Chapter 46 Transport Operations

Question 1

1. The use of the lights and siren on an ambulance:
   A) gives you the legal right of way.
   B) is a request for the right of way.
   C) enables you to exceed the speed limit.
   D) is statistically the safest mode of transport.

Answer 1

B) is a request for the right of way.

Ans: B
Page: 2173
Type: General Knowledge

Question 2

2. In contrast to a type II ambulance, a type III ambulance:
   A) is a specialty van that usually has a modular ambulance body.
   B) does not allow access from the cab to the patient compartment.
   C) is a standard van with a walk-through to the patient compartment.
   D) has an ambulance body that can be transferred to a new chassis

Answer 2

A) is a specialty van that usually has a modular ambulance body.

Ans: A
Page: 2174
Type: General Knowledge

Question 3

3. What entity is responsible for making recommendations regarding infection control practices that include all areas of personal protective equipment, sharps containers, and disinfecting equipment that is carried on an ambulance?
   A) Centers for Disease Control and Prevention
   B) United States Department of Transportation
   C) National Highway Traffic Safety Administration
   D) Occupational Safety and Health Administration

Answer 3

D) Occupational Safety and Health Administration

Ans: D
Page: 2173

Question 4

4. The equipment and supplies that are carried in the back of an ambulance:
   A) are dictated by the medical director.
   B) should follow standard federal guidelines.
   C) must be stowed safely yet easily accessible.
   D) should be standardized in every ambulance.

Answer 4

C) must be stowed safely yet easily accessible.

Ans: C
Page: 2173
Type: General Knowledge

Question 5

5.  Which of the following pieces of equipment requires regular calibration?
A)  Pulse oximeter
B)  Cardiac monitor
C)  Non-invasive blood pressure cuff
D)  Electronic thermometer

Answer 5

B) Cardiac monitor

Ans: B
Page: 2174
Type: General Knowledge

Question 6

6. Which of the following entities created the first standardized list of equipment to be carried on an ambulance?
   A) U.S. Department of Transportation
   B) American College of Surgeons
   C) American Academy of Orthopaedic Surgeons
   D) National Registry of Emergency Medical Technicians

Answer 6

B) American College of Surgeons

Ans: B
Page: 2173
Type: General Knowledge

Question 7

7. The motor oil level of the ambulance:
   A) should be checked prior to starting the engine.
   B) should be checked while the engine is running.
   C) is checked 5 minutes after the engine is turned off.
   D) must be checked a minimum of three times per shift.

Answer 7

A) should be checked prior to starting the engine.

Ans: A
Page: 2176
Type: General Knowledge

Question 8

8. Unless the fluid level is low, you should NOT uncap the brake fluid reservoir because:
   A) air will be drawn into the hydraulic brake lines.
   B) the reservoir is pressurized and may cause burns.
   C) doing so releases pressure within the brake lines.
   D) brake fluid absorbs moisture from the atmosphere.

Answer 8

D) brake fluid absorbs moisture from the atmosphere.

Ans: D
Page: 2176
Type: General Knowledge

Question 9

9. When checking the ambulance engine, you note the odor of sewer gas. What should you do?
   A) Thoroughly clean the battery terminals and cables.
   B) Open the coolant cap and check the coolant level.
   C) Close the hood and take the ambulance out of service.
   D) Start the ambulance and check the voltage on the battery.

Answer 9

C) Close the hood and take the ambulance out of service.

Ans: C
Page: 2176
Type: General Knowledge

Question 10

10. Which of the following statements regarding belt noise is correct?
    A) Belt noise is a low-pitched drone that is synchronous with road speed.
    B) The noise made from an engine belt is usually harmless and corrects itself.
    C) Belt noise is a squealing sound related to a load on one of the belt-operated appliances.
    D) Belt noise is a sign that the engine’s alternator or water pump is malfunctioning.

Answer 10

C) Belt noise is a squealing sound related to a load on one of the belt-operated appliances.

