Chapter 37 Hazmat

Question 1

Key Terms

area where the Incident Command post and support functions are located

Answer 1

Cold Zone

Question 2

Key Terms

the first on the scene to establish order and initiate the Incident Command System

Answer 2

Command

Question 3

Key Terms

a chemical and/or physical process that reduces or prevents the spread of contamination from persons or equipment: the removal of hazardous substances from employees and their equipment to the extent necessary to preclude foreseeable health effects

Answer 3

Decontamination

Question 4

Key Terms

a predefined set of instructions for a community’s emergency responders

Answer 4

Disaster Plan

Question 5

Key Terms

any substance or material in a form that poses an unreasonable risk to health, safety, and property when transported in commerce or kept in storage of a warehouse, port, depot, or railroad facility

Answer 5

Hazardous Material

Question 6

Key Terms

area immediately surrounding a hazmat incident; extends far enough to prevent adverse effects outside the zone

Answer 6

Hot Zone

Question 7

Key Term

the person or persons who assume overall direction of a large-scale incident

Answer 7

Incident Command

Question 8

Key Term

a subset of the National Incident Management System (NIMS) designed specifically for management of multiple-casualty incidents

Answer 8

Incident Command System (ICS)

Question 9

Key Term

any medical or trauma incident involving multiple patients

Answer 9

Multiple-Casualty Incident (MCI)

Question 10

Key Term

the management system used by federal, state, and local governments to manage emergencies in the United States

Answer 10

National Incident Management System (NIMS)

Question 11

Key Term

command organization in which a single agency controls all resources and operations

Answer 11

Single Incident Command

Question 12

Key Term

the area where ambulances are parked and other resources are held until needed

Answer 12

Staging Area

Question 13

Key Term

person responsible for overseeing ambulances and ambulance personnel at a multiple-casualty incident

Answer 13

Staging Supervisor

Question 14

Key Term

a measurable representation of ability to manage a sudden influx of patients. It is dependent on a well-functioning incident management system and the variables of space, supplies, staff, and any special consideration (contaminated or contagious patients, for example)

Answer 14

Surge Capacity

Question 15

Key Term

person responsible for communicating with sector officers and hospitals to manage transportation of patients to hospitals from a multiple-casualty incident

Answer 15

Transportation Supervisor

Question 16

Key Term

the area in which patients are treated at a multiple-casualty incident

Answer 16

Treatment Area

Question 17

Key Term

person responsible for overseeing treatment of patients who have been triaged at a multiple-casualty incident

Answer 17

Treatment Supervisor

Question 18

Key Term

the process of quickly assessing patients at a multiple-casualty incident

Answer 18

Triage

Question 19

Key Term

the area where secondary triage takes place at a multiple-casualty incident

Answer 19

Triage Area

Question 20

Key Term

the person responsible for overseeing triage at a multiple-casualty incident

Answer 20

Triage Supervisor

Question 21

Key Term

color-coded tag indicating the priority group to which a patient has been assigned

Answer 21

Triage Tag

Question 22

Key Term

command organization in which several agencies work independently but cooperatively

Answer 22

Unified Command

Question 23

Key Term

zone where personnel and equipment decontamination and hot zone support take place; it includes control points for the access corridor and, thus, assists in reducing the spread of contamination

Answer 23

Warm Zone

Question 24

Critical Decision Making

One of the key elements of this chapter is handling the multiple-casualty incident. The concepts that were described in the “Scene Size-Up” chapter return here with increased importance. For each of the following scenarios, determine what resources you would call for in your initial report to the dispatcher.

You are called to a shopping mall for “sick people.” You arrive to find dozens of people standing outside the mall, coughing and rubbing their eyes. Looking around the parking lot, you see hundreds of cars.

Answer 24

Activate your MCI plan. Based on the fact that you see “dozens” of people, you may be looking at 25+ patients, and more may still be inside. This is a large-scale multiple-casualty incident and must be treated as such. It is a bigger issue than simply calling for additional ambulances. This will require prolonged operations and resources. Be sure the hazmat team is activated.

Question 25

Critical Decision Making

One of the key elements of this chapter is handling the multiple-casualty incident. The concepts that were described in the “Scene Size-Up” chapter return here with increased importance. For each of the following scenarios, determine what resources you would call for in your initial report to the dispatcher.

You arrive at a motor-vehicle crash in which two cars collided at an intersection with considerable force. One patient has been ejected. Three others don’t appear to be moving.

