REVIEW!! Scene Size-Up

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Which one of the following is true about dispatch​ information? A. Callers may deliberately provide false information. B. Callers only report accurate information. C. Routine calls automatically alert the emergency medical technician​ (EMT) to be cautious. D. It generally does not provide enough information to anticipate needed personal protective equipment​ (PPE).

A Callers may deliberately provide false information. Callers at times may deliberately give inaccurate information. For​ example, a caller may report chest pains when the problem is a stabbing or a gunshot wound. If the caller had reported the​ facts, it is likely that law enforcement personnel would also have been​ dispatched, something the caller wished to avoid.

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. There are four badly damaged vehicles involved. What would your NEXT action​ be? A. Contact dispatch and request additional EMS units. B. Begin triage. C. Position the ambulance to protect the scene. D. Determine the number of victims.

A Contact dispatch and request additional EMS units. 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 prior to 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 involved with patient care.

When approaching a possible crime scene in the​ dark, why is it recommended that you hold your flashlight out and to the side of your​ body? A. If someone is waiting to harm responding emergency​ personnel, they will most likely aim at the​ light, under the assumption that it is being held directly in front of the carrier. B. If you are carrying the jump kit in one​ hand, it will help to prevent back injuries by balancing the weight more effectively. C. It will be easier to illuminate your feet and watch where you​ walk, ensuring that you do not step on potential evidence. D. It will light the path better for any partners who may be walking behind you.

A If someone is waiting to harm responding emergency​ personnel, they will most likely aim at the​ light, under the assumption that it is being held directly in front of the carrier. If you are using a​ flashlight, hold it​ beside, not in front​ of, your body so that you​ don't make your body a possible target. Only the first person in line should carry a flashlight because anyone with a flashlight behind the first person will backlight those in front. It is not an issue of balancing the weights you may be carrying because a flashlight is considerably lighter than your gear bag.​ Also, lighting the path and illuminating your feet are less relevant than the risk of making yourself a potential target.

What is the BEST course of action the EMT on scene can take when she learns that there are more patients than the immediate resources can​ handle? A. Institute the MCI plan. B. Care only for the most ill or injured patients. C. Immediately transport the most critical patients. D. Care only for the most stable​ patients, as they are most likely to live.

A Institute the MCI plan. If you discover that conditions at a scene are beyond your ability to​ handle, call for additional resources. Such resources may include law​ enforcement, fire,​ rescue, or utility company​ personnel; a hazardous materials​ team; or an additional basic life support unit or advanced life support team.​ If, after studying the​ scene, you determine that there are more patients than your unit can effectively​ handle, initiate your local​ multiple-casualty plan. Follow local protocols in doing so.

The EMT obtains a call from dispatch to respond for a victim down on the street. Which statement made by dispatch should alert the EMTs there is an increased risk of​ danger? A. Shots fired in the street B. Single motor vehicle accident C. Child choking at a restaurant D. Person is intoxicated

A Shots fired in the street Reports of shots fired should always alert the EMT to be cautious. An intoxicated​ person, a child choking at a​ restaurant, and a single motor vehicle accident would not increase the level of danger for the EMTs who respond.

You arrive on scene for a motor vehicle collision​ (MVC) on a freeway. At this​ time, state patrol still has the outside lane of the highway open for traffic. You are​ concerned, however, for your safety while operating at the scene. What should you​ do? A. Tell the state trooper to close the freeway temporarily. B. Only care for the most critical patients. C. Do nothing until more EMS help arrives. D. Move all the patients to the side of the road before beginning treatment.

A Tell the state trooper to close the freeway temporarily. An EMT will not be able to perform​ safely, let alone​ efficiently, if they are concerned for their safety at the scene of an MVC. As​ such, the EMT has the right to have the police shut down the freeway to make the scene safer until all patients have been transported.

You are called to the scene of a motor vehicle accident. As you approach the​ scene, you notice that no law enforcement is present and that an auto has left the roadway and struck a​ tree, causing moderate damage. The driver is still in the vehicle and is talking to a bystander. As you get​ closer, you notice a mangled tricycle near the edge of the roadway. In terms of scene​ size-up, what is your most important​ suspicion? A. There may be a critically injured victim that is not readily visible. B. The driver of the auto is not seriously injured. C. You should position the ambulance between traffic and the tricycle. D. You should have dispatch call the police.

