test 100 transport
You receive a call at 3:00 a.m. for a patient who is slumped over the steering wheel of his car, which is parked on the shoulder of the road. Your unit and a police officer arrive at the scene at the same time. You should: A: approach the vehicle from the front to ensure maximum visibility. B: park the ambulance 25 feet in front of the patient's vehicle. C: stay in your unit until the police officer checks the patient. D: shine a spotlight in the side view mirror of the patient's vehicle. You selected D; The correct answer is C; Reason: Unfortunately, it is not uncommon for people to fake illness or injury with the intent of harming responding personnel. In this situation, you should utilize the safety resource at the scene: the police officer. You and your partner should stay in the unit until the police officer checks the patient to ensure it is safe for you to approach. Remember, the safety of you and your partner comes first!
A 52-year-old woman crashed her minivan into a tree. She is pinned at the legs by the steering wheel and is semiconscious. After gaining access to the patient, you should: A: immediately apply high-flow oxygen to the patient and allow extrication to begin. B: have the fire department disentangle the patient and quickly remove her from the car. C: perform a primary assessment and provide any life-saving care before extrication. D: rapidly assess her from head to toe, obtain vital signs, and apply a cervical collar. You selected C; This is correct! Reason: Unless there is an immediate threat of fire, explosion, or other danger, you should perform a primary assessment and begin any live-saving care as soon as you have gained access to the patient. If you wait to do this until after the patient has been disentangled, it may be too late; the patient may already be dead. After you have assessed the patient and treated any immediate threats to life, allow extrication to commence. Once the patient has been freed from the vehicle, continue any life-saving care and perform a rapid head-to-toe assessment to identify and treat other life-threatening injuries. Another EMT can obtain vital signs as you rapidly assess the patient. Prepare for immediate transport after the rapid head-to-toe assessment has been performed and the appropriate spinal precautions have been taken.
A patient presents with severe bradycardia, hypersalivation, vomiting, and excessive tearing. Which of the following agents would MOST likely cause his signs and symptoms? A: Phosgene B: Anthrax C: Chlorine D: Soman You selected B; The correct answer is D; Reason: Nerve agents (eg, V agent [VX], sarin [GB], soman [GD], tabun [GA]) are among the most deadly chemicals developed. Designed to kill large numbers of people with small quantities, nerve agents can cause cardiac arrest within seconds to minutes of exposure. Nerve agents, discovered while in search of a superior pesticide, are in a class of chemical called organophosphates, which are found in household bug sprays, agricultural pesticides, and some industrial chemicals. Organophosphates block an essential enzyme in the nervous system, which cause the body's organs to become overstimulated. The mnemonic "DUMBELS" can help you recall the signs and symptoms of nerve agent exposure; it stands for Diarrhea; Urination; Miosis (constricted pupils); Bradycardia; Emesis (vomiting), Lacrimation (excessive tearing); and Seizures, Salivation, and Sweating. You can also use the mnemonic "SLUDGEM," which stands for Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis, and
A set of regulations and ethical considerations that define the extent or limits of an EMT's job is called: A: confidentiality. B: the Medical Practices Act. C: a duty to act. D: scope of practice. You selected B; The correct answer is D; Reason: The set of legal regulations and ethical considerations that define the job of the EMT is called the scope of practice. The scope of practice provides a clear delineation of the EMT's roles and responsibilities. Duty to act is defined as a legal obligation to respond to every call for help while on duty and in your jurisdiction, whether you are paid for your services or not. Confidentiality entails not releasing any patient information to those not directly involved in the care of the patient. The Medical Practices Act describes the minimum qualifications of those who may engage in emergency medical care and establishes a means of certification.
Which of the following practices will provide you with the highest degree of safety when responding to an emergency call? A: Wearing your seatbelt and shoulder harness B: Always requesting fire department assistance C: Routinely using the lights and siren D: Asking the police to escort you to the scene You selected B; The correct answer is A; Reason: Consistent safety practices, such as wearing your seatbelt and shoulder harness, driving with due regard for others, and avoiding excessive speed, will afford you the highest degree of safety when responding to an emergency call. Unless used to guide you to an area you are unfamiliar with, escort vehicles should be avoided. Escort vehicles are especially dangerous at intersections; as the escort vehicle proceeds through the intersection, other motorists often do not expect a second emergency vehicle to follow. As a result, they may pull out into the intersection, thinking it is clear, and collide with your ambulance (wake effect collision). The use of lights and siren increases the danger factor, especially if used in conjunction with excessive speed. Lights and siren ask for, not demand, the courtesy of the right of way.
At the scene of a mass-casualty incident, you notice a bystander who is emotionally upset. An appropriate action to take would be to: A: tell the bystander to leave the scene at once. B: assign the bystander a simple, non-patient-care task. C: notify the police and have the bystander removed. D: have the bystander assist you with patient care. You selected B; This is correct! Reason: One of the most effective ways to reduce stress in a bystander at the scene of a mass-casualty incident is to assign the bystander a task that is not related to patient care. This may involve assisting other bystanders who are having difficulties as well or providing water to the rescuers. An obviously distressed bystander should not simply be sent away from the scene, but should be looked at as a patient as well. Clearly, if the bystander becomes aggressive or violent, law enforcement personnel should get involved.