Answer 25

Assume that you will need an ambulance and crew for each of the four critical patients. You may also need to call for fire department response for extrication or personnel assistance.

Question 26

Critical Decision Making

One of the key elements of this chapter is handling the multiple-casualty incident. The concepts that were described in the “Scene Size-Up” chapter return here with increased importance. For each of the following scenarios, determine what resources you would call for in your initial report to the dispatcher.

You are treating a woman in her home for flulike symptoms. You notice that her husband and one child are also sick. You check on another child sleeping in the same residence and find that he won’t wake up.

Answer 26

This may be a carbon monoxide situation. Assume that there are four patients—and you and your crew now also fall into the patient category. Exit the building, taking the patients with you. Immediately call for additional ambulances and the fire department.

Question 27

Short Answer

List the information contained in an initial report of a hazardous material incident.

Answer 27

When giving an initial report of a hazardous material incident, be sure to alert the dispatcher to the fact that you are dealing with a hazmat incident and request appropriate support services. Try to identify the hazardous materials by using binoculars to look for identifying signs, labels, or placards. If possible, try to report:

 - The material involved
 - Wind direction
 - Safe staging location
 - The number of fire and hazmat resources you think you will need
 - Who has information on the substance involved such as MSDS sheets.

Question 28

Short Answer

Explain how to identify a hazardous material and how to obtain information about that material.

Answer 28

When involved in transportation, vehicles are required to have placards that can be referenced in the yellow emergency response guide. This not only helps identify the substance but also guides the medical care, evacuation, and emergency actions. Buildings may use the NFPA 704 system, which can advise responders about the flammability, danger, and reactivity of the substances inside. The real gold standard, though, is for the building owner, shipper, or keeper of the substance to provide responders with the MSDS, or material safety data sheet. The biggest challenge in dealing with a hazmat situation is in accurately identifying the substance. The most complicated situations can often involve unknown substances or chemicals. In this situation, the hazmat team may have to do extensive work to determine the substance involved.

Question 29

Short Answer

Describe the general assessment and emergency care of a patient with a hazardous material injury.

Answer 29

Care of a patient with a hazardous material injury always starts with a scene size-up, scene safety, and the ABCs. In a hazmat situation, the critical determination is whether the patient poses a risk of secondary contamination to the rescuers. Any patient with a hazardous material injury must be fully decontaminated by a qualified hazmat team before being turned over to the EMS personnel, regardless of the severity of his medical condition.

Question 30

Short Answer

Describe the major components and benefits of an Incident Management System.

Answer 30

The major components and benefits of the Incident Command System are interoperability between responding agencies, clear lines of authority, and a management structure conducive to managing a large incident.

Question 31

Short Answer

Define the basic role of the EMT at a multiple-casualty incident.

Answer 31

Overall, the role of EMS in a multiple-casualty incident is triage, treatment, and transportation. The role of the first arriving EMTs is to initiate their agency’s incident management plan. Establish Command, do a scene size-up, give an arrival report to dispatch, request or cancel resources, and begin triage-transportation activities.

Question 32

Short Answer

Explain why patients are assigned priorities during triage.

Answer 32

Assigning priorities during triage allows limited resources to focus efforts on patients with the greatest needs. The process is focused on saving lives by putting effort into patients the most serious injuries first. This gives the greatest number of people the greatest chance of survival.

Question 33

Short Answer

Identify four priority categories of triage.

Answer 33

The four priority categories of triage are:

• Priority-1 (RED)—Treatable life-threatening conditions
• Priority-2 (YELLOW)—Serious but non-life-threatening conditions
• Priority-3 (GREEN)—Walking wounded
• Priority-4 (BLACK)—Dead or expected to die

Question 34

Critical Thinking Exercises

When you are first on scene at a possible multiple-casualty incident with possible hazardous material involvement, what should you do? The purpose of this exercise will be to think through your actions at such an incident.

Your call is to a motor-vehicle collision with an unknown number of injuries. As your unit approaches the scene, you see that three cars and downed wires are involved. You get a whiff of gasoline as you pass by. The drivers are visible in each vehicle—one appears to be conscious, and the other two are bent forward or slumped back. There are passengers visible in two vehicles, one or more of whom may need extrication. How should you proceed?

Answer 34

Establish a perimeter around the danger area, and keep people out. Radio an arrival report to dispatch, and request additional resources such as the power company, fire department, extrication, and position your vehicle to protect the scene and create a safe working area. This should be performed in a manner with your local procedures.