Ch 49

Question 1

When removing a vehicle’s roof, you must first:

• remove at least one door so patient assessment can begin.
• remove all glass to prevent it from falling on the patient.
• break the safety glass of the window closest to the patient.
• cut the vehicle posts farthest away from the patient.

Answer 1

remove all glass to prevent it from falling on the patient.

Question 2

As the first responding unit to arrive at the scene of a confined space rescue, what is the most important information to share with the technical rescue team when they arrive?

The patient’s name, weight in pounds, and any known medical problems

Your scene assessment and recommended approach to the rescue effort

The documented statements of any individuals who witnessed the event

Whether the incident has changed significantly since your arrival

Answer 2

Whether the incident has changed significantly since your arrival

Question 3

Which of the following ECG findings is the most significant in a patient who was entrapped for a prolonged period of time?

• First-degree AV block
• Peaked T waves
• Small P waves
• Tachycardia

Answer 3

Peaked T waves

Question 4

Which of the following statements regarding vehicle stabilization is correct?

• After a vehicle is properly cribbed, its suspension system is adequately stable.
• Vehicle cribbing is made of steel and is used to keep a vehicle from rolling.
• The use of step blocks eliminates the need to deflate a crashed vehicle’s tires.
• Vehicles that are positioned upright on all four wheels should be stabilized.

Answer 4

Vehicles that are positioned upright on all four wheels should be stabilized.

Question 5

Your initial attempt to rescue a person from the water should involve:

• reaching out to the victim using any readily available object.
• rowing out to the person in a raft or canoe if one is available.
• removing encumbering clothing and swimming to the victim.
• throwing the victim a flotation device that is attached to rope.

Answer 5

reaching out to the victim using any readily available object.

Question 6

Access to a patient and the initiation of treatment can begin only after the:

• patient has been disentangled.
• fire department is at the scene.
• scene has been made safe.
• triage officer is present.

Answer 6

scene has been made safe.

Question 7

As soon as you reach an unresponsive victim who is floating in the water, you should:

• float a buoyant backboard under the victim and initiate ventilations.
• move the victim’s face above water and manually open their airway.
• turn the patient supine without manipulating their head or neck.
• immediately assess for the presence of breathing and for a central pulse.

Answer 7

turn the patient supine without manipulating their head or neck.

Question 8

You and your partner are the first to arrive at a rollover vehicle crash. The vehicle apparently rolled several times and ended up on all four wheels on a slight incline. The driver is still in the vehicle, but does not appear to be entrapped. You should:

• deflate all tires by removing the valve stems with pliers.
• stabilize the patient’s head in a neutral, inline position.
• place cribbing in the front and back of all four wheels.
• position step blocks at all four corners of the vehicle.

Answer 8

place cribbing in the front and back of all four wheels

Question 9

Packaging a patient is defined as:

• preparing the patient for movement as a unit.
• splinting all fractures before moving a patient.
• ensuring that full spinal precautions are taken.
• securely fastening a patient to a long backboard.

Answer 9

preparing the patient for movement as a unit.

Question 10

When heavy extrication tools are required to force a damaged door open, you should:

• gain access to the patient by removing the door that is closest to the patient.
• first place 4-inch by 4-inch cribbing underneath the door to hold it in place.
• peel the door down and away from the patient with the spreader.
• avoid trying to force a door open if the patient is leaning against it.

Answer 10

avoid trying to force a door open if the patient is leaning against it.

Question 11

Which of the following gases is characterized by a pungent odor, and, because it is lighter than air, rises to the upper atmospheric level in confined spaces?

• Nitrogen dioxide
• Hydrogen sulfide
• Methane
• Ammonia

Answer 11

Ammonia

Question 12

A 7-year-old child was playing near a large pile of sand when the ground underneath her collapsed. You can hear her crying and asking for her mother. Until the technical rescue team arrives at the scene, you should:

• throw the child a rope and ask her to tie it around her waist so you can pull her out.
• maintain verbal contact with the child, but avoid going near the edge of the trench.
• get as close to the edge of the trench as possible and attempt to visualize the child.
• use several long backboards as shoring to decrease the risk of a secondary collapse.