Ans: C
Page: 2175

Question 11

11.  An ambulance should be removed from service immediately if you feel or hear:
A)  belt noise.
B)  brake fade.
C)  tire squeal.
D)  a slight drift.

Answer 11

B) brake fade.

Ans: B
Page: 2175
Type: General Knowledge

Question 12

12. High-performance EMS systems typically use a fractile response time standard, in which:
    A) a significant fraction of all responses must be achieved within an established time.
    B) the ambulance must arrive at the scene within 8 minutes in 50% of all dispatches.
    C) turnaround time for the entire call should be no more than 1 hour in 90% of all calls.
    D) medics must be in the ambulance and en route within 2 minutes of being dispatched.

Answer 12

A) a significant fraction of all responses must be achieved within an established time.

Ans: A
Page: 2177
Type: General Knowledge

Question 13

13. When determining productivity of an EMS system, the EMS provider:
    A) calculates the ratio of EMS calls to the number of operating ambulances.
    B) determines the number of paramedics on duty versus the number of EMS calls.
    C) calculates the number of critical patients per month and how many survived.
    D) measures how many patient transports per hour each ambulance accomplishes.

Answer 13

D) measures how many patient transports per hour each ambulance accomplishes.

Ans: D
Page: 2177
Type: General Knowledge

Question 14

14. A third-service EMS system is one in which:
    A) a public agency not affiliated with the fire department provides EMS service.
    B) an EMS ambulance is housed in a fire department and is staffed by EMTs.
    C) responders from a fire department assist the ambulance on every EMS call.
    D) a privately owned ambulance service works in tandem with a public EMS system.

Answer 14

Ans: A
Page: 2177
Type: General Knowledge

Question 15

15. In a tiered-response EMS system:
    A) every ALS ambulance that responds has at least three paramedics on board.
    B) an ambulance with two paramedics makes the initial response to every EMS call.
    C) an EMS system attempts to assign ALS ambulances only where they are needed.
    D) a first response vehicle, BLS ambulance, and ALS ambulance respond to every call.

Answer 15

C) an EMS system attempts to assign ALS ambulances only where they are needed.

Ans: C
Page: 2177
Type: General Knowledge

Question 16

16. The goal of system status management is to:
    A) allow paramedics ample time to rest before going on another call.
    B) minimize response times by deploying EMS resources strategically.
    C) ensure that every ambulance is staffed with at least one paramedic.
    D) post at least three ambulances in an area where most EMS calls occur.

Answer 16

B) minimize response times by deploying EMS resources strategically.

Ans: B
Page: 2177
Type: General Knowledge

Question 17

17. Upon arriving at a motor-vehicle crash, the paramedic should look for safety hazards and then:
    A) direct traffic away from the crash scene.
    B) evaluate the need for additional resources.
    C) begin treating the most critically injured.
    D) establish a centralized treatment location.

Answer 17

B) evaluate the need for additional resources.

Ans: B
Page: 2178
Type: General Knowledge

Question 18

18. With respect to emergency driving, due regard means that:
    A) an ambulance must never exceed the posted speed limit, even if it is responding to a call for a critical patient.
    B) the emergency vehicle operator can legally exceed the posted speed limit by 20 miles per hour, but only if it is safe to do so.
    C) an ambulance must use its lights and siren and remain at least 100 feet behind a vehicle that is failing to yield.
    D) the use of lights and siren does not exempt you from operating the ambulance with concern for the safety of others.

Answer 18

D) the use of lights and siren does not exempt you from operating the ambulance with concern for the safety of others.

Ans: D
Page: 2185
Type: General Knowledge

Question 19

19. Which of the following statements regarding the use of emergency escorts is correct?
    A) Many drivers will only see the first emergency vehicle and assume that it is clear once that vehicle has passed.
    B) If you are using an emergency escort, you should follow closely behind it to avoid a wake effect collision.
    C) Use of a police escort is an acceptable practice, because it often facilitates a faster response time to the scene.
    D) