safe location for treatment of patients who have been decontaminated.
Which of the following statements regarding a disaster plan is FALSE?
A disaster plan should be written to address any conceivable incident. A disaster plan should be written to address the events that are conceivable for a particular location (e.g., Kansas needs to plan for tornadoes, not hurricane
Which of the following settings should MOST make the EMT consider the likelihood of a hazardous materials incident?
A warehouse Of the choices listed, a warehouse is the setting most likely to present the possibility of a hazardous materials incident.
Which of the following must be assessed on a hazmat team member before he or she enters the hot zone?
Baseline vitals Vitals must be taken before and after a team member suits up and works in the hot zone.
Which of the following findings would result in a patient at an MCI being categorized as yellow in START triage?
Breathing <30 times per minute, radial pulse present, alert To be placed in the yellow category in START triage, a patient must not have been able to move with the walking wounded but must be breathing less than 30 times per minute, have a radial pulse or capillary refill less than 2 seconds,and be alert.
Which of the following is considered a valuable informational resource in dealing with hazardous materials incidents?
CHEMTREC CHEMTREC is a 24-hour hotline operated by the American Chemistry Council
Which of the following BEST describes secondary triage?
Checking the same criteria as in primary triage after the patient reaches the triage area to determine whether a patient'spriority should be upgraded or downgraded Secondary triage refers to the process of reassessing findings from primary triage to reclassify the patient if necessary.
Flammable solids, substances that are dangerous when wet, and spontaneously combustible materials are:
Class 4 materials. In the hazard classification system, Class 4 materials include flammable solids, spontaneously combustible materials, and materials that are dangerous when wet.
In which of the following areas at a hazmat incident are normal triage, stabilization, and treatment performed?
Cold zone The cold zone is the area at a hazmat incident that is adjacent to the warm zone and is where normal treatment is performed.
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 In general, treatment is not performed during triage. However, immediate control of severe bleeding can keep a patient who is otherwise salvageable from deteriorating, which would then require additional resources.
No minimum training hours are required for which level of training?
First Responder Awareness Most EMTs are required to be trained to the First Responder Awareness level, which has no minimum required training hours. Rescuers at this level are likely to witness or discover a hazardous substance release. They are trained only to recognize the problem and initiate a response from the proper organizations.
Which level of training is required for hazardous materials responders who are first on the scene to protect people, property, and the environment?
First Responder Operations The First Responder Operations level of training is required for those who respond initially to hazardous materials incidents to protect life, property, and the environment.
To command activities at a hazardous materials incident site, the minimum level of training necessary is:
Hazardous Materials Specialist. A Hazardous Materials Specialist is expected to have advanced knowledge and skills and to command and support activities at the incident site.
It is characteristic of a disaster plan to be all of the following EXCEPT which one?
Impractical A disaster plan is designed to be achievable, and it is based on the actual availability of resources, not the best-casescenario in which resources are abundant or unlimited.
If an EMS unit is the first to respond to a multiple-casualty incident, which role does the most senior EMT assume?
Incident commander The most senior first-arriving EMT assumes incident command until additional resourcesarrive, at which time command is transferred to the most appropriate leader to manage the situation.
The characteristics of a rehab area include all of the following EXCEPT which one?
Large enough to accommodate a single crew A rehab center must be large enough to accommodate multiple crews.
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. All clothing and equipment that is worn or used in the warm or hot zones must be left at the scene for proper clean-up or disposal.
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. Do a quick walk through the scene (or if it is a hazmat scene, observe from a safe distance) and assess the number ofpatients, hazards, and degree of entrapment. Identify the number of patients, including the "walking wounded," apparent priority of care, need for extrication, number of ambulances needed, other factors affecting the scene and corresponding resources needed to address them, and areas where resources can be staged.
Which of the following BEST describes the patients who are assigned to the green category in triage?
Minor The green category is used for patients with minor injuries, often referred to as "the walking wounded."
Which warning placard is diamond-shaped and divided into four smaller diamonds?
NFPA 704 System A commonly used placarding system is the National Fire Protection Association (NFPA) 704 System. It uses numerical and color coding to show the type and degree of health hazard, fire hazard, reactivity, and specific hazard contained within a fixed facility. The placard uses a diamond shape divided into four smaller diamonds for the different types and degrees of hazards.
Which of the following is LEAST likely an effect of a hazardous material?