Answer 12

maintain verbal contact with the child, but avoid going near the edge of the trench.

Question 13

A frantic woman called 9-1-1 after her father, a 77-year-old man with Alzheimer disease, wandered off into a wooded area near her home. When you arrive at the scene, the woman tells you that she is not sure in which direction her father headed. What should you do?

• Notify the dispatcher and request a helicopter to attempt to find the man.
• Ask the daughter if her father has any other known medical conditions.
• Remain with the daughter and immediately request a search and rescue team.
• Have your partner stay with the daughter as you attempt to locate the man.

Answer 13

Remain with the daughter and immediately request a search and rescue team.

Question 14

Which of the following statements regarding cold-water immersion is correct?

• Tachycardia occurs after falling in cold water and lowers the basal metabolic rate.
• Water that is colder than 70 degrees Fahrenheit will cause a marked increase in oxygen demand.
• The cold protective response secondary to hypothermia can protect vital organs.
• In extremely cold water (35 degrees Fahrenheit or less), a person is likely to die after 5 minutes of submersion.

Answer 14

The cold protective response secondary to hypothermia can protect vital organs.

Question 15

After gaining access to a patient with extrication procedures, the next step involves:

• pulling the steering column forward with a hydraulic tool.
• removing parts of the vehicle that are trapping the patient.
• performing a complete physical assessment of the patient.
• quickly but carefully moving the patient onto a backboard

Answer 15

removing parts of the vehicle that are trapping the patient.

Question 16

A 29-year-old man was pulled from icy water after being submerged for approximately 10 minutes. He is unresponsive, apneic, and pulseless. He does not appear to have any injuries. The most appropriate treatment for this patient involves:

• immobilizing his spine, initiating CPR, removing his wet clothing, and ceasing resuscitative efforts if unsuccessful after 5 minutes.
• assessing his cardiac rhythm, but attempting resuscitation only if the cardiac monitor reveals ventricular fibrillation or ventricular tachycardia.
• defibrillating up to three times if he is in ventricular fibrillation, removing his wet clothing and applying blankets, and transporting.
• protecting his spine, initiating resuscitative measures, removing his wet clothing and applying warm blankets, and transporting

Answer 16

protecting his spine, initiating resuscitative measures, removing his wet clothing and applying warm blankets, and transporting

Question 17

The most common swift water rescue scenario involves:

• a swift water rescue technician who does not wear a flotation device.
• undertow ocean currents that force the victim under water.
• people who attempt to drive their vehicles across a flooded bridge.
• a canoer who is entrapped in thick brush in fast-moving water

Answer 17

people who attempt to drive their vehicles across a flooded bridge.

Question 18

In addition to identifying and evaluating any hazards, scene stabilization typically involves:

• treating the patient as soon as possible.
• determining if air transport is available.
• observing the incident’s geographic area.
• removing a trapped patient from a vehicle.

Answer 18

observing the incident’s geographic area.

Question 19

If you must break a window to gain access to a patient trapped in his or her vehicle, you should:

• try to lower the window as far as possible before breaking it.
• break the safety glass of a side window with a center punch.
• break the windshield and approach the patient from the front.
• ensure that the patient and all rescuers are protected properly

Answer 19

ensure that the patient and all rescuers are protected properly

Question 20

Which of the following statements regarding utility hazards at the scene of a rescue operation is correct?

• Natural gas displaces carbon dioxide in the air.
• Live power lines usually arc or produce sparks.
• Utility hazards can be above or below the ground.
• You should park at least 10 feet away from downed power lines.

Answer 20

Utility hazards can be above or below the ground.

Question 21

If you believe that your assigned task at a rescue incident may be unsafe, it would be most appropriate for you to:

• reorganize the rescue effort as dictated by the situation.
• proceed with the task while exercising extreme caution.
• assign yourself a task that poses less of a safety threat.
• bring your concern to the attention of the safety officer.

Answer 21

bring your concern to the attention of the safety officer.