A There may be a critically injured victim that is not readily visible. An important quality for the EMT to have is being able to​ "read" the scene and determine whether there may be additional patients who are not readily accounted for. In this​ situation, while you do not have enough information to determine the actual condition of the​ driver, the scene would indicate that there might be another victim whom you need to either locate or rule out the presence of. The tricycle may have been parked in the​ roadway, but the rider may also be under the car.

Principles of scene safety that should be followed by the EMT are best exemplified​ by: A. calling for assistance if a scene is outside your area of training or expertise. B. disarming​ and/or restraining violent patients as soon as possible. C. learning how to use your EMS equipment as offensive weapons. D. removing patients from hazardous areas.

A calling for assistance if a scene is outside your area of training or expertise. Under certain​ circumstances, the EMT may need to call upon additional specialized resources that are beyond the capabilities of the responding EMS providers. These would include water​ rescue, high angle​ rescue, utility​ services, and law enforcement. EMTs should not attempt to disarm a patient or remove the patient from a hazardous area they are not equipped and trained​ for, as this violates the principle of scene safety. EMTs should use their equipment in a physical altercation ONLY if necessary and ONLY as a defensive weapon.

In a patient with a medical​ condition, your scene​ size-up helps you to determine​ the: A. nature of the illness. B. chief complaint. C. specific age of the patient. D. mechanism of injury.

A nature of the illness. In a patient who is not injured but is suffering from a medical​ condition, you will begin to determine the nature of the illness​ (NOI) during scene​ size-up. The​ patient, relatives,​ bystanders, or physical evidence at the scene may provide you with clues to determine from what the patient is suffering. 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. The mechanism of injury is for trauma​ patients, the age of the patient has nothing to really do with​ it, and the chief complaint is what the problem is that is bothering the patient. For​ example, the chief complaint can be​ "chest pain," but that chest pain could come from a knife wound​ (MOI) or from a cardiac problem​ (NOI).

Although MOST calls to which the EMT responds go by​ uneventfully, the EMT should stay aware of being surrounded by a large crowd for all of the following​ reasons, EXCEPT: A. the number of children in the crowd watching you. B. fighting or loud voices. C. weapons visible or in use. D. signs of alcohol or drug use.

A the number of children in the crowd watching you. If a crowd has gathered before your​ arrival, assess the crowd. Be aware that the size of the crowd is less important than its mood. Is the scene​ chaotic? If​ so, do not allow yourself to be pulled into the chaos. Is the scene​ hysterical? Again, do not be pulled in. Does the crowd seem hostile to your​ presence? If it​ does, your options include retreating until appropriate backup arrives or taking the patient and leaving. You may also witness drug or alcohol​ abuse, see​ weapons, or hear loud​ voices; all of these are a concern. Children would be the least likely concern at this scene.

You are dispatched to the scene of a child bitten by a dog where the fire department has already responded. What step of scene​ size-up can you begin to perform prior to​ arrival? A. Instruct bystanders on bleeding control. B. Determine from dispatch if the animal is secured. C. Place the trauma kit in close proximity. D. Establish the seriousness of the bite.

B Determine from dispatch if the animal is secured. Determination that the animal is secured can be made by​ on-scene fire department personnel 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. It would be difficult to establish the seriousness of the bite until you are bedside with the​ patient, and instructing bystanders on bleeding control is the task of the EMD. Placing your equipment around the patient is accomplished only after you have arrived on scene.

You are dispatched for a call with a patient with chest pain. You arrive on scene at a residential address. You approach the scene​ carefully, and upon entering the​ scene, you find a male patient on the floor who has been shot in the chest. You can hear voices coming from another​ room, but you are not sure who the people are. What would be your best course of​ action? A. Provide treatment of immediate life threats and then leave the scene. B. Exit the scene and call for law enforcement. C. Call for law​ enforcement, and then begin care. D. Provide treatment of immediate life threats only.

B Exit the scene and call for law enforcement. Assessment of the scene for safety issues is always a dynamic situation. In this​ case, the call came in as​ "chest pain"​ (which certainly the patient​ had), but the caller probably realized that if he 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.