The scene size-up includes all of the following components, EXCEPT: A: determining if the scene is safe. B: evaluating the mechanism of injury. C: donning personal protective gear. D: assessing the need for assistance. You selected C; This is correct! Reason: The components of the scene size-up include determining scene safety, assessing the mechanism of injury (MOI) or nature of illness (NOI), determining the number of patients, and requesting additional help if needed. Personal protective equipment (PPE) should be donned prior to beginning the scene size-up.
During the triage process, which of the following injuries or conditions would classify a patient as a high priority? A: Partial-thickness burns with no respiratory difficulty B: Pulselessness and apnea C: A large avulsion to the arm and an altered mental status D: Unilateral femur fracture and tachycardia You selected B; The correct answer is C; Reason: During triage, patients with an altered mental status, who are in shock, or who have problems with airway, breathing, or circulation, are potentially salvageable and are given immediate priority. Patients who are pulseless and apneic have low priority in a mass-casualty situation. If you focus your efforts on cardiac arrest patients, who will most likely not survive anyway, patients who could have potentially been saved will die as well. Remember, the goal of triage is to provide the greatest good for the greatest number of patients.
The technique of rapid extrication from a vehicle involves: A: applying a cervical collar, grasping the patient by the clothing, and quickly removing him or her onto the stretcher. B: manually stabilizing the head, applying a cervical collar, and removing the patient from the vehicle onto a long backboard. C: applying a vest-style extrication device, sliding a long backboard under the patient's buttocks, and removing him or her from the vehicle. D: grabbing the patient by his or her clothing, protecting his or her spine as much as possible, and dragging him or her from the vehicle. You selected C; The correct answer is B; Reason: The rapid extrication technique is indicated if the patient has life-threatening injuries and/or is in need of treatment that requires a supine position. It is performed by manually stabilizing the patient's head (an EMT in the backseat typically does this), applying a cervical collar, sliding a backboard under the patient's buttocks, and removing him or her from the vehicle and onto the backboard. The vest-style extrication device is not appropriate to use when performing the rapid extrication technique; it takes too long to correctly apply. Do not confuse the rapid extrication technique with an emergency move. An emergency move, which is indicated if you or the patient's safety is in imminent danger, involves grabbing the patient by the clothing, protecting his or her spine as much as possible, and dragging him or her from the vehicle to a safe place.
In most states, the EMT is required to report which of the following occurrences? A: Injury to a minor B: Animal bite C: Motor vehicle crash D: Drug overdose You selected C; The correct answer is B; Reason: Although each state may have slightly differing reporting laws, most require the EMT to report cases such as child or elderly abuse, sexual assault, animal bites, and injury that occurs during the commission of a crime. Injury to a minor is typically not a reportable case unless abuse is suspected. Motor vehicle crashes and drug overdoses are not reportable cases either, unless they occur during the commission of a crime.
You are giving a presentation to a group of laypeople on the importance of calling EMS immediately for cardiac arrest patients. What point should you emphasize the MOST? A: CPR and defibrillation are key factors in patient survival. B: Cardiac drug therapy is the most important EMS treatment. C: Laypeople are incapable of providing adequate CPR. D: Rapid transport significantly reduces patient mortality. You selected B; The correct answer is A; Reason: Early high-quality CPR and defibrillation are the most crucial initial treatments to provide to a patient in cardiac arrest. Adequately performed CPR can keep the heart and brain oxygenated, thus increasing the chance of defibrillation success. Ventricular fibrillation (V-Fib) is the most common initial dysrhythmia seen in adult patients with sudden cardiac arrest and requires prompt defibrillation. Untreated V-Fib will rapidly deteriorate to asystole, the mortality rate from which is very high. You should also advise the audience that compression-only CPR has been linked to patient survival.
In which of the following situations is an emergency move of a patient from his or her wrecked vehicle clearly indicated? A: The patient appears unresponsive and a high-power line is lying across the hood. B: Gas is leaking from the vehicle and there is a small fire in the engine compartment. C: The patient has an altered mental status; diaphoresis; and rapid, shallow breathing. D: Your primary assessment reveals that the patient has signs and symptoms of shock. You selected B; This is correct! Reason: An emergency move is indicated if you or the patient's life is in immediate danger. Gas leaking from the vehicle and a fire in the engine compartment are clear indicators that you and the patient's lives are in imminent danger. An emergency move involves grabbing the patient by the clothing, protecting his or her spine as much as possible, and dragging him or her from the vehicle to a safe place. The rapid extrication technique, which involves manually stabilizing the patient's head, applying a cervical collar, and removing the patient from the vehicle onto a long backboard, is indicated if the patient's condition is unstable and/or he or she is in need of treatment that requires a supine position. Never approach or touch a vehicle that is in contact with a high-power line; have the power company cut the power to the line first and then remove the patient from the vehicle.
Proper body mechanics when lifting and moving a patient include: A: twisting at the waist when moving around a corner. B: using the muscles of your lower back to lift. C: keeping the weight as close to you as possible. D: maintaining a slight curvature of your back. You selected B; The correct answer is C; Reason: General guidelines for safe lifting and moving include keeping the weight as close to your body as possible; keeping your back in a straight, locked-in position; using the muscles of your thighs to lift; and avoiding twisting when moving a patient around a corner. Back injuries are the most common injury sustained by the EMT and can be easily avoided if proper lifting and moving techniques are observed.