Question 22

The rescue team has just removed the door from a badly damaged car. The patient, a young woman, is pinned between the steering wheel and driver’s seat. You should:

• place a heavy glass-proof blanket over the patient, go around to the opposite side of the vehicle, and provide reassurance to the patient.
• limit your primary assessment and treatment to airway management until she has been disentangled from the vehicle.
• perform a primary assessment, attempt to treat any life-threatening injuries, and remain with the patient as she is being disentangled.
• assess the patient’s level of consciousness, reassure her that she will be okay, and allow the rescue team to disentangle her.

Answer 22

perform a primary assessment, attempt to treat any life-threatening injuries, and remain with the patient as she is being disentangled.

Question 23

Which of the following items of information is typically obtained by the dispatcher prior to sending rescue units to the scene?

Number of patients involved

The patient’s medical history

The patient’s medication list

The prognosis of the patient

Answer 23

Number of patients involved

Question 24

The preferred initial method for disentangling a patient who is trapped between the seat and steering wheel involves:

• displacing the dashboard forward.
• trying to slide the seat back on its track.
• using a powered hydraulic spreader.
• removing the bolts that secure the seat.

Answer 24

trying to slide the seat back on its track.

Question 25

A police officer was shot when he attempted to serve a warrant. The shooter is still inside the residence, which is surrounded by SWAT team members. You have provided initial treatment, have loaded the officer into the ambulance, and are ready to depart. Your next action should be to: - immediately turn your lights and siren on to announce your exit. - confirm with the incident commander that it is safe to exit. - choose a different route than the one used to enter the scene. - wait for the shooter to be neutralized before departing.

Answer 25

confirm with the incident commander that it is safe to exit.

Question 26

Prior to displacing a dash, you should anticipate that rescue personnel will first: - cut the bottom of the A post where it meets the floor. - place a high-lift mechanical jack at the base of the B post. - tie the doors in an open position so they do not move. - place a protective barrier between the A post and patient.

Answer 26

tie the doors in an open position so they do not move.

Question 27

You are dispatched to a local lake for a possible drowning. When you arrive, you can see a young woman floating face down in the water, approximately 20 feet from the bank. Witnesses state that they heard her scream, and then found her in her present condition. After you and your partner safely swim to the patient, you should first: - roll her face up as a single unit while manually stabilizing her head and neck. - place her onto a floatable backboard and immediately remove her from the water. - have your partner stabilize her head and neck as you palpate for a carotid pulse. - carefully roll her over, open her airway with the jaw-thrust maneuver, and assess for breathing.

Answer 27

roll her face up as a single unit while manually stabilizing her head and neck.

Question 28

The objective of dash displacement is to: - pull the dash straight forward. - laterally displace the dashboard. - lift the dash up and move it forward. - remove the entire dash from the vehicle

Answer 28

lift the dash up and move it forward.

Question 29

Once you have succeeded in establishing verbal contact with a patient who is in the process of being rescued, it is most important to: - speak slowly and distinctly. - answer all of the patient's questions. - remain in contact with patient. - use the patient's first name.

Answer 29

remain in contact with patient.

Question 30

You and your partner are standing by at the scene of a residential fire when you hear that a badly burned woman has been located by fire fighters on the side of the house opposite your ambulance. You should: - stay where you are and have fire fighters bring the patient to you. - dispatch another ambulance to the scene to take care of the patient. - immediately move the ambulance to the other side of the residence. - send your partner to the other side of the residence to find the patient

Answer 30

stay where you are and have fire fighters bring the patient to you.

Question 31

The first step in assuming the self-rescue position if suddenly immersed in fast-moving water involves: keeping your feet together and moving in the direction of the moving water. rolling into a face-up arched position with the lower back higher than the feet. keeping your head down and your chin tucked to avoid striking an object. using your hands to change direction, avoiding objects, and diverting to a safe place.

Answer 31

rolling into a face-up arched position with the lower back higher than the feet.