Which of the following scenes would MOST likely have more than one​ patient? A. Call to a grocery store of abdominal pain B. High school basketball playoff game where a fight reportedly broke out C. Dispatch tells that you are responding to a call for chest pain D. Construction site where a piece of heavy machinery rolled over

B High school basketball playoff game where a fight reportedly broke out The EMT must always remain dynamic about the changing characteristics of a scene because dispatch information is only as good as the information the caller is giving dispatch.​ However, if you keep in mind an index of​ suspicion, given the nature of competitive sports during a playoff​ game, if a fight breaks​ out, it will typically involve numerous people. At a construction​ site, the rollover of a piece of machinery will likely involve fewer people​ (if not just​ one), and information from dispatch about a chest pain or abdominal pain patient also is more likely to mean just one patient.

Any type of equipment that is used to reduce your risk of personal injury or illness is referred to​ as: A. PEP. B. PPE. C. SSD. D. BSO.

B PPE. Before arriving on the​ scene, you must anticipate what Standard Precautions and other personal protection is necessary. Equipment that you put on to reduce your risk of personal injury or illness is called personal protective equipment​ (PPE). This may range from simple examination gloves to a complex breathing apparatus and suits that are used in a toxic environment.​ PEP, BSO, and SSD are all fictitious abbreviations.

You are on the scene of a house​ fire, standing by in case someone is injured. Over​ time, more and more bystanders are starting to stop and watch what is going on. You suddenly hear a loud explosion from the house that causes windows to be blown out and flames to erupt from the roof. What should you do​ first? A. Inform dispatch of what you just witnessed. B. Tell the bystanders they must move further away. C. Start to move toward the burning house in case someone was just injured. D. Drive the ambulance to a safe location.

B Tell the bystanders they must move further away. At any​ scene, the​ EMT's first responsibility is to ensure the safety of​ themselves, their​ partner, the​ patient, and any bystanders. In this​ situation, the​ EMT's first action should be to move the bystanders to a safe location should a second explosion should occur. Moving the ambulance is also​ important, but it does not supersede the need to prevent further loss of life or injury.

The recent study A National Description of Violence toward Emergency Medical Services Personnel​ states: A. male providers are more likely to experience physical violence. B. close to half of the participants had experienced physical abuse. C. spitting was the most common type of physical violence. D. physical violence is the most common type of abuse.

B close to half of the participants had experienced physical abuse. In a recent study published in Prehospital Emergency Care​, A National Description of Violence toward Emergency Medical Services​ Personnel, the authors found that​ 69% of the​ (1,789) emergency medical service​ (EMS) personnel​ studied, had experienced some form of violence over the preceding 12 months while providing EMS care. Verbal abuse was more common​ (67%) compared to physical violence​ (43.6%). However, the prevalence of physical violence is alarming in that it occurred to close to half of the EMS providers surveyed. The types of physical violence include​ punching, slapping, or scratching​ (32.9%); spitting​ (29.6%); biting​ (11.1%); being struck with an object​ (8.9%); stabbing or attempted stabbing​ (2%); and, shooting or attempted shooting​ (1.2%). These acts of violence or verbal abuse are committed by the​ patient, family​ member, or a bystander. The study also found that female EMS personnel were more likely to experience physical violence than male EMS providers.

The process of ensuring scene safety​ is: A. done quickly and done once. B. dynamic and ongoing. C. not the job of the EMT. D. accomplished early in the assessment.

B dynamic and ongoing 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. In​ addition, because scenes can be dynamic in nature and always shifting in​ activity, assuring scene safety is an ongoing process.

Just as protection from traffic at the scene of a collision is important to the​ EMT, the EMT should also conduct a systematic scene​ size-up to: A. find out the​ patient's medical history. B. protect herself from violence. C. determine the chief complaint. D. determine the mechanism of injury.

B protect herself from violence. The first phase of assessment is the scene​ size-up, in which the EMT should ensure that the scene is safe for​ herself, her​ partner, the​ patient, and bystanders. If the scene is not safe for whatever​ reason, the EMT has no duty to act on behalf of the patient. The EMT should always protect herself and her crew from violence with a systematic scene​ size-up. Determining the mechanism of​ injury, the​ patient's chief​ complaint, and the past medical history of the patient are done after the scene has been ensured to be safe for anyone who enters.

As an​ EMT, your initial evaluation of the scene is called​ the: A. initial assessment. B. scene​ size-up. C. hazard assessment. D. primary assessment.

B scene​ size-up. The scene​ size-up is the​ EMT's initial evaluation of a scene. The primary purpose is to determine whether the scene is safe to​ enter, but following​ 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. The primary survey​ (previously called the initial​ assessment) is to determine whether there are life threats present to the patient. The hazard assessment is a fictitious term.