Medical control has ordered you to administer one tube of oral glucose to a hypoglycemic patient. Immediately after receiving this order, you should: A: document the order on the prehospital care report. B: ask medical control to repeat the order word for word. C: repeat the order back to medical control word for word. D: administer the medication and reassess the patient. You selected B; The correct answer is C; Reason: Immediately after receiving an order from medical control, you should repeat the order back to medical control word for word. This will ensure that you heard correctly and understand the order to be carried out. If you receive an order that seems inappropriate, you should ask the physician to repeat the order back to you for clarification. Reassess the patient after administering the medication and document the time and patient's response (good or bad) on your patient care report.
You arrive at the scene of an 80-year-old woman who is weak and lightheaded. Her son, who called 911, is present and asks you to transport his mother to the hospital. You should: A: advise the son that he can probably drive his mother to the hospital. B: assess the woman and determine if she wishes to be treated and transported. C: take the woman's vital signs and apply supplemental oxygen if necessary. D: comply with the son's request and transport the woman to the hospital. You selected B; This is correct! Reason: You must obtain consent from any mentally competent adult patient prior to initiating treatment. Just because the patient is 80 years old does not mean that she does not have decision-making capacity. And just because her son wants her to be transported does not mean that she does. Ask her if she wishes to be treated and transported to the hospital. If she does, then you have obtained consent and should proceed accordingly. If she does not, you should determine if she has decision-making capacity; that is, whether or not she is mentally competent. If she is determined to have decision-making capacity, then you cannot legally treat or transport her. If she does not have decision-making capacity (eg, she is confused, under the influence of drugs or alcohol), then you may treat and transport under the law of implied consent. It is not the EMT's decision to determine, let alone recommend, that a patient be taken to the hospital via privately owned vehicle (POV). If the patient requests EMS treatment and transport, you are legally obligated to do so.
Most crashes involving ambulances occur: A: at intersections. B: at stop signs. C: at stop lights. D: on the highway. You selected C; The correct answer is A; Reason: Intersection crashes are the most common and usually the most serious type of collision in which ambulances are involved. When approaching an intersection, you should come to a complete stop, look in both directions for pedestrians and other motorists, and then proceed with caution. Remember, your lights and siren do NOT give you the right of way; they ask other motorists for the courtesy of the right of way. If you proceed through an intersection without stopping and strike another vehicle that had the right of way, you will be held liable. Whether or not your lights and siren were in use at the time of the incident is irrelevant.
You are called to a local state park where a hiker fell from a cliff into a thick, wooded area with rough terrain. It is cold and foggy and a thunderstorm is approaching. You will MOST likely move the patient to the ambulance by: A: placing the patient in a basket stretcher and using at least four people to carry him to the ambulance. B: requesting a helicopter to hoist the patient out of the wooded area and carry him to a site near the ambulance. C: bringing the ambulance stretcher to the patient, loading him onto it, and removing him from the wooded area. D: assisting the patient in walking from the wooded area to the ambulance if his injuries are not life-threatening. You selected B; The correct answer is A; Reason: The basket stretcher, also called a Stokes basket, is ideal for moving patients across rough terrain. Because the patient fell from a cliff, he will require spinal motion restriction precautions. Secure him to a long backboard and place the backboard in the basket stretcher. When carrying a patient across rough terrain, you should utilize at least four people to ensure a safe patient move. Clearly, the patient should not walk; he should be suspected of having a spinal injury due to the fall. A wheeled ambulance stretcher is impractical in situations were the patient must be moved over rough terrain. In many cases, a helicopter can be used to move patients from remote areas to a landing site near the ambulance or directly to the hospital. However, in this case, the weather (eg, fog, approaching thunderstorm) will likely prohibit a helicopter from being able to safely fly.
The EMT should avoid focusing all of his or her attention on a single critical patient during the triage process because: A: all of his or her supplies will likely be depleted on that one patient. B: three EMTs are required to effectively manage a critical patient. C: the patient will most likely die before he or she can be transported. D: other patients may die of problems that may have been corrected. You selected B; The correct answer is D; Reason: Triage is the process of rapidly assessing patients in order to determine their treatment priority. Focusing your attention on one patient during the triage process not only defeats the purpose of triage (to do the greatest good for the greatest number of people), but it neglects other patients who may die from injuries or conditions that may have been corrected if detected earlier.
When requesting medical direction for a patient who was involved in a major motor-vehicle accident, you should do all of the following, EXCEPT: A: question an order if it seems to be inappropriate. B: use proper medical terminology when speaking. C: describe the severity of damage to the patient's vehicle. D: use radio codes to describe the situation. You selected B; The correct answer is D; Reason: When giving a report to medical control or requesting medical direction, you should avoid the use of radio codes, such as "10-50." The physician may not be familiar with such codes. There is clearly less risk of confusion if you use plain English. At the same time, you should use proper medical terminology, especially when describing the patient's injuries. Information regarding the severity of damage to the patient's vehicle is critical information and should be relayed to the physician; this can help him or her appreciate the significance of the situation. Do not be afraid to question an order that is contrary to your training or protocols; the physician may have simply made an error. Repeating an order back to the physician, word for word, will minimize the risk of this occurring.
