EMT Chapter 39 Incident Command

Which of the following patients would have the HIGHEST treatment priority at the scene of a mass-casualty-incident? 24-year-old man who is unconscious, has snoring respirations, and severe burns 32-year-old woman who is pulseless and apneic with an abdominal evisceration 29-year-old woman who is in full cardiac arrest with massive open chest trauma 32-year-old woman with an open head injury, exposed brain matter, and no carotid pulse

24-year-old man who is unconscious, has snoring respirations, and severe burns

Interoperability, an important feature of the NIMS, refers to the ability of:

Agencies of different types or from different jurisdictions to communicate with each other

How does a disaster differ from a mass-casualty incident? Disasters may not involve personal injuries In a disaster, EMS may be on the scene for days to weeks Only an elected official can declare a disaster All of the above

All of the above

What is the purpose of the incident command system (ICS)? Ensuring responder and public safety Achieving incident management goals Ensuring the efficient use of resources All of the above

All of the above

As an EMT, what is your role at a HazMat incident?

As an EMT, your job is to report to a designated area outside of the hot and warm zones and provide triage, treatment, transport, or rehabilitation when HazMat team members bring patients to you.

Upon arrival at a scene in which the incident command system has been activated, you should expect to:

Be passed from sector to sector, as needed, in between assignments

Once patients have been decontaminated and moved to the staging area, how should you continue care?

Begin as if they have not received any treatment

When dealing with a hazardous materials incident, where should you set up your decontamination area?

Between the hazard zone and the treatment area

In which control zone would you find the staging area for EMS?

Cold zone

A carboy is a container that would MOST likely be used to store and transport:

Corrosives

A 49-year-old man has been removed from his overturned tanker, which was carrying a hazardous material. The tank ruptured and he was exposed to the material. When rescue personnel bring him to the decontamination area, they note that he is unconscious and has slow, shallow breathing. They should:

Cut away all of the patient's clothing and do a rapid rinse to remove as much of the contaminating matter as they can

Oxygen is stored in which type of container?

Cylinder

You and your partner are the first to arrive at the scene of a motor vehicle accident. As you approach the scene, you can see multiple patients, some walking and others who are still in their vehicles. You should:

Declare a multiple-casualty incident and request additional resources

The process of removing or neutralizing and properly disposing of a hazardous material is called:

Decontamination

Which of the following is NOT a common role of the EMT at the scene of a HazMat incident? Rehabilitation Decontamination Transportation Triage and treatment

Decontamination

During a motor vehicle collision involving multiple patients, the incident commander would MOST likely:

Designate a safety officer, but retain all other command functions

The purpose of the incident command system (ICS) is to:

Ensure responder and public safety, achieve incident management goals, and ensure the effective use of resources

As the first-arriving senior EMT at the scene of an incident, you should perform a scene size-up and then:

Establish command

When EMS responds to a disaster, as part of their response within the ICS, EMS would start with a scene size-up. What is the next step for the first responding units? A. Communicating with additional units B. Establishing command C. Caring for any injuries D. Stabilizing the incident

Establishing command

Injuries or conditions that would be classified as first priority (red tag; immediate) include all of the following, EXCEPT: Severe medical problems Fractures of multiple long bones Any airway or breathing difficulty Uncontrolled or severe hemorrhage

Fractures of multiple long bones

A large tanker truck has overturned on a highway. When you arrive, you see a clear liquid leaking from the rear of the tanker. The driver, who appears to be unconscious, is still in the vehicle and is bleeding heavily from the face. You should: A. immediately notify law enforcement for traffic control. B. fully assess the situation and request the appropriate assistance. C. put on gloves, a gown, and a mask and quickly remove the driver. D. go to the rear of the tanker and determine what type of fluid is leaking.

Fully assess the situation and request appropriate assistance

Which control zone at a HazMat incident includes the area immediately surrounding the release, which is also the most contaminated area and the area that the HazMat team works in?

Hot zone

Which of the following statements regarding transport of patients from a multiple-casualty incident or disaster site is correct?

Immediate-priority patients should be transported two at a time

Which toxicity level would you assign a hazardous material spill that could cause a person temporary damage or residual injury unless prompt medical treatment is given?

Level 2

Which toxicity level includes materials that are extremely hazardous to health? Contact with these materials requires full protective gear so that none of your skin surface is exposed.

Level 3

General principles for approaching a potential HazMat incident include:

Maintaining a safe distance and viewing the scene with binoculars

The incident commander arrives with a notebook containing basic information about the chemical makeup of a substance, the potential hazards it presents, appropriate first aid in the event of an exposure, and other pertinent data for safe handling of the material. This information is contained in which of the following resources?

Material Safety Data Sheet (MSDS)

How will you decide to declare a mass-casualty incident?

One ambulance and two EMTs can effectively treat and transport only 2 stable patients or 1 critical patient at a time. At least 3 patients define an MCI

According to the START triage system, what should you do if you encounter an unresponsive patient who is not breathing?

Open the airway and reassess breathing status

You and your partner arrive at the scene where a truck has crashed into a small building, injuring eight people. You immediately request additional ambulances and begin the triage process. The first patient that you triage is a young female who is conscious and apneic. She has an open head injury and her pulse is weak and thready. You should:

Place a red tag on her and continue triaging

The HazMat team members enter the hot zone to approach the patients. They visually examine the containers to determine what chemicals may be in the hot zone. Which type of drum is used for the storage of corrosives such as acids, bases, and oxidizers?

Polyethylene

Which of the following is NOT a responsibility of the treatment supervisor? Primary assessment Secondary triage Patient packaging Communication with the medical branch director

Primary assessment

You have a critically injured patient in the back of your ambulance, ready to be transported. There are other injured patients at the scene and it will be approximately 10 minutes before other ambulances will arrive. Law enforcement personnel are at the scene. You should:

Remain at the scene until at least one other ambulance arrives

A Level 4 hazardous material:

Requires specialized gear designed for protection against that particular hazard

According to the JumpSTART triage system, infants or children not developed enough to walk or follow commands, including children with special needs:

Should be taken to the treatment area for immediate secondary triage

The HazMat teams finds a small pesticide bag underneath a patient after lifting him. Which of the following is a requirement when labeling pesticide bags? Permissible exposure limits Routes of entry The EPA establishment number Contact information for the responsible party

The EPA establishment number

The reference used as a base for your initial actions at a HazMat incident is:

The Emergency Response Guidebook

Which of the following statements BEST describes a mass-casualty-incident?

The patient count exhausts your resources

Which of the following situations MOST likely involves a hazardous material? Milk truck that overturned and is leaking fluid Tractor trailer rig that is emitting a visible cloud Moving van that collided head-on with a small car Pickup truck from the gas company that struck a tree

Tractor trailer rig that is emitting a visible cloud

The MOST appropriate location to park your ambulance at a HazMat incident is:

Upwind at least 100 feet from the incident

Once command has been established, what are your duties?

Your job is to locate and triage patients

You may be required to call CHEMTREC to gain further information on potential exposures. List the basic information needed when calling CHEMTREC.

· The name of the chemical(s) involved in the incident (if known) · Name of the caller and callback telephone number · Location of the incident or problem · Shipper or manufacturer of the chemical (if known) · Container type · Railcar or vehicle markings or numbers · The shipping carrier's name · Recipient of material · Local conditions and exact description of the situation