When you respond to a private residence and there are multiple family members complaining of headache and​ nausea, you should​ consider: A. whether they might have all become injured in a crash. B. the possibility of CO poisoning and get everyone out of the house. C. whether the illness is related to their family. D. whether they all go to the same school.

B the possibility of CO poisoning and get everyone out of the house A toxic environment will generally cause all people within it to suffer from similar symptoms.​ Therefore, the EMT who is called to a residence in which all occupants exhibit similar signs and symptoms must assume that the environment is toxic until it has been proven not to be. Faulty furnaces cause such problems every winter. The EMT who encounters this situation during the winter months should be prepared to consider the possibility of carbon monoxide poisoning. A blocked flue on a​ gas-powered hot water tank can produce the same problem in a​ closed, air-conditioned residence at the peak of summer.

The ambulance arrives on scene with the EMTs and paramedic. Which finding would necessitate calling for additional​ assistance? A. Person lying face down in a pool B. Victim in cardiac arrest C. Downed power line D. Person with nausea and vomiting

C Downed power line A downed power line would necessitate calling for assistance from the power or utility company. An ambulance staffed with an EMT and a paramedic should be able to manage a victim in cardiac​ arrest, a person with nausea and​ vomiting, and a person lying face down in a pool without calling for outside help due to hazards.

What concept is applied when the EMT attempts to determine how the patient may have been​ injured? A. Historical account B. Nature of call C. Mechanism of injury D. Scene hazards

C Mechanism of injury 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 provides only a degree of suspicion of the types of injuries. It does not provide any indication of the actual injuries or condition. Scene hazards are a threat to​ you, nature of call is what dispatch infers about the emergency from the​ caller, and historical account is a fictitious term.

Be very alert for severe trauma to what anatomical regions of the body when responding to snowmobile and​ all-terrain vehicle​ crashes? A. Wrists and shoulders B. Ankles and knees C. Neck and airway D. Pelvis and femur

C Neck and airway ​Snowmobiles, also known as snow​ machines, and​ all-terrain vehicles​ (ATVs) are commonly operated on uneven terrain at fast​ speeds, two factors that contribute to rollovers.​ Crush-type injuries are​ common, as are injures to the neck and face​ (airway) from the rollovers. With these​ vehicles, be especially alert for​ "clothesline" type injuries. In these​ injuries, a rider is pulled off the vehicle by a low​ branch, wire,​ rope, or other​ low-hanging object. Severe trauma to the neck and airway is common with this type of crash.

You are approaching a victim of a motor vehicle accident still sitting in the car. The patient is carrying on a conversation with a bystander outside the window and appears conscious and well oriented. As you approach the open​ driver's door, you notice that the air bag never​ deployed, the steering wheel is​ bent, and there is a starburst on the windshield. What is the MOST important conclusion you can draw from this​ observation? A. The patient may have chest injuries he does not realize. B. You should immediately fit a cervical collar. C. The air bag may still​ deploy, injuring you or the patient. D. The patient may have a head injury.

C The air bag may still​ deploy, injuring you or the patient. While all the choices are important​ considerations, deployment of the airbag 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. Fitting a cervical collar may be​ important, but it does not replace the need for you to keep yourself safe.

It is a hot sunny day and you are dispatched to the scene of a​ 62-year-old man complaining of shortness of breath. On your arrival you are waved into the backyard where the man is lying on the​ ground, behind a push​ mower, in respiratory distress with stridor. In terms of​ NOI, which of the following should be a primary consideration prior to executing a treatment​ plan? A. The neighbor should be able to provide you with an accurate accounting of the incident. B. If not in the​ shade, he should be immediately moved there. C. The nature of your​ patient's illness may be very different from his chief complaint. D. He should not be exerting himself in such heat.

C The nature of your​ patient's illness may be very different from his chief complaint Your patient may be suffering from respiratory​ disease, a cardiac​ problem, an allergic​ reaction, or a toxic exposure. All of these could fit the NOI of a patient lying behind a lawn mower outside in the sun with dyspnea. Remember that your initial NOI may not always agree with what the actual medical emergency​ is; this will be confirmed by your history and physical exam of the patient.