Question 32

In contrast to low-angle rope rescues, high-angle rescues: involve situations where the patient must be removed from a cliff or other high area that is more than 50 feet from the ground. involve any situation in which the ground is used as primary support and the rope system is used as a secondary means of support. involve situations where the slope of the ground is greater than 45 degrees and rescuers or patients are dependent on a life safety rope. are situations where the slope of the ground is greater than 45 degrees and the rescuers are dependent on the fixed surface of the ground.

Answer 32

involve situations where the slope of the ground is greater than 45 degrees and rescuers or patients are dependent on a life safety rope.

Question 33

Immediately upon arriving at the scene involving a technical rescue situation: a rapid and accurate scene size-up must be conducted. the paramedic must ascertain the number of patients. additional resources must be summoned to the scene. an emergency treatment area must be identified.

Answer 33

a rapid and accurate scene size-up must be conducted.

Question 34

Immediate implementation of an incident management system is critical because: many technical rescue incidents become complex and require a large number of assisting units and personnel. each ambulance or rescue unit that responds to the scene must have one person who assumes the role of incident commander. there must be one person in charge of assigning tasks to incoming ambulances, rescue units, and other emergency resources. technical rescue incidents tend to attract large crowds and media who must be updated regularly on the status of the rescue situation.

Answer 34

many technical rescue incidents become complex and require a large number of assisting units and personnel.

Question 35

Once the patient has been disentangled, your primary focus should be to: protect the patient's spine. safely remove the patient. perform a detailed exam. begin emergency care.

Answer 35

safely remove the patient

Question 36

You arrive at the scene of a motor vehicle crash in which a small passenger car struck a power pole at a high rate of speed. As you size up the scene, you can see that the driver is severely entrapped in his car and is screaming in pain. The fire department is en route to the scene with extrication equipment. You should: carefully search in and around the car to ensure that there is only one patient. stay away from the car until the absence of any utility hazards is confirmed. make initial contact with the patient and manually stabilize his head in place. attempt to move any power lines away from the car with a long tree branch.

Answer 36

stay away from the car until the absence of any utility hazards is confirmed.

Question 37

In a four-door vehicle, the B posts are located: behind both of the rear doors. between the front and rear doors. behind the rear passenger windows. closest to the front of the vehicle.

Answer 37

between the front and rear doors.

Question 38

Descending on a fixed rope from a severe angle is called: scrambling. a hasty rope slide. rappelling. self-belay.

Answer 38

Rappelling

Question 39

Which of the following situations is an example of a technical rescue incident? Treating a patient who fell down several flights of stairs Moving a 180-pound man from his living room to the ambulance Disentangling a young woman from her badly damaged vehicle Performing CPR on a patient who experienced cardiac arrest

Answer 39

Disentangling a young woman from her badly damaged vehicle

Question 40

A late-model sport utility vehicle struck a tree head on. You are able to gain access to the driver, who was the sole occupant, through the passenger-side door. The patient appears to be unconscious and has blood bubbling from his mouth when he breathes. Upon entering the vehicle, it is most important for you to: recall that if the air bags did not deploy during the collision, they could still do so and may severely injure you. ask the rescue team to remove the driver's side door with the hydraulic spreader so your partner can gain access. carefully open the patient's airway with the jaw-thrust maneuver, and ask your partner for a suction unit. conduct a brief head-to-toe exam and then rapidly remove the patient from the vehicle by grabbing him under his arms.

Answer 40

recall that if the air bags did not deploy during the collision, they could still do so and may severely injure you.

Question 41

Which of the following items of personal protective equipment is required to assume the heat-escape-lessening position (HELP)? Thermal protection Personal flotation device An approved helmet Contamination protection

Answer 41

Personal flotation device

Question 42

Which of the following gases is commonly found in swamps and sewers; is colorless, toxic, and flammable; and is released when bacteria break down organic matter in the absence of oxygen?

Answer 42

Hydrogen sulfide

Question 43

Which of the following factors would be the least likely to cause a secondary collapse during a trench rescue incident? • Excessive environmental heat • Vibration of rescue equipment • Standing at the edge of a trench • Water eroding away the soil

Answer 43

Excessive enviornmental heat.