Ch 48

Question 1

Because extrication and rescue can be medically complex:

• no lengthy extrication or rescue operation should commence until an emergency physician is present at the scene.
• the officers responsible for these functions usually function under a specialty branch of the incident command system.
• the position of extrication or rescue officer should always be assumed by an experienced EMT or paramedic.
• anyone who requires extrication or rescue should be triaged and receive basic lifesaving care before being extricated or rescued.

Answer 1

the officers responsible for these functions usually function under a specialty branch of the incident command system.

Question 2

A man stormed into a daycare center and opened fire with a semiautomatic rifle. The scene has been secured by law enforcement, and you are in the process of triaging the injured children. The first child you assess, a 4-year-old boy, is unresponsive and apneic but has a pulse. After manually opening his airway, he remains apneic. You should:

• consider him nonsalvageable and place a black tag on him.
• categorize him as an immediate patient and continue triaging.
• assist his ventilations while closely monitoring his pulse rate.
• provide five rescue breaths and reassess his respiratory status.

Answer 2

provide five rescue breaths and reassess his respiratory status.

Question 3

Communicating with area hospitals to determine their capabilities and resources is a responsibility of the:

• transportation unit leader.
• chief medical officer.
• treatment unit leader.
• individual paramedic.

Answer 3

transportation unit leader.

Question 4

When sizing up the scene of a multiple-casualty incident, it is most important to:

• assess for hazards.
• determine what caused the incident.
• request a hazmat team.
• request additional help.

Answer 4

assess for hazards.

Question 5

Command functions include the:

• triage officer.
• logistics section chief.
• liaison officer.
• finance section chief.

Answer 5

liaison officer.

Question 6

During an incident involving a building collapse, a paramedic is assigned eight rescuers to function under his authority. However, as the incident progresses, the paramedic finds that he is unable to effectively manage the personnel assigned to him. He should:

• transfer authority to one of the rescuers assigned to him and then follow that person’s directions.
• release half of the rescuers assigned to him and instruct them to report directly to the incident commander.
• divide tasks and delegate supervision of some tasks to one or more of the rescuers assigned to him.
• send two of the rescuers to the triage section since this is where they will most likely be needed.

Answer 6

divide tasks and delegate supervision of some tasks to one or more of the rescuers assigned to him.

Question 7

Which of the following statements regarding the rehabilitation group is correct?

• In addition to meeting the responders’ needs for rest, fluids, and food, the rehabilitation officer must be prepared to conduct a defusing session if a responder shows signs of stress.
• Ideally, the rehabilitation section should be located within view of the scene so that responders can return to the incident quickly if they are requested to do so by a section officer.
• Victims of a major incident who are not physically injured should report to the rehabilitation section for food, water, rest, protection from the elements, and psychological support.
• The primary purpose of the rehabilitation section is to conduct brief physical examinations on all responders before they actively engage in functions that are required by the incident.

Answer 7

In addition to meeting the responders’ needs for rest, fluids, and food, the rehabilitation officer must be prepared to conduct a defusing session if a responder shows signs of stress.

Question 8

Which of the following injuries or conditions should be assigned the highest triage priority?

• Multiple long bone fractures
• Respiratory distress
• Partial-thickness burns
• Cardiopulmonary arrest

Answer 8

Respiratory distress

Question 9

Triage tags that have tear-off receipts are most useful to the:

• treatment supervisor.
• triage supervisor.
• incident commander.
• transportation supervisor.

Answer 9

transportation supervisor.

Question 10

The National Incident Management System standard incident command structures are based on:

• a single command system, cooperation between state and local governments, and a mechanism to warn the public.
• an incident command system, multiagency coordination systems, and public information systems.
• a unified command system, multijurisdictional cooperation, and continuous public education.
• U.S. military oversight, coordination among multiple public and private agencies, and a warning system.

Answer 10

an incident command system, multiagency coordination systems, and public information systems.

Question 11

Using the incident command system provides a modular organizational structure that:

• requires a uniform approach to any major incident.
• remains static in all incidents involving mass casualties.
• depends on the size and complexity of the incident.
• is overseen by the most experienced paramedic.

Answer 11

depends on the size and complexity of the incident.

