EMT Ch 37: Hazardous Materials, 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. A. 1 B. 4 C. 3 D. 2
A. 1
Which of the following is required on the exterior of a tanker truck that is carrying hazardous cargo? A. A DOT hazard placard B. An NFPA 704 placard C. A cargo manifest D. A safety data sheet
A. A DOT hazard placard
Which of the following is the BEST description of a safety data sheet (SDS)? A. Papers that must accompany hazardous materials during transport B. Papers kept on site with hazardous chemicals C. A placard that must be attached to a fixed container of hazardous materials D. A resource book published by the U.S. Department of Transportation for referencing hazardous materials
B. Papers kept on site with hazardous chemicals
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. A. Priority 0 B. Priority 1 C. Priority 2 D. Priority 3
B. Priority 1
Which warning placard is diamond-shaped and divided into four smaller diamonds? A. DOT hazard label B. Material data safety sheet (MSDS) C. UN Globally Harmonized System D. NFPA 704 System
D. NFPA 704 System
What is the number of patients that generally serves as the lowest possible threshold for a multiple-casualty incident? A. 2 B. 15 C. 3 D. 10
C. 3
Which of the following statements regarding a disaster plan is FALSE? A. A disaster plan should be well-publicized. B. A disaster plan should be rehearsed. C. A disaster plan should be written to address any conceivable incident. D. A disaster plan should be realistic.
C. A disaster plan should be written to address any conceivable incident.
Which of the following must be assessed on a hazmat team member before he or she enters the hot zone? A. Task assignment B. Allergies C. Baseline vitals D. Height and weight
C. 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? A. Environmental Protection Agency (EPA) B. Regional poison control center C. CHEMTREC D. OSHA
C. CHEMTREC
At a hazardous materials incident, which of the following areas is used for triaging patients, performing necessary treatment, and stabilizing patients before transport? A. Warm zone B. Hot zone C. Cold zone D. Decon zone
C. Cold zone
Which of the following is NOT a responsibility of an EMT at the scene of a hazardous materials emergency? A. Rehabilitating the hazmat team B. Staying in the cold zone C. Decontaminating injured victims D. Treating injured patients
C. Decontaminating injured victims
Field decontamination takes place in the: A. cold zone. B. hot zone. C. warm zone. D. safe zone.
C. warm zone.
Simple Triage and Rapid Treatment (START) is a system that relies on some simple commands and what three physiologic parameters? A. Circulation, sensory, and motor status B. Respiration, pain, and mental status C. Respiration, pulse, and mental status D. Respiration, sensory, and motor status
C. Respiration, pulse, and mental status
Which of the following is NOT a mechanism of decontamination from hazardous materials? A. Disposing B. Emulsifying C. Disinfecting D. Deodorizing
D. Deodorizing
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? A. Locate the patient for whom you were requested and begin treatment while another ambulance is en route for the other patients. B. Request a hazardous materials incident response and begin treating all patients displaying respiratory difficulties. C. Move the people with respiratory difficulties to a distant corner of the parking lot and set up a treatment sector. D. Evaluate the scene further for indications of a hazardous environment and request a hazardous materials response.
D. Evaluate the scene further for indications of a hazardous environment and request a hazardous materials response.
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. A. Hazardous Materials Technician B. Hazardous Materials Specialist C. First Responder Awareness D. First Responder Operations
D. First Responder Operations
Which of the following hazmat training levels requires at least eight hours of training? A. Hazardous Materials Specialist B. Hazardous Materials Technician C. First Responder Awareness D. First Responder Operations
D. First Responder Operations
If an EMS unit is the first to respond to a multiple-casualty incident, which role does the most senior EMT assume? A. Scene leader B. Ground chief C. Section coordinator D. Incident commander
D. Incident commander
At what point should transport of the injured begin at an MCI? A. After triage has identified "immediate" category patients and transport has been coordinated through the treatment and transport units B. After all "minor" patients have been directed to a treatment area to relieve congestion at the scene C. After all patients have been triaged D. As soon as the first ambulance arrives
A. After triage has identified "immediate" category patients and transport has been coordinated through the treatment and transport units
In which of the following zones is the EMT expected to be staged at the scene of a hazardous materials incident? A. Cold zone B. Warm zone C. Ground zero D. Hot zone
A. Cold zone
Which of the following is a principle of effective Incident Command? A. Command is most effective when one person is responsible for not more than 6 other people. B. Police, fire, and EMS must establish separate command locations. C. The command location must not be revealed to anyone on the scene. D. Anyone on the scene should report directly to Incident Command.