The MOST effective means of preventing the spread of disease is: A: wearing gloves with all patients. B: up-to-date immunizations. C: effective handwashing. D: wearing a mask with all patients. You selected B; The correct answer is C; Reason: According to the Centers for Disease Control and Prevention (CDC), the most effective way of preventing the spread of disease is to frequently and effectively wash your hands, especially in between patients. The regular use of gloves with all patients and wearing a mask when managing a patient with a communicable disease (ie, tuberculosis) will decrease your chance of disease exposure. Remaining up-to-date with your immunizations will reduce your risk of contracting certain diseases if you are exposed.
Which of the following practices will provide you with the highest degree of safety when responding to an emergency call? A: Asking the police to escort you to the scene B: Always requesting fire department assistance C: Routinely using the lights and siren D: Wearing your seatbelt and shoulder harness You selected C; The correct answer is D; Reason: Consistent safety practices, such as wearing your seatbelt and shoulder harness, driving with due regard for others, and avoiding excessive speed, will afford you the highest degree of safety when responding to an emergency call. Unless used to guide you to an area you are unfamiliar with, escort vehicles should be avoided. Escort vehicles are especially dangerous at intersections; as the escort vehicle proceeds through the intersection, other motorists often do not expect a second emergency vehicle to follow. As a result, they may pull out into the intersection, thinking it is clear, and collide with your ambulance (wake effect collision). The use of lights and siren increases the danger factor, especially if used in conjunction with excessive speed. Lights and siren ask for, not demand, the courtesy of the right of way.
The immobilization device MOST appropriate to use for a patient with multiple injuries and unstable vital signs is the: A: scoop immobilization device. B: short spine board immobilization device. C: long spine board immobilization device. D: vest-style immobilization device. You selected B; The correct answer is C; Reason: When caring for a critically injured patient with multiple injuries, the patient's entire body should be immobilized. This is most quickly and effectively accomplished using a long spine board. Vest-style devices or short spine boards take too long to apply and will not provide full body immobilization. The scoop (orthopaedic) stretcher is effective for maneuvering patients in narrow spaces but will not allow for full spinal immobilization because of the vertical opening down the center of the device.
As you step out of the ambulance at the scene of a nighttime motor vehicle crash on the highway, your MOST immediate concern should be: A: rapid assessment of all injured patients. B: whether the car will catch on fire. C: the presence of oncoming traffic. D: placing safety flares by the ambulance. You selected B; The correct answer is C; Reason: Nighttime traffic crashes, especially those that occur on a highway, pose a significant risk to the safety of the EMT. Therefore, immediately upon exiting the ambulance, the concern for oncoming traffic should be at the front of the EMT's mind. Drivers can be blinded by all of the emergency lighting and inadvertently veer off of the road and strike the rescuer. Safety flares are used less commonly than in the past; they have been known to blow off the road and start grass fires or ignite gasoline leaking from a vehicle. Reflective cones or triangles are safer and are used more often than flares. After ensuring your own safety, which includes notifying the fire department if the vehicle is leaking gas, you should then proceed to the patients.
The primary clinical feature associated with exposure to a vesicant agent is: A: skin blistering. B: vomiting blood. C: muscle twitching. D: tachycardia. You selected B; The correct answer is A; Reason: The primary route of exposure of blister agents, or vesicants, is the skin. If vesicants are left on the skin or clothing long enough, they produce vapors that can enter the respiratory tract. Vesicants cause burn-like blisters to form on the victim's skin as well as in the respiratory tract (if inhaled). Vesicant agents include sulfur mustard (H), Lewisite (L), and phosgene oxime (CX). The symbols H, L, and CX are military designations. Vesicants usually cause the most damage to damp or moist areas of the body, such as the armpits, groin, and respiratory tract.
When the incident command system is activated at the scene, you should expect to: A: receive instructions and then function independently. B: be assigned one responsibility for the duration of the incident. C: report back to your section officer in between assignments. D: be immediately directed to the established treatment area. You selected B; The correct answer is C; Reason: The incident command system (ICS) was established in order to maximize effective operations at the scene and maximize the number of lives saved. Deviation from the ICS jeopardizes lives and increases the risk of losing control over the situation. When you arrive at the scene in which the ICS has been activated, you should report to the staging area, where you will be directed to the area in which you are needed. Report to the section officer of that area, receive your instructions, and carry them out. When you have completed your assignment, you must return to the section officer for further instructions. Depending on the situation, you may be sent to another section. The sections that you work in and the responsibilities that you are given may change during the incident. At no time should you attempt to function independently (freelancing); this defeats the purpose of the ICS and puts lives in jeopardy.
You arrive at the scene where a man fell approximately 40 feet and landed on his head. He is unresponsive, has agonal gasps, and a weak carotid pulse. Further assessment reveals an open head injury with exposed brain matter. Upon identifying this patient as an organ donor, you should: A: request authorization from medical control not to initiate care. B: provide rapid transport only because the patient likely will not survive. C: manage the patient aggressively and provide rapid transport. D: recognize that the patient's injuries disqualify him as an organ donor. You selected B; The correct answer is C; Reason: It is unlikely that the patient will survive his injury; however, he is still breathing, albeit very poorly, and has a weak carotid pulse. Therefore, you should begin immediate and aggressive treatment and transport him promptly, just as you would for any other critically injured patient. It would clearly be inappropriate to request authorization to provide no care at all. If it is determined by a physician that he will not survive his injury, his organs can potentially be harvested and save several lives.