Scalds if heated too high Water scalds if heated too high and is not a hazardous material. The other effects are self-produced by the materials themselves and are the effects of certain hazardous materials.
Which of the following must be done before leaving the warm zone and entering the cold zone at a hazmat incident?
Shed all contaminated clothing. Before entering the cold zone at a hazmat incident, the rescue team that was in the hot zone must be decontaminated and shed all their contaminated clothing.
What does the triage mnemonic START stand for?
Simple triage and rapid treatment The mnemonic START stands 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 Ambulances wait in the staging area until requested for patient transport.
You are START triaging a child who is not breathing. When you have opened the airway, the child does not begin breathing. Which of the following is the CORRECT next step?
Tag the child as "black" and move on. In START triage, a patient is categorized as "black" if, after opening the airway, you discover that there is no pulse.
During START triage, you encounter an adult patient who is not breathing. Which of the following actions is the NEXT step you should take?
Open the airway and reassess breathing. In START triage, open the airway of a patient who is not breathing. If the patient begins breathing and can maintain his or her airway, categorize the patient as red. If he or she does not begin breathing, categorize the patient as black.
Which of the following would place a patient as a priority 1 or red during START triage?
Respirations >30 per minute, absent radial pulse, and altered mental status over 30, absent radial pulse, and altered mental status are criteria for category 1 or red.
Which of the following is a reference that provides the names of chemicals and concise but thorough descriptions of the actions that should be taken in case of a hazmat emergency?
The Emergency Response Guidebook The North American Emergency Response Guidebook (ERG) is a resource that provides the names of chemicals and concise but thorough descriptions of the actions that should be taken in case of a hazmat emergency.
Which of the following is the BEST choice for triage supervisor?
The most knowledgeable EMS provider The most knowledgeable EMS provider is the best choice for triage supervisor.
Which of the following must be identified in hazardous materials shipping papers?
The origin of the shipment The exact name of the substance, the quantity of the substance, its origin, and its destination are required information on shipping papers.
Who is responsible for overseeing ambulances and ambulance personnel at an MCI?
The staging supervisor The staging supervisor is responsible for overseeing ambulance operations at an MCI.
During triage of a six-year-old patient, you discover that she is awake, breathing 28 times per minute, has a palpablepulse, and responds to verbal stimuli. The patient is NOT ambulatory. What is the CORRECT triage category for thispatient?
Yellow The patient's vitals and LOC along with the patient's non-ambulatory status make her a category yellow.
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.
To be classified as "walking wounded" in primary triage, a patient:
must have only minor musculoskeletal or soft-tissue injuries. To be classified as "walking wounded" in primary triage, a patient must have only minor musculoskeletal or soft-tissue injuries.
Priority 3 patients are also known as:
walking wounded. Priority 3 patients are the "walking wounded."
A decontamination corridor would be established in the:
warm zone. Establish a decontamination corridor (area where patients will be decontaminated) in the warm zone, an area immediately adjacent to the hot zone.
Which of the following is a 24-hour resource operated by the American Chemistry Council?
CHEMTREC CHEMTREC, a 24-hour hotline for hazardous materials resources, is a service of the American Chemistry Council. They can provide your dispatcher or you with information about a hazardous material through a twenty-four-hour toll-free telephone number for the United States and Canada.
Which of the following statements BEST describes primary triage?
An initial determination of each patient's priority for treatment and transport The purpose of primary triage is to determine each patient's priority for treatment and transport.
Which of the following tasks must be accomplished before a patient can leave the warm zone?
Decontamination Patients must be completely decontaminated before entering the cold zone in order to avoid secondary contamination ofresponders, equipment, ambulances, and other personnel.
Which of the following should immediately increase your suspicion of a hazardous materials incident?
Emergency site at a factory Hazardous material incidents are especially likely to take place at factories; along railroads; and on local, state, and federal highways.
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 theprocess?
Opening the airway You must rapidly assess each remaining patient, stopping only to secure an airway or stop profuse bleeding. It is important that you not develop "tunnel vision"long dash spending time rendering additional care to any one patient and thus failing to identify and correct life-threatening conditions of the remaining patients.
Which of the following statements BEST describes the treatment that is acceptable during triage in MCIs?
Opening the airway and controlling severe bleeding You must rapidly assess each remaining patient, stopping only to secure an airway or stop profuse bleeding. It is important that you not develop "tunnelvision"long dash spending time rendering additional care to any one patient and thus failing to identify and correctlife-threateningconditions of the remaining patients
Which of the following is the BEST description of a safety data sheet (SDS)?
