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.