Which of the following statements regarding the high-efficiency particulate air (HEPA) respirator is correct? A: Long sideburns or a beard will prevent the proper fit of a HEPA respirator. B: A HEPA respirator should be placed on any patient with tuberculosis. C: A HEPA respirator is necessary only if the patient with suspected tuberculosis is coughing. D: A surgical mask provides better protection against tuberculosis than a HEPA respirator. You selected C; The correct answer is A; Reason: If you are caring for a patient with known or suspected tuberculosis (TB), regardless of whether the patient is coughing, you should place a surgical mask (or high-flow oxygen, if indicated) on the patient and a high-efficiency particulate air (HEPA) respirator (N-95 or higher) on yourself. Unlike a surgical mask, the HEPA respirator is specifically designed to prevent exposure to the bacterium that causes TB. A surgical mask, however, will reduce the transmission of germs from the patient into the air. Do not place a HEPA respirator on the patient; it is unnecessary and uncomfortable. Use of a HEPA respirator should comply with OSHA standards, which state that facial hair, such as long sideburns or beards, will prevent a proper fit.
When driving in emergency mode on a multilane highway, the emergency vehicle operator should keep to the: A: right shoulder so that traffic flow is not disrupted. B: center lane so the traffic can flow around the ambulance. C: extreme right lane so motorists can yield to the left. D: extreme left lane so motorists can yield to the right. You selected B; The correct answer is D; Reason: When traveling on a highway with more than one lane, the emergency vehicle operator should remain in the extreme left-hand (fast) lane. This allows other motorists to yield to the right as they see you approach. A motorist's typical initial reaction is to slam on their brakes and then look for the best direction to yield; this may be to the left or right, depending on the traffic. Do not attempt to pass a motorist until he or she is clearly aware of your presence and has yielded accordingly. Passing other motorists on the right is unsafe and should be avoided.
You arrive at the scene of a traffic accident in which multiple vehicles are involved. You see at least two patients who are lying on the road and are not moving. You should: A: begin immediate patient care. B: request additional ambulances. C: notify medical control for advice. D: begin triaging the patients. You selected B; This is correct! Reason: As soon as you determine that there are more patients than you and your partner can effectively manage, you should immediately request additional help. Waiting until you are overwhelmed with critically injured patients is not the time to call for help. When in doubt, it is best to call for help. You can always cancel any incoming ambulances if you later determine that they are not needed. After you have called for assistance, you should begin triaging and caring for the patients to the best of your ability.
When providing care to multiple patients at the scene of a mass-casualty incident, your goal should remain focused on: A: immobilizing all patients at the scene. B: keeping all bystanders at a safe distance. C: transporting patients to the hospital. D: initiating CPR for those in cardiac arrest. You selected B; The correct answer is C; Reason: At the scene a mass-casualty incident, you will be faced with many challenges, including ensuring your safety, extrication, triage, and patient care. In the midst of all of these activities, however, you must never lose sight of your ultimate goal, which is to transport all patients to the hospital as soon as possible.
The safest emergency vehicle operator is one who: A: has a positive attitude. B: drives with due regard. C: drives with lights and siren. D: is physically fit. You selected C; The correct answer is B; Reason: One of the most important attributes of a safe emergency vehicle operator is the ability to drive with due regard for others. This means that the operator must be aware of others around him or her and to keep their safety in mind. The EMT should never assume that all drivers will see or hear the ambulance. A positive attitude about one's ability to safely operate an emergency vehicle is also an important attribute. Although sometimes indicated for the patient's condition, the use of lights and siren increase the risk of an ambulance crash.
When using the power lift to lift a stretcher, you should: A: ensure that you lift with your palms facing up. B: place your hands palms down on the stretcher. C: maintain a slight inward curve to your back. D: bend at the waist and keep your back straight. You selected C; The correct answer is A; Reason: In order to achieve the best grip and to avoid injury to your wrists, you should lift a stretcher, backboard, or other carrying device with your palms facing up. Do not bend at the waist; bend at the knees and keep your back in a straight, locked-in position.
Following an apparent terrorist attack, numerous patients present with shortness of breath and persistent coughing. A green haze is noted in the area in which the patients are located. Which of the following agents should you suspect they were exposed to? A: V agent (VX) B: Chlorine (CL) C: Phosgene oxime D: Tabun (GA) You selected B; This is correct! Reason: The patient's signs and symptoms are indicative of a pulmonary (choking) agent, specifically chlorine (CL). Chlorine (CL) was the first chemical agent ever used in warfare. It has a distinct odor of bleach and creates a green haze when released as a gas. Initially, it produces upper airway irritation and a choking sensation. Later signs and symptoms include shortness of breath, chest tightness, hoarseness and stridor as the result of upper airway swelling, and gasping or persistent coughing. Phosgene, not to be confused with phosgene oxime (a blistering [vesicant] agent), is also a pulmonary (choking) agent. Tabun (GA) and V agent (VX) are examples of chemical nerve agents. Nerve agents are among the most deadly chemicals developed. Designed to kill large numbers of people with small quantities, nerve agents can cause cardiac arrest within seconds to minutes of exposure.