A. Command is most effective when one person is responsible for not more than 6 other people.
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? A. EMS sector officer B. Medical direction C. Incident Commander D. Dispatch
A. EMS sector officer
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. A. First Responder Awareness B. Hazardous Materials Specialist C. First Responder Operations D. Hazardous Materials Technician
A. First Responder Awareness
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. A. Hazardous Materials Specialist B. First Responder Awareness C. First Responder Operations D. Hazardous Materials Technician
A. Hazardous Materials Specialist
To command activities at a hazardous materials incident site, the minimum level of training necessary is: A. Hazardous Materials Specialist. B. First Responder Operations. C. First Responder Awareness. D. Hazardous Materials Technician.
A. 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. A. Hazardous Materials Technician B. First Responder Awareness C. Hazardous Materials Specialist D. First Responder Operations
A. Hazardous Materials Technician
When you call an emergency response hotline regarding hazardous materials, which information is LEAST relevant? A. How long ago you believe the incident might have begun B. Nature and location of the problem C. Injuries and exposures D. Estimate of the quantity of material transported and released
A. How long ago you believe the incident might have begun
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? A. Incident Commander of the scene B. Staging supervisor C. Transport sector supervisor D. Triage sector supervisor
A. Incident Commander of the scene
Using START triage guidelines, a patient on the scene of a mass-causality incident who has no pulse is deemed a ________ patient. A. Priority 0 B. Priority 2 C. Priority 1 D. Priority 3
A. Priority 0
Which of the following statements about decisions made by the transportation unit at an MCI is TRUE? A. Priority 1 patients should be transported first, immediately after treatment. B. Each ambulance should radio the receiving hospital with a detailed patient report. C. Ambulatory patients may be sent to a hospital on a bus without EMS personnel. D. High-priority patients should all be transported to the same hospital.
A. Priority 1 patients should be transported first, immediately after treatment.
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. A. Priority 3, green tag B. Priority 1, red tag C. Priority 4, black tag D. Priority 2, yellow tag
A. Priority 3, green tag
Which of the following is NOT a function of the rehabilitation sector in a hazardous materials incident? A. Providing a decontamination corridor from the hot zone B. Performing medical assessment of rescue crews C. Providing for hydration of rescue crews D. Taking baseline vital signs before rescuers enter the operations area
A. Providing a decontamination corridor from the hot zone
What is the purpose of secondary triage? A. To reevaluate each patient's priority for treatment and transport B. To conduct a comprehensive examination of all patients C. To assess patients who were not immediately found in the initial response D. To perform START triage
A. To reevaluate each patient's priority for treatment and transport
When involved in a multiple-casualty incident, staging refers to which of the following? A. Waiting in a designated location until called upon by the designated sector officer B. Setting up a triage center from the back of your ambulance C. Keeping a log of all patients transported D. Staying on station until called upon to receive a patient
A. Waiting in a designated location until called upon by the designated sector officer
An example of psychological first aid for a patient at an MCI is: A. assuring the patient that everything he feels is normal and that responders are doing everything they can. B. directing the patient to begin providing care to less critical patients. C. telling the patient that despite how it looks, everyone at the scene will be okay. D. asking the patient to consider the possibility he is in denial.
A. assuring the patient that everything he feels is normal and that responders are doing everything they can.
Emotionally incapacitated EMTs: A. may not return to duty even after they have rested. B. may rest until they are ready to return to duty. C. must leave the area, clock out, and go home. D. must observe on scene without providing treatment.
A. may not return to duty even after they have rested.
Which of the following are desirable characteristics of the safe or "cold" zone in a hazardous materials incident? A. Upwind, on the same level as the spill B. Downwind, uphill from the spill C. Upwind, uphill from the spill D. Downwind, downhill from the spill
A. Upwind, on the same level as the spill
When seeking expert advice on how to proceed at a hazardous materials incident, which of the following information is important to provide? A. Your background in chemistry B. Amount of the substance involved C. Your level of EMS certification D. Your suspicions as to cause
B. Amount of the substance involved
Which of the following is a 24-hour resource operated by the American Chemistry Council? A. HAZTECH B. CHEMTREC C. MSDS D. CHEMTRANS
B. 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. A. EPA B. CHEMTREC C. HAZMART D. OSHA
B. CHEMTREC
In which of the following areas at a hazmat incident are normal triage, stabilization, and treatment performed? A. Command post B. Cold zone C. Temperate zone D. Warm zone
B. Cold zone
Which of the following is NOT an acceptable way of attempting to identify a hazardous material? A. Checking the material safety data sheet B. Collecting a sample of the material for laboratory analysis C. Asking the driver of the tractor-trailer truck involved in the incident D. Using binoculars to obtain information from the placard on a container
B. Collecting a sample of the material for laboratory analysis
What is the highest level of training for hazmat incidents under OSHA regulations? A. Material Safety Data Sheet Coordinator B. Hazardous Materials Specialist C. First Responder Operations D. Hazardous Materials Director
B. Hazardous Materials Specialist
In which type of incident would unified command be MOST appropriate? A. An incident that involves only fire/rescue B. Involvement of different branches of public safety C. An incident that involves only EMS D. More than three patients at a scene
B. Involvement of different branches of public safety
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. A. Priority 3, green tag B. Priority 1, red tag C. Priority 2, yellow tag D. Priority 4, black tag
B. 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. A. Priority 2, yellow tag B. Priority 1, red tag C. Priority 4, black tag D. Priority 3, green tag
B. Priority 1, red tag
Which of the following sector officers or supervisors is responsible in large-scale incidents for the provision of restrooms and meals and rotation of crews? A. Command B. Staging C. Transportation D. Supply
B. Staging
Which statement regarding the diamond-shaped placards involved in the transportation of dangerous goods is FALSE? A. These placards may have a four-digit identification number for the material. B. These placards are always carefully vetted and accurate. C. These placards show the hazard class. D. These placards bear a division number for the material.