Why is it important NOT to simply rush into a​ patient's house when you arrive on the​ scene? A. Because a family member or a home health care provider who may currently be en route may want to assess the patient first. B. Because some calls do not require any equipment to be carried into the house. C. The scene should be sized up for threats and violence. D. You can be sure to bring the correct equipment into the house with you.

C The scene should be sized up for threats and violence. Personal protection of the EMT is of primary importance. An injured or helpless EMT cannot provide emergency care to a patient. In​ addition, attention and resources may be diverted from the patient to the injured​ EMT, risking further compromise to the patient. You must study each and every scene carefully and determine whether it is safe to approach the patient. This determination must be made on all​ responses, but different scenes will present different characteristics to consider.

Which of the following findings at a motor vehicle collision​ (MVC) would BEST indicate that more than one patient may be​ involved? A. The car was overturned in a ditch. B. The vehicle has four doors. C. You find a​ woman's purse in the car and a man was driving. D. The vehicle involved was a SUV.

C You find a​ woman's purse in the car and a man was driving. If you arrive on scene and a male patient is driving but you find a​ woman's purse in the​ vehicle, it does not necessarily mean 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. The fact that the car has four doors does not necessarily mean that multiple people were in​ it, nor does the fact that it was an SUV or a vehicle overturned in a ditch.

An accident scene involving a chemical spill would likely require the additional resources of what​ entity? A. CISD B. Rescue C. Water rescue D. Hazmat

D Hazmat 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. The term​ "rescue" has multiple meanings depending on the context in which it is being used. Water rescue is reserved for situations involving a body of water. A CISD is an event for providers who were involved in a particularly difficult scene or situation that may have negative effects on the​ providers' mental health.

You are alongside a busy highway for a​ two-car MVC, and will be loading the patient into the ambulance in about 5 minutes. Traffic has just been opened up again by the local police. Which of the following statements is most​ correct? A. Do not load the patient until an EMS supervisor can arrive to watch for oncoming traffic. B. Immediately enter the ambulance and have the fire department​ (FD) load the patient into the ambulance. C. Disregard the passing​ traffic, as they will automatically avoid your scene. D. Keep an eye on the passing traffic for the safety of yourself and your crew.

D Keep an eye on the passing traffic for the safety of yourself and your crew. EMS providers should always dedicate someone to watch passing traffic and provide a warning about any issues that may arise. If there is not a person to dedicate to​ this, all EMS providers should maintain situational awareness of the passing traffic. Waiting for an EMS supervisor to arrive may take too long and delay​ care, making the FD load the patient does not offer them any​ safety, and assuming that the passing traffic will automatically miss you is a potentially fatal assumption to make.

As you approach the scene of an automobile​ accident, you notice that law enforcement is NOT present. Which of the following should be your initial action during the scene​ size-up? A. Put on the additional personal protection equipment that you determine you will need. B. Park your unit in a location that will protect the scene. C. Establish whether there are any victims who will require transport. D. Radio dispatch to verify that the police are en​ route, and stage your ambulance to help protect the scene.

D Radio dispatch to verify that the police are en​ route, and stage your ambulance to help protect the scene. Verifying that the additional resources you will need have been notified should be done​ immediately, as it may take time for them to arrive. The other​ choices, while all​ necessary, can be conducted after this process is started.

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. Personal protective equipment B. ​MOI/NOI determination C. Environmental hazards D. Resource determination

D Resource determination Because getting backup requires extra​ time, this phase is critical. A prompt call to your dispatch center can save critical minutes in a​ life-threatening situation, even before you arrive. Environmental hazards are those things such as weather and terrain that complicate the scene.​ MOI/NOI determination refers to the basic category​ (medical or​ trauma) into which the patient fits on the basis of what is wrong and how it happened.

Whenever EMTs arrives on the scene of an​ emergency, what is the first assessment phase they must complete prior to touching the​ patient? A. Determining how many patients are injured B. Determining the chief complaint C. Seeking additional resources D. Scene safety

D Scene safety Once standard and PPE precautions have been​ taken, the primary goal of EMTs upon arrival at a scene to which they have been dispatched is scene safety. This means assessment of a scene to ensure the​ well-being of the​ EMTs, their patient or​ patients, and any bystanders. Determining the chief​ complaint, seeking additional​ resources, and determining the number of patients on scene all are steps that are done after ensuring that the scene is safe to enter.