Which of the following creates a secure loop at the working end of a rope, which can be used to attach the end of the rope to a fixed object or a piece of equipment? A: Figure eight knot B: Half hitch C: Figure eight on a bite D: Clove hitch You selected B; The correct answer is C; Reason: Although EMTs infrequently perform special rescue operations (ie, urban search and rescue [USAR]), they should have a basic working knowledge of the different ropes and knots used for rescue purposes. The figure eight on a bite knot creates a secure loop at the working end of the rope, the part of the rope used for forming the knot. This loop can be used to attach the end of the rope to a fixed object or a piece of equipment, or to tie a life safety rope around a person. The loop may be of any size, from an inch to several feet in diameter. The figure eight is a basic knot used to produce a family of other knots, including the figure eight on a bite and the figure eight with a follow-through. A simple figure eight knot is seldom used. The half hitch is not a secure knot by itself, which is why it is used in conjunction with other knots. The clove hitch is used to attach a rope firmly to a round object, such as a tree or fencepost.
Upon arriving at the scene of a crash involving a large truck, you immediately note the presence of an orange placard on the side of the tank that the truck is pulling. This indicates that the vehicle is carrying a/an ______________ agent. A: explosive B: flammable C: corrosive D: radioactive You selected C; The correct answer is A; Reason: The color of a warning placard indicates the general classification of agent being carried, while the United Nations (UN) number in the center of the placard indicates the exact agent being carried. For example, a red placard bearing the UN number 1203 indicates gasoline; red indicates the classification (flammable), and 1203 indicates the exact agent (gasoline). Orange placards indicate explosive or blasting agents, placards that are half yellow and half white indicate radioactive agents, and black placards indicate corrosive agents. Use your emergency response guidebook (and binoculars, if appropriate) to identify both the classification and exact agent involved.
Which of the following is an example of the EMT providing care based on standing orders? A: Following assessment of a patient with a terminal illness, the EMT notifies the patient's personal physician to determine whether he or she requires any special care. B: After confirming that a patient's blood pressure is adequate, the EMT contacts medical control and requests permission to assist the patient with his prescribed nitroglycerin. C: The EMT defibrillates a patient with the automated external defibrillator, directs immediate resumption of CPR, and then contacts medical control for further guidance. D: Prior to administering oral glucose to a patient with hypoglycemia, the EMT confirms the proper dosage and requests authorization from the base station physician. You selected B; The correct answer is C; Reason: Standing orders define certain treatment interventions that the EMT is authorized to perform prior to contacting medical control. For example, the EMT knows that a cardiac arrest patient requires CPR, cardiac rhythm analysis with the AED, and defibrillation (if indicated); contacting medical control before performing these crucial interventions would only waste time and increase the chance of a negative patient outcome. Standing orders generally apply to interventions that the patient requires in order to prevent immediate death. Follow your local protocols regarding which interventions you are authorized to perform prior to contacting medical control.
You and your partner have secured a trauma patient to a long backboard and are preparing to lift the backboard onto the stretcher. When doing so, you should: A: lift the backboard from the sides instead of from the ends. B: be sure to lift the backboard with the powerful muscles of your back. C: ensure that the strongest EMT is positioned at the head of the backboard. D: recall that most of the patient's weight is at the foot end of the backboard. You selected B; The correct answer is C; Reason: Since more than half of the patient's weight is distributed to the head end of a backboard, you should always ensure that the strongest EMT is at that position. This will reduce the risk of injury to less strong personnel as well as the risk of dropping the patient. The backboard should be lifted from the ends, not the sides; you have less control over the board if it is lifted from the sides. When lifting any patient, you should use the powerful muscles of your thighs, not your back, to lift. Keep your back straight and in a locked-in position.
While caring for an injured patient, you remove blood-soaked clothing in order to treat his injuries. You should dispose of the clothing by: A: placing it in a regular trash can. B: leaving it at the hospital. C: leaving it at the scene. D: placing it in a biohazard bag. You selected C; The correct answer is D; Reason: The appropriate method for disposing of soiled clothing or any other "nonsharp" contaminated item is to place it in a red biohazard bag. The biohazard insignia as well as the red color alerts others that the items within the bag are contaminated.
Upon arriving at a scene in which a tanker truck overturned and is spilling an unknown liquid on the ground, you should: A: park upwind from the scene. B: quickly identify the material. C: turn off your warning lights. D: stay downhill from the scene. You selected D; The correct answer is A; Reason: At the scene of a potential or actual hazardous materials incident, you should park the ambulance in an area that is both upwind and uphill from the incident. However, you must be prepared to quickly relocate if the wind direction changes. Staying uphill is important because many hazardous materials collect in low-lying areas, such as valleys. After ensuring that you are in a safe place, attempt to identify the chemical involved by reading the placard on the tanker (with binoculars) and referencing the placard number in the emergency response guidebook
Which of the following is considered minimum personal protective equipment (PPE) when suctioning an unresponsive patient's airway? A: Gloves, head cover, and eye protection B: Gloves and a mask C: Gloves, gown, and eye protection D: Gloves and full facial protection You selected C; The correct answer is D; Reason: You should wear gloves when assessing or treating any patient. The level of personal protective equipment (PPE) used beyond gloves is dictated by the risk and type of exposure. When managing a patient's airway (eg, suctioning, ventilating with a bag-mask device), you should use, at a minimum, gloves and full facial protection. This will protect you from oral and eye exposure if the patient coughs or vomits. A gown should be worn, in addition to gloves and full facial protection, any time there is a risk of blood splatter. Examples of when this may occur include delivering a baby or caring for a combative patient with severe external bleeding. The level of PPE you use in a given situation should be guided by reasonable judgment and common sense.