B. These placards are always carefully vetted and accurate.
When transporting patients from the scene of a mass-casualty incident, who should be responsible for contacting the receiving hospital? A. Transporting EMT B. Transportation supervisor C. Incident commander D. Triage supervisor
B. Transportation supervisor
Who is the person that is in charge of tracking the patient's final destination? A. Treatment officer B. Transportation supervisor C. Incident Commander D. Staging supervisor
B. Transportation supervisor
What should be done with an EMT who has become emotionally incapacitated at an MCI? A. Talk to the EMT with calm empathy until he feels better enough to return to duty. B. Treat the EMT as a patient and remove him to a place of rest. C. Review the EMT's performance to identify what went wrong. D. Direct the EMT to treat only Priority 3 patients.
B. Treat the EMT as a patient and remove him to a place of rest.
Where is the decon corridor located where patients, personnel, and equipment are decontaminated? A. Hot zone B. Warm zone C. Cool zone D. Cold zone
B. Warm zone
A multiple-casualty incident is: A. any medical or trauma incident that requires extensive rescue efforts. B. any medical or trauma incident involving multiple patients. C. any trauma incident involving a patient with multisystem injuries. D. any trauma incident involving five or more critically injured patients.
B. any medical or trauma incident involving multiple patients.
Organization for a smaller MCI would involve: A. aides to the triage supervisor. B. command and a triage supervisor. C. site operations. D. treatment and transportation supervisors.
B. command and a triage supervisor.
As it pertains to hazardous materials, the Occupational Safety and Health Administration requires employers to: A. train employees to handle any type of hazardous materials incident. B. document the appropriate level of training for each employee. C. ensure there is at least one person on-site trained at the technician level. D. have knowledge of all hazardous materials on the premises.
B. document the appropriate level of training for each employee.
You arrive at the scene of a potential hazardous materials incident and see several patients lying on the ground next to an overturned truck with what looks like chemicals leaking out of it in all directions. You should: A. approach cautiously. B. take a command position. C. immediately act to save the patients. D. call out to the patients to see if any can leave the area of the accident.
B. take a command position.
A hot zone is: A. immediately identifiable with placards. B. the area immediately surrounding a hazmat incident. C. an area where personnel and equipment are decontaminated. D. an area where the support functions for an incident response are located.
B. the area immediately surrounding a hazmat incident.
Flammable solids, substances that are dangerous when wet, and spontaneously combustible materials are: A. Class 1 materials. B. Class 2 materials. C. Class 3 materials. D. Class 4 materials.
D. Class 4 materials.
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? A. Wear heavy cloth gloves. B. Place towels on the floor of the ambulance to soak up contaminated runoff water. C. Dispose of patient care equipment such as blood-pressure cuffs and backboards. D. Wear a gown, mask, and goggles to prevent secondary contamination.
C. Dispose of patient care equipment such as blood-pressure cuffs and backboards.
No minimum training hours are required for which level of training? A. First Responder Operations B. Hazardous Materials Specialist C. First Responder Awareness D. Hazardous Materials Technician
C. First Responder Awareness
Which of the following is represented by the blue area of the NFPA 704 placard? A. Instability hazards B. Flammability hazards C. Health hazards D. Special hazards
C. Health hazards
Which of the following should NOT be considered during the scene size-up of a hazardous materials emergency? A. Identification of the substance B. The properties and potential dangers of the substance C. How quickly the materials may be cleaned up D. Potential for spread of the substance
C. How quickly the materials may be cleaned up
Which of the following is NOT a desirable characteristic of the rehabilitation sector of a hazardous materials incident? A. It allows for rapid reentry to the emergency operation. B. It is large enough to accommodate multiple rescue crews. C. It is located in the warm zone. D. It is protected from weather elements.