In which part of your assessment will you determine the need for additional​ resources? A. Secondary assessment B. Reassessment C. Primary assessment D. Scene​ size-up

D Scene​ size-up At any time during the scene​ size-up, it may be necessary to recognize your own limitations and call for additional resources or specially trained personnel for situations or rescues that are beyond your training. This may include hazmat or other specially trained people. This determination is made during the scene​ size-up. The​ primary, secondary, and reassessment are all focused on the patient.

You have arrived at the scene of a shooting on the​ "rough" side of town. As you draw near the​ address, you​ see, lying on the​ porch, what appears to be a man who has been shot. There are two or three other people standing around the​ body, waving at you to hurry up. What is your first action or primary​ concern? A. ​Bystanders' safety B. Your​ partner's safety C. Your​ patient's safety D. Your own safety

D Your own safety The overriding goal during any scene​ size-up is to determine whether there are life threats or risks to​ you, the responding EMT. If there is a risk or the threat of​ one, do not enter the scene until the threat has been controlled. You have no duty to act for the patient if you are at risk of injury or harm. After you have ensured your​ safety, you focus on the safety of your partner and then the safety of the patient and bystanders.

The purpose of a thorough scene assessment by EMTs is to ensure their own​ well-being as well as the​ well-being of patients​ and: A. property. B. criminals. C. law enforcement. D. bystanders.

D bystanders. The first rule is to protect your own safety. Then focus your attention on your partner and any patients who are in immediate​ harm's way. Once this has been​ done, you can focus your attention on the safety of bystanders so that none of them become a victim. After all of​ this, you will start your patient assessment and management. Law enforcement officers focus on​ criminals, property, and issues of law.

While caring for a patient at a secured crime scene where people are starting to gather to​ watch: A. for​ safety, move or secure weapons you find near the patient. B. assist law enforcement in searching the scene for clues. C. ask the patient about the crime so you can report the answers to law enforcement. D. have one EMT constantly watch bystanders and the surrounding area.

D have one EMT constantly watch bystanders and the surrounding area. Be alert to the possibility that the patient at the crime scene may be not simply a victim but also a perpetrator or that bystanders at the scene may include the perpetrator. Be prepared for the possibility that such a patient or bystander 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 patient to alert you if a scene begins to turn dangerous. It is law​ enforcement's job to secure​ firearms, interview​ victims, and look for clues.

You arrive on the scene of a​ head-on car crash on a busy highway. Knowing that the speed limit is 70 miles per hour gives you a​ high: A. mechanism of injury. B. Glasgow score. C. trauma score. D. index of suspicion.

D index of suspicion. While the mechanism of injury refers to how the patient was injured​ (car crash versus fall versus physical​ altercation), the index of suspicion is the degree of your anticipation that the patient has been​ injured, or has been injured in a specific​ way, based on your knowledge that certain mechanisms usually produce certain types of​ injuries, such as knowing that the speed limit is 70 miles per hour​ (mph) at the scene of a car crash. The trauma score is a numerical representation of how critically the patient is injured. The Glasgow coma scale is a numerical representation of mental status.

When assessing a patient who has received a traumatic​ injury, initially you will want to know​ the: A. nature of illness. B. index of injury. C. index of suspicion. D. mechanism of injury.

D mechanism of injury. 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 subsequent index of suspicion. The nature of illness is determined when you have a patient suffering from an illness. Index of injury is a fictitious descriptor.

Dispatch information A. is always accurate. B. seldom indicates the need for assistance from other agencies. C. is often unreliable for scene preparation. D. should be used to prepare for the scene.

D should be used to prepare for the scene. Dispatch information should be used to prepare for the​ scene, but remain alert to the possibility of different circumstances upon your arrival.

An example of an environmental factor that must be considered to manage a scene effectively and not sustain a personal injury​ is: A. the absence of a working flashlight on the ambulance. B. a group of bystanders behind a police security line watching the events unfold. C. a spill from a tanker truck in another section of town. D. unstable surfaces or slopes.

D unstable surfaces or slopes Environmental factors are those that pertain to the​ terrain, temperature, or weather while on a scene. If the EMTs find that the ground or surface on which they must walk unstable or excessively​ sloped, special rescue skills may be used to​ access, treat, and extricate the patient. A group of bystanders remaining behind the line established by police is of less​ concern, nor would a spill in another section of town be of immediate concern. If a flashlight is not​ working, it is a problem only if there are no other sources of light.​ However, there is likely another flashlight on the ambulance or in the possession of another emergency provider.


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