Papers kept on site with hazardous chemicals A safety data sheet (SDS) is kept on file at the site where there are hazardous chemicals. These sheets must be maintained at the work site by the employer and available to all employees on the grounds, because employees working with hazardous materials have a right to know about them. If you can safely obtain these sheets, they generally name thesubstance, its physical properties, fire and explosion hazard information, health hazard information, and emergency first-aid treatment.
Which statement BEST describes the use of the "black" category in START triage?
Patients who are deceased or who are expected to die because they cannot maintain their airway or breathing The "black" category is for deceased or "expectant" patients.
Which of the following statements BEST explains the difference between primary triage and secondary triage?
Patients' conditions may stabilize or deteriorate after primary triage has assigned them a priority based on their condition,requiring reassignment of priority for treatment and transport in secondary triage. Secondary triage is performed after primary triage to detect any changes in the patients' priority for transport.
Which of the following is a basic principle of disaster preparedness planning?
Prepare a plan that is specific, practical, and well-understood. Preparing a plan that is specific, practical, and well-understood is a basic principle of disaster preparedness. The plan must be focused on events conceivable for the area, realistic, well-publicized, and rehearsed.
At an MCI, which of the following is performed when the EMT FIRST encounters an injured patient?
Primary triage The first process that is performed when an EMT encounters a patient at an MCI is primary triage.
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. Once patients have been properly assessed and triaged, and once treatment for the patients has been initiated according to their priority, consideration must be given to the order in which the patients will be transported to a hospital. This is done according to triage priority.
Which of the following has the HIGHEST priority at a hazardous materials incident?
Protecting the safety of all rescuers and patients The highest priority concerning hazardous materials is given to protecting the safety of all rescuers and patients.
In addition to toxicity and flammability, which of the following is among the harmful properties of hazardous materials?
Reactivity The three principle ways in which hazardous materials are dangerous are through their toxicity, flammability, and reactivity.
Which of the following hazards is represented by the yellow area on an NFPA placard?
Reactivity The yellow area of an NFPA placard represents reactivity hazards.
The highest priority for treatment and transport at an MCI are patients who are triaged to which of the following categories?
Red Patients who are categorized as red are those with the most immediately life-threatening injuries. They are the highest priority for treatment and transport.
A patient at an MCI is unresponsive but breathing 24 times per minutes with a strong radial pulse. To what triage category should the patient be assigned?
Red This patient meets criteria for the red category because he cannot follow commands.
Which of the following statements regarding a small-scale MCI that expands into a large-scale MCI is MOST accurate?
There will be more variables for the responding EMTs to consider over a longer timeframe. Though the principles of managing small- and large-scale MCIs are generally the same, large-scale MCIs unfold over a longer period of time and require greater support from outside agencies. Well-trained and practiced EMTs can usually cope with a small-scale MCI pretty well. However, experience has shown that even the best-trained EMTs have a difficult time managing an incident of greater magnitude.
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. Hazardous Materials Specialists have advanced knowledge and skills and provide command and support at the site of hazardous materials incidents
Which of the following BEST describes the use of secondary triage?
To reevaluate the treatment priorities designated during primary triage The purpose of secondary triage is to reevaluate the decisions that were made in the primary triage process.
Which of the following statements BEST describes primary triage?
To reevaluate the treatment priorities designated during primary triage The purpose of secondary triage is to reevaluate the decisions that were made in the primary triage process.
Which of the following words BEST describes the attitude EMTs should have when responding to an MCI?
Vigilant It is important for the responder to be vigilant for unhealthy behaviors brought about by stressful events.
only those individuals who are directly subordinate to Command.
You should open a patient's airway and control severe bleeding. During primary triage, you must rapidly assess each remaining patient, stopping only to secure an airway or stop profuse bleeding. It is important that you not develop "tunnel vision"long dash spending time rendering additional care to any one patient and thus failing to identify and correct life-threatening conditions of the remaining patients.
Surge capacity refers to:
a measurable representation of ability to manage a sudden influx of patients. Surge capacity is a measurable representation of ability to manage a sudden influx of patients. It is dependent on a well-functioning incident management system and the variables of space, supplies, staff, and any special considerations(contaminated or contagious patients, for example).