Upon arriving at the scene of an overturned tanker truck, you see a clear liquid leaking from the rear of the tank. The driver is still in the vehicle and you can see that his face is covered with blood. You should: A: request fire department assistance if they are not already en route. B: approach the rear of the tanker to identify the type of fluid leaking. C: ensure that the ambulance is downwind and downhill from the tanker. D: put on gloves, a gown, and a mask and quickly remove the driver. You selected C; The correct answer is A; Reason: Upon determining that you are dealing with a potential hazardous materials incident, you should immediately request specially trained personnel (eg, fire department, Haz-Mat team) if they are not already en route to the scene. Do not approach a vehicle that may be leaking a hazardous material, even if the patient is still in the vehicle, or you may become a casualty as well. Most ambulances are not equipped with the personal protective equipment required for hazardous materials. Park your ambulance in a location that is both upwind and uphill from the incident. Until additional personnel arrive, try to identify the material being carried by reading the United Nations (UN) number on the safety placard affixed to the tanker; however, this should be done from a safe distance and with the use of binoculars.
Which of the following situations is an example of abandonment? A: An EMT gives a verbal report to an emergency nurse. B: An EMT departs the scene after a paramedic arrives. C: A paramedic transfers care to an advanced EMT. D: An EMT transfers care of a patient to a paramedic. You selected B; The correct answer is C; Reason: Abandonment occurs any time you disengage from a patient while he or she still requires care or you relinquish your responsibility of patient care to a provider of lesser training. If a paramedic transfers patient care to an advanced EMT (AEMT)—clearly a provider with a lower level of training—then the paramedic has abandoned his or her patient. When delivering a patient to the emergency department, you must give your verbal report to a registered nurse or a physician.
While triaging patients at a mass-casualty incident, you encounter a responsive middle-aged female with a respiratory rate of 26 breaths/min. What should you do next? A: Assess for bilateral radial pulses B: Assess her ability to follow commands C: Administer high-flow oxygen at once D: Triage her as immediate (red tag) You selected B; The correct answer is A; Reason: According to the Simple Triage And Rapid Treatment (START) method, if you encounter an adult patient with a respiratory rate that is less than 10 breaths/min or greater than 29 breaths/min, you should triage him or her as immediate (red tag) and move to the next patient. However, if the patient's respiratory rate is between 10 and 29 breaths/min, you should assess his or her hemodynamic status by checking for bilateral radial pulses. If the patient's radial pulses are absent, triage him or her as immediate and move to the next patient. If the patient's radial pulses are present, assess his or her ability to follow simple commands. If the patient is able to follow simple commands, triage him or her as delayed (yellow tag) and move to the next patient. If the patient is unable to follow simple commands, triage him or her as immediate and move to the next patient. Treatment does not occur during the initial triage process.
Which of the following vaccinations is NOT currently recommended by the Centers for Disease Control and Prevention (CDC)? A: Measles, mumps, rubella B: Tetanus, diphtheria, and pertussis C: Smallpox D: Hepatitis B You selected C; This is correct! Reason: Immunization requirements are usually set by the state department of health, but generally follow recommendations made by the Centers for Disease Control and Prevention (CDC). Recommended immunizations for health care providers include tetanus, diphtheria, and pertussis (Tdap, DTaP) boosters (every 10 years); measles, mumps, rubella (MMR) booster; influenza vaccine (yearly); and hepatitis B vaccine (single or three-shot series). Smallpox vaccinations ceased in 1972 after the World Health Organization (WHO) officially declared the disease eradicated.
As an EMT, your primary responsibility is to: A: transport all patients to the hospital. B: provide competent patient care. C: keep yourself as safe as possible. D: ensure the safety of your partner. You selected B; The correct answer is C; Reason: As an EMT, your primary responsibility is to yourself. An injured or dead EMT is of no use to a patient. After ensuring the safety of yourself, your crew, and any bystanders, patient care should be initiated.
While assisting a paramedic in starting an IV on a patient, you are inadvertently stuck by the contaminated needle while attempting to place it in the sharps container. You should: A: cease patient care immediately. B: hold the paramedic liable for the needle stick. C: notify your supervisor and request an HIV test. D: seek medical care as soon as possible. You selected C; The correct answer is D; Reason: If you receive an exposure while providing patient care, you should notify your supervisor or designated infection control officer and seek medical care as soon as possible. However, this should be done after you have completed patient care. You will be tested for bloodborne pathogens such as HIV and hepatitis B, and based on the degree of exposure, the physician may suggest immediate treatment. The paramedic did not intentionally stick you with the needle; therefore, you cannot hold him or her liable. Careful and appropriate handling of needles and other sharps will reduce your risk of an accidental stick.