Question 12

Upon arriving at the scene of a multiple vehicle crash, you call for additional resources and begin triaging patients using the START triage system. The first patient you assess is a young male who is unconscious and apneic. After manually opening his airway, you note that he starts breathing shallowly. You should:

• place a yellow tag on him and continue triage.
• secure his airway with an endotracheal tube.
• categorize him as an immediate patient.
• assess the rate and quality of his radial pulse

Answer 12

categorize him as an immediate patient

Question 13

Which of the following events would most likely cause an open, or uncontained, multiple-casualty incident?

• Small explosion
• Tornado
• Bus wreck
• Two-car collision

Answer 13

tornado

Question 14

The primary duty of the triage unit leader is to:

• evacuate patients to the most appropriate treatment area.
• ensure that every patient receives an initial assessment.
• immediately identify the most critically injured patients.
• quickly remove the deceased from the triage area.

Answer 14

ensure that every patient receives an initial assessment.

Question 15

When functioning at the scene of a major incident, communication should:

• involve the use of codes to limit air time.
• occur via radio to keep everyone updated.
• incorporate signals for privacy purposes.
• be face-to-face to minimize radio traffic.

Answer 15

be face-to-face to minimize radio traffic.

Question 16

If a disaster situation requires a morgue unit leader, it is most important for the person who is assigned that function to:

• work directly with law enforcement officials to positively identify the deceased as soon as possible.
• quickly remove the bodies from the scene, even if a storage and removal plan has not been established.
• leave all of the dead victims in their original locations until a coroner or mortician is at the scene.
• be aware that some mass-casualty incidents involving numerous fatalities may be crime scenes.

Answer 16

be aware that some mass-casualty incidents involving numerous fatalities may be crime scenes.

Question 17

According to the START triage system, a nonbreathing patient should be triaged as immediate if:

• the airway is completely blocked by swelling.
• a manual airway maneuver restores breathing.
• they do not respond to two rescue breaths.
• they are in need of immediate intubation.

Answer 17

a manual airway maneuver restores breathing.

Question 18

In contrast to primary triage, secondary triage:

• is typically performed by a physician.
• involves initial placement of triage tags.
• requires a more rapid assessment.
• is performed in the treatment area.

Answer 18

is performed in the treatment area.

Question 19

Which individual has the authority and responsibility to stop an emergency operation if they believe that a rescuer is in danger?

• Safety officer
• Logistics chief
• Rescue officer
• Triage officer

Answer 19

Safety Officer

Question 20

Which of the following interventions would most likely be performed while triaging patients with the SALT method?

• Needle chest decompression
• Complex fracture stabilization
• intravenous fluid boluses
• Supplemental oxygen therapy

Answer 20

Needle chest decompression

Question 21

According to the START triage system, if a patient has a strong radial pulse, you should:

• control bleeding and assess mental status.
• place them in the delayed category.
• assess their ability to follow commands.
• determine whether their pulse rate is slow or fast.

Answer 21

control bleeding and assess mental status.

Question 22

Which of the following statements regarding the unified command system is correct?

• The response plan developed by a unified command system should focus only on major events such as building collapses, plane crashes, and terrorist attacks.
• A unified command system functions optimally if one incident commander from each agency is identified before a multiple-casualty incident actually occurs.
• In a unified command system, multiple agencies from multiple jurisdictions work together to develop a plan that involves shared responsibilities.
• A unified command system is difficult to establish before an incident and is activated when the resources of one agency are significantly overwhelmed.

Answer 22

In a unified command system, multiple agencies from multiple jurisdictions work together to develop a plan that involves shared responsibilities.

Question 23

Upon arriving at the scene of a major incident, you can clearly see that there are numerous patients, some of whom are receiving care and others of whom are walking around unattended. You should:

• report to the staging area for further instructions.
• immediately triage the unattended patients.
• move the walking patients to a separate area.
• notify dispatch and request air medical transport.

Answer 23

report to the staging area for further instructions.

Question 24

Multiple-casualty equipment and supplies needed for airway control include:

• large-bore IV catheters.
• oral and nasal airways.
• supplemental oxygen.
• dressings and bandages.

Answer 24

oral and nasal airways.