Hazardous material is:
any material that poses an unreasonable risk to life, health, or property. A hazardous material is any substance or material in a form that poses an unreasonable risk tohealth, safety, and property when transported in commerce or kept in storage at a warehouse,port, depot, or railroad facility.
A multiple-casualty incident is:
any medical or trauma incident involving multiple patients. A multiple-casualty incident is any medical or trauma incident involving multiple patients.
You respond to a call for multiple medical patients who all passed out at the same time while working at a chemical processing plant. You strongly suspect a hazmat incident. Keeping your distance from the scene of the incident, you must:
attempt to identify the hazardous material and assess the severity of the situation. You must make an attempt to identify the hazardous material and assess the severity of the situation. Until that is done, it will be difficult to determine the risk to the public, rescuers,patients, and the environment. You must try to find out what the substance is and what its properties and dangers might be; whether or not there is imminent danger of the contamination spreading; what you can hear, see, and smell; how many patients are involved;and if there is any danger of secondary contamination from the patients.
EMS providers who become emotionally incapacitated during an MCI should be:
treated as patients. EMS workers who become emotionally incapacitated should be treated as patients.
Identification of chemical hazards starts with:
awareness and knowledge of what exists in the community. Identification of chemical hazards starts with awareness and knowledge of what exists in the community. Spend some time with local police and fire agencies, and learn about or developpre-incident plans for common hazardous materials. Local emergency management agencies often have joint hazardous material training sessions and exercises. Take time to participate in these types of sessions and learn how to work with other public safety providers.
Psychological first aid involves:
caring, honest engagement with patients in emotional distress. Psychological first aid involves caring, honest engagement with patients in emotional distress.
Division 1.6 of the hazard classification system identifies:
extremely insensitive detonating articles. Class 1 of the hazard classification system is explosives. Division 1.6 is extremely insensitive detonating articles.
A substance is LEAST likely to be a hazardous material if it:
forms part of a daily diet. No material that could be part of a daily diet could be a hazardous material. The other effects are hazards produced by various hazardous materials.
First-cut primary triage involves:
identifying the walking wounded. The first triage cut can be done rapidly by using a bullhorn, PA system, or loud voice to direct all patients capable of walking (Priority 3) to move to a particular area. This has a two-foldpurpose. It quickly identifies the individuals who have an airway and circulation, and it physically separates them from patients who will generally need more care.
Emotionally incapacitated EMTs:
may not return to duty even after they have rested. EMTs who become emotionally incapacitated should be treated as patients and removed to an area where they can rest without viewing the scene. These patients must be monitored by an EMS provider until a clinically competent provider can take over. These EMTs should not be allowed to return to duty. They should be evaluated by a trained medical professional who can properly assess psychological health.
Ideally on the scene of an MCI, those who directly communicate with Command should be:
only those individuals who are directly subordinate to Command. The flow of communications at the scene of a large-scale MCI should correspond to the organizational chart being used. Accordingly, the only unit talking to the communications center and requesting resources is Command. The only ones who talk to Command are those directly subordinate to Command. All others talk to only the officer or supervisor they are assigned to. These mandates should be addressed in your standard operating guidelines.
The plan for a large-scale MCI:
should be a logical extension of the plan for a small-scale MCI. For any MCI plan to be effective, it must be flexible and expandable enough to be used from small three-patient incidents to large-scale incidents of fifteen or more patients. In other words, the plan for "the big one" should be a logical extension of the same plan used to manage smaller incidents.
If arriving units are not needed right away, they should wait in the:
staging area. Arriving units should wait in the staging area until they are needed.
A large-scale MCI creates a situation that:
tests the capabilities of even the best-trained EMTs. Though the principles of managing small- and large-scale MCIs are generally the same, large-scale MCIs unfold over a longer period of time and require greater support from outside agencies. Well-trained and practiced EMTs can usually cope with a small-scale MCI pretty well. However, experience has shown that even the best-trained EMTs have a difficult time managing an incident of greater magnitude.
To identify the exact substance an overturned chemical truck was carrying, the EMT would consult:
the bill of lading. Check invoices, bills of lading (trucks), and shipping manifests (trains). If you can safely obtain them, these documents will identify the exact substance being transported, the exact quantity, its place of origin, and its destination.
The person responsible for communicating with sector officers and hospitals to manage transportation of patients to hospitals from a multiple-casualty incident is the:
transportation supervisor. The transportation supervisor is the person responsible for communicating with sector officers and hospitals to manage transportation of patients to hospitals from a multiple-casualty incident.