Which of the following situations presents the greatest risk for suicide? A: A man who was recently diagnosed with stage 4 lung cancer B: An EMT who saved a drowning child and receives no media attention C: A woman who quit her job for one that pays a lot more D: A woman who is planning a family trip, but gets called away to work You selected B; The correct answer is A; Reason: Any patient with a significant, most often negative, life change is at risk for suicide. Common catalysts to suicide include chronic depression, the loss of a loved one or a job, relationship problems, financial difficulties, and the diagnosis of a serious or terminal illness. There have been a number of cases in which EMS personnel who performed a heroic act have committed suicide after receiving excessive media attention
While en route to the scene of an injured person, dispatch advises you that law enforcement personnel are at the scene. This indicates that: A: the scene is potentially unsafe. B: a crime has been committed. C: the patient is critically injured. D: the scene is safe for you to enter. You selected B; The correct answer is A; Reason: The presence of law enforcement at the scene indicates, at a minimum, that the scene is potentially unsafe, otherwise they would not be there. While you are en route, you should make radio contact with the police officers at the scene to determine if it is safe for you to enter; you should also inquire about the severity of the patient's injuries. The more information you obtain before you arrive, the better. For all you know, you could arrive and find yourself in the middle of a fire fight! The mere presence of law enforcement at the scene does NOT ensure a safe environment.
While functioning at a large-scale terrorist incident, it is important for the EMT to: A: begin immediate treatment of the most critically injured. B: identify the person or persons responsible for the event. C: use triage and base patient care on available resources. D: avoid placing any casualty in a "delayed" treatment status. You selected C; This is correct! Reason: During a terrorist incident, the basic foundations of triage and patient care remain the same; however, the treatment can and will vary. Terrorist incidents can produce a single casualty, hundreds of casualties, or thousands of casualties. When presented with wide-spread mass casualties, you must remember situational awareness. What you do in one situation may not be appropriate for another situation. In large-scale terrorist incidents, it is important to use triage and base patient care on available resources. When triaging casualties, use the same triage process that you would for any other mass-casualty incident. Remain focused on providing the greatest good for the greatest number of people, not the person or persons responsible for the incident.
You are called to treat a 55-year-old man who is experiencing difficulty breathing. After making contact with your patient, he extends his arm out to allow you to take his blood pressure. This is an example of: A: informed consent. B: formal consent. C: implied consent. D: actual consent. You selected B; The correct answer is D; Reason: Actual consent, also referred to as expressed consent, is when the patient asks for your help outright. This may also include nonverbal gestures, such as extending the arm to you to allow you to take the blood pressure. Informed consent involves explaining your proposed treatment to the patient, including the potential benefits and risks of the treatment. Implied consent involves treating an unresponsive patient or minor child (when the parents are not present) based on the assumption that the patient (or the parents of a minor) would consent to emergency treatment.
Which of the following statements regarding the use of an escort vehicle when en route to an emergency call is correct? A: An escort vehicle should be used only if you are unfamiliar with the patient's location. B: An escort vehicle will allow you to arrive at the scene quicker. C: With an escort vehicle, the risk of an accident at an intersection is reduced significantly. D: To avoid getting separated from the escort vehicle, you should closely follow it. You selected A; This is correct! Reason: Generally, escort vehicles should not be used when responding to an emergency scene. The biggest danger of using an escort occurs at intersections, which is where most ambulance crashes occur. Drivers may yield to the escort vehicle, but may not be prepared for a second vehicle following the escort (wake effect collision). The only time that an escort may be required is when you are unfamiliar with the location of the patient and need assistance getting there. If an escort must be used, you must follow at a safe distance of at least 500 feet.
You are dispatched to a call for an unresponsive patient. Which of the following is the MOST important information that you should initially obtain from the dispatcher? A: Whether or not the patient is breathing B: The patient's sex and approximate age C: The exact location of the patient D: The call back number of the caller You selected C; This is correct! Reason: You should attempt to obtain as much patient information from the dispatcher as you can. However, in order to help the patient, you must know his or her location; therefore, this is the most important initial question to ask. Once you determine where the patient is, you should then try to ascertain the sex and approximate age of the patient, whether or not he or she is breathing, and any other information that can help you prepare to provide care. The caller's phone number is generally not disclosed to the responding EMTs, although this is important information for the dispatcher to obtain. In many dispatch systems, the caller's phone number (and location in some cases) automatically appears on the computer screen when the 911 call is answered.
As soon as you begin transport of a patient to the hospital, you should: A: notify the receiving facility. B: advise dispatch of your status. C: contact medical control. D: conduct a detailed examination. You selected B; This is correct! Reason: Immediately upon departing the scene with a patient, you should first inform the dispatcher that you are en route to the hospital. Never leave the dispatcher in the dark, for it is the dispatcher's job to know what units are available to answer emergency calls. Notifying the receiving facility, contacting medical control, and performing a detailed assessment of your patient all can occur while you are en route to the hospital.
Your actions at the scene of a critically injured patient who was shot during a robbery should include: A: providing care when the police authorize you to. B: caring for the patient while manipulating the scene minimally. C: starting immediate care as you would with any other patient. D: performing a primary assessment only. You selected A; The correct answer is B; Reason: After ensuring your own safety, your priority while functioning at a crime scene is to provide care to the patient. However, you should make a reasonable effort to avoid manipulating the scene in order to preserve potential evidence. If furniture or other objects do not need to be moved to gain access to the patient and provide adequate working space, they should be left in place. Conversely, if any obstacles impede your care of the patient, they must be moved as needed. Seeking law enforcement approval before treating a critically injured patient would clearly waste