C. It is located in the warm zone.
The characteristics of a rehab area include all of the following EXCEPT which one? A. Located in the cold zone B. Easily accessible to EMS units C. Large enough to accommodate a single crew D. Free from exhaust fumes
C. Large enough to accommodate a single crew
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? A. Make an initial scene report to the communications center. B. Prevent uncoordinated or undirected activity at the scene. C. Make a sweep to determine what needs must be met. D. Control on-scene communication as help arrives.
C. Make a sweep to determine what needs must be met.
Which of the following BEST describes the required contents of shipping papers associated with hazardous materials? A. Health hazards, flammability hazards, explosion hazards, and special hazards B. Route of exposure, signs and symptoms, classification, and chemical structure C. Name of the substance, quantity, origin, and destination D. The levels of toxicity, flammability, and reactivity
C. Name of the substance, quantity, origin, and destination
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: A. yellow tagged. B. red tagged. C. Priority 3 walking wounded. D. Priority 4 walking wounded.
C. Priority 3 walking wounded.
What source will provide first aid information about hazardous materials for employees at a work site? A. Shipping manifest B. Bill of lading C. Safety data sheets D. Placard
C. Safety data sheets
Identification of chemical hazards starts with: A. identification of hazardous materials placards. B. being alerted to the presence of hazardous materials by dispatch. C. awareness and knowledge of what exists in the community. D. seeing fumes in the air at the incident scene.
C. awareness and knowledge of what exists in the community.
ICS systems recognize that the manageable span of control is: A. 18 people. B. 12 people. C. 24 people. D. 6 people.
D. 6 people.
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. A. Priority 2 B. Priority 1 C. Priority 0 D. Priority 3
D. Priority 3
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. A. Priority 2, yellow tag B. Priority 4, black tag C. Priority 1, red tag D. Priority 3, green tag
D. 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. A. Priority 2, yellow tag B. Priority 3, green tag C. Priority 1, red tag D. Priority 4, black tag
D. Priority 4, black tag
Which of the following has the HIGHEST priority at a hazardous materials incident? A. Decontaminating clothing, equipment, and the vehicle B. Providing patient care C. Immediately removing patients from a hazardous area D. Protecting the safety of all rescuers and patients
D. Protecting the safety of all rescuers and patients
Which of the following personal protective items must be used by EMS personnel caring for patients in a hazardous materials emergency? A. Chemical permeable gloves B. HEPA mask C. Structural firefighting gear D. Tyvek or other chemical impermeable coveralls
D. Tyvek or other chemical impermeable coveralls
Which of the following statements about primary triage when resources are limited is TRUE? A. It is inappropriate for EMTs to assign "walking wounded" patients to assist more seriously injured patients. B. CPR is begun on patients without breathing and a pulse if there are no injuries that are obviously incompatible with life. C. No interventions are performed during primary triage. D. You should open a patient's airway and control severe bleeding.
D. You should open a patient's airway and control severe bleeding.
Disaster plans are a predefined set of instructions that should be written to address the events that are conceivable for: A. the United States including Alaska and Hawaii. B. the contiguous United States. C. the North American continent. D. a particular location.
D. a particular location.
A command organization in which a single agency controls all resources and operations is: A. a unified command. B. an Incident Command System. C. an Incident Command. D. a single incident command.
D. a single incident command.
You are directed to establish a rehab area at a hazmat incident. You know that this area must be: A. established within the warm zone. B. away from the media and the public. C. at least a quarter of a mile from the hot zone. D. easily accessible to EMS units.
D. easily accessible to EMS units.
Gross decontamination is the: A. alteration or removal of most residual contamination. B. residual contamination that remains on a host following decontamination procedures. C. complete removal or neutralization of a contaminant. D. removal or chemical alteration of the majority of a contaminant.
D. 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: A. wave the EMT off the scene and tell him to return to the station. B. administer psychological first aid to the EMT until he feels capable of returning to duty. C. direct the EMT to the collection point for walking wounded triage patients. D. remove the EMT to a resting area and monitor him until a clinically competent provider can take over.
D. 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: A. danger zone. B. warm zone. C. hot zone. D. safe zone.
D. safe zone.
If arriving units are not needed right away, they should wait in the: A. triage area. B. treatment area. C. transportation area. D. staging area.
D. staging area.
A decontamination corridor would be established in the: A. cold zone. B. dead zone. C. hot zone. D. warm zone.
D. 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? A. 35-year-old pregnant woman with a cut on her head, neck pain, and numbness and tingling in her arms B. Unresponsive 9-year-old male with an open skull fracture who is in cardiac arrest C. 30-year-old man with multiple lower extremity fractures who is awake, has a strong radial pulse, and is complaining of severe pain D. 70-year-old woman who is awake but having difficulty breathing and has absent lung sounds on the right side
D. 70-year-old woman who is awake but having difficulty breathing and has absent lung sounds on the right side