EMT chap 39: Incident Management

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When a rehabilitation area is established at the scene of a mass-casualty incident, it should:

. be in a location that prevents visualization of the scene itself.

Level ___ hazardous materials would cause irritation on contact but only mild residual injury, even without treatment

1

Which of the following patient's would have the HIGHEST treatment priority at the scene of a mass casualty incident?

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

How does a disaster differ from a mass casualty incident?

All of the above Disasters may not involve personal injuries I'm a disaster EMS may be on scene for days or weeks Only an elected official can declare a disaster

What is the purpose of the incident command system?

All of the above Ensuring responder And public safety Achieving incident management goals Ensuring the efficient use of resources

Casualty collection area

An area set up by physicians, nurses, and other hospital staff near a major disaster scene where patients can receive further triage and medical care

Bulk storage containers

Any container other than non-bulky storage container such as fixed tanks, Highway cargo tanks, rail tank cars, totes, and intermodal tanks. These are typically found in manufacturing facilities and are often surrounded by secondary containment system to help control an accidental release

Upon arriving 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

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

Between the hazard zone and treatment area

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

Corrosives

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

Decontamination

Which of the following is NOT a role of the EMT at the scene of a HazMat incident?

Decontamination

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 firs responding units

Establishing command

Injuries or conditions that would be classified as first priority (red tag; immediate) include all of the following, EXCEPT:

Fractures of multiples long bones

A large tanker truck had 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 it still in the vehicle and is bleeding heavily from the face. You should:

Fully assess the situation and request the appropriate assistance

Carboys

Gas, plastic, or steel containers, ranging in volume from 5 to 15 gallons

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

Immediate-priority patients should transported two at a time

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

Level 2

What is the primary difference between a disaster and an MCI?

MCIs are usually short term and disasters are long term

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.

At a very large incident, the __________ section is responsible for managing the tactical operations usually handled by the IC on routine EMS

Operations

38. A tour bus has overturned, resulting in numerous patients. When you arrive, you are immediately assigned to assist in the triage process. Patient 1 is a middle-aged male with respiratory distress, chest pain, and a closed deformity to his right forearm. Patient 2 is a young female who is conscious and alert, but has bilateral femur fractures and numerous abrasions to her arms and face. Patient 3 is an older woman who complains of abdominal pain and has a history of cardiovascular disease. Patient 4 is unresponsive, is not breathing, has a weak carotid pulse, and has a grossly deformed skull. What triage categories should you assign to these patients?

Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant (black)

You are triaging victims of a train derailment. Patient A has significant bleeding from an abdominal injury. Patient B has several simple fractures of the femur and ulna. Patient C is conscious and complaining of head and neck pain. Patient D is in cardiac arrest. How would you prioritize these patients?

Patient A has significant bleeding from an abdominal injury and should be tagged as red. Patient B has relatively minor fractures and should be tagged as green. Patient C likely has a neck injury and should be tagged as yellow. Patient D will likely not survive and should be tagged as black.

Which type of drum is used for the storage of corrosives such as acids, based, or oxidizers?

Polyethylene

Which of the following is a member of the command staff?

Public information officer

During triage, how should you tag a child who is breathing fewer than 15 breaths/min?

Red

A Level 4 hazardous material:

Requires specialized gear designed for protection against that particular hazard

The ____ area is where incoming ambulances meet and await further instructions at the scene of a mass casualty incident

Staging

Which of the following is a requirement when labeling pesticide bags?

The EPA establishment number

Which of the following statements best describes a mass casualty incident?

The patient count exhausts your resources

Bills of lading

The shipping papers used for transport of chemicals over roads and highways; also referred to as freight bills

Which of the following situations most likely involves a hazardous material?

Tractor trailer rig that is emitting a visible cloud

The _______ supervisor is responsible for notifying area hospitals and determining their availability and capabilities

Transportation

Command functions under the ICS include all of the following, EXCEPT:

Triage officer

The most appropriate location to park your ambulance at a Hazmat incident is:

Upwind at least 100' from the incident

A patient who has experienced a back injury, with or without spinal cord damage, would be triaged with a ___________ tag during a mass-casualty incident

Yellow

Burn patients without airway compromise and patients with multiple bone or joint injuries should be marked with a __________ triage at a mass-casualty incident.

Yellow

Which level of PPE do you need to wear when dealing with a Level 1 or 2 toxicity level?

a level-C suit.

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.

According to the JumpSTART triage system, if a pediatric patient has a respiratory rate of 40 breaths/min, you should:

assess for a distal pulse.

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 unconscious and apneic. She has an open head injury and her pulse is weak and thready. You should:

assign her a low priority and continue triaging

Historically, the weak point at most major incidents has been:

communication

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.

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 mass-casualty incident and request additional resources.

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

designate a safety officer, but retain 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

The two important underlying principles of the NIMS are standardization and what?

flexibility

According to the JumpSTART triage system, if a pediatric patient is not breathing, you should:

immediately check for a pulse.

In order to accomplish the goal of primary triage, it is important to:

keep the triage assessment brief and the patient categories basic.

Which toxicity level includes materials that are extremely hazardous to health?

level 4

General principles for approaching a potential HazMat incident include:

maintaining a safe distance and viewing the scene with binoculars.

Which of the following is NOT a responsibility of the treatment supervisor?

primary assessment

If an incident increases in scope and complexity, the IC should consider:

relinquishing command to someone with more experience.

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

During a HazMat incident, you are working in the treatment area. As patients are removed from the danger zone, you should:

remain where you are and have the patients brought to you.

When victims involved in a mass-casualty incident are moved to the treatment area

secondary triage is performed and the appropriate treatment is rendered

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.

A critical function of the safety officer is to:

stop an emergency operation whenever a rescuer is in danger.

After recognizing that an incident involves a hazardous material, you should contact the hazardous materials team and then:

take measures to ensure the safety of yourself and others.

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

the Emergency Response Guidebook.

A patient in respiratory arrest at the scene of a mass-casualty incident would typically be classified as a fourth priority (black tag; expectant) patient, unless:

there are enough resources to provide care for him or her.

According to the START triage system, which of the following patients should be triaged as an immediate priority (red tag)?

unresponsive with a respiratory rate of 34 breaths/min

In which control zone would you find the decontamination area?

warm zone


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