Question 25

If an emergency physician is present at the scene of a mass-casualty incident, they would be most likely to: - transport patients to receiving medical facilities. - make initial and secondary triage decisions. - establish an area that protects responders from the elements of the situation. - assume control over complex rescuer operations.

Answer 25

make initial and secondary triage decisions

Question 26

According to the JumpSTART triage system, if an infant or child is not breathing, you should: - manually open the patient's airway. - immediately assess for a pulse. - deliver five rescue breaths. - categorize the patient as expectant.

Answer 26

immediately assess for a pulse.

Question 27

An individual's span of control: - represents the number of personnel who report to them. - is the degree of responsibility assigned by a higher authority. - limits their autonomy to delegate tasks to another person. - should be self-assigned and dependent on the incident size.

Answer 27

represents the number of personnel who report to them.

Question 28

Which of the following statements regarding critical incident stress management at the scene of a mass-casualty incident is correct? - Critical incident stress management should begin only after all patients have been cared for appropriately. - At a multiple-casualty incident, rescuers are unable to self-heal, and they lose their resiliency to cope with the stress. - Rescuers should be encouraged, but not forced, to report to the rehabilitation sector for a stress debriefing. - Critical incident stress management is a crucial and mandatory part of any disaster and should be enforced.

Answer 28

Rescuers should be encouraged, but not forced, to report to the rehabilitation sector for a stress debriefing.

Question 29

Which of the following duties is a main responsibility of the incident commander? - Authorizing medical treatment interventions - Working with environmental health specialists - Managing tactical operations at the scene - Establishing strategic objectives and priorities

Answer 29

Establishing strategic objectives and priorities

Question 30

During an incident involving an explosion, you determine that two critically injured patients should be transported to a trauma center by air. After stabilizing the patients' conditions to the best of your ability, you should: - notify the transportation supervisor and request that they establish a landing zone. - contact the incident commander and request permission to utilize air transport. - call the receiving trauma center and update them on the patients' conditions. - request air transport immediately and determine where you will land the helicopter.

Answer 30

notify the transportation supervisor and request that they establish a landing zone.

Question 31

Broadly speaking, the finance section chief is responsible for: • documenting all expenditures at an incident and seeking reimbursement. • determining what impact the incident will have on the economy of the affected area. • tracking all personnel overtime and ensuring that they are compensated. • predetermining how much a major incident would affect the system's finances.

Answer 31

documenting all expenditures at an incident and seeking reimbursement.

Question 32

While triaging patients at a multiple-casualty incident, you rapidly assess a patient and determine that she is conscious and alert but cannot feel or move anything below her umbilicus. You should: • place a yellow tag on her and move on to the next patient. • categorize her as an immediate patient and continue triage. • apply full spinal motion restriction precautions at once. • conduct a more in-depth neurologic exam of the patient.

Answer 32

place a yellow tag on her and move on to the next patient.

Question 33

At a very large incident, the operations section is responsible for: • ensuring that there is ample lighting and functional communications equipment during the incident. • locating food, shelter, and health care for you and the other responders present at the incident. • managing the tactical operations job usually handled by the incident commander on routine EMS calls. • obtaining data regarding problems that may arise at the incident and revising the plan to solve the problem.

Answer 33

managing the tactical operations job usually handled by the incident commander on routine EMS calls.

Question 34

Prior to implementing any plans or operations at the scene of a multiple-casualty incident, you should first: • notify your supervisor or the incident commander. • acquire the assistance of at least seven other rescuers. • make sure the assigned safety officer is present. • move any unnecessary personnel away from the area.

Answer 34

notify your supervisor or the incident commander.

Question 35

You are caring for a patient with non–life-threatening injuries in the treatment section of a multiple-casualty incident when you are approached by several TV reporters who are seeking details regarding the incident. You should: • provide a brief overview of the current situation. • ignore the reporters' questions and continue patient care. • direct the reporters to the public information officer. • firmly tell the reporters to leave the scene immediately.

Answer 35

direct the reporters to the public information officer.

Question 36

Multiple-casualty equipment and supplies needed for airway control include: oral and nasal airways. dressings and bandages. large-bore IV catheters. supplemental oxygen.

Answer 36

Oral and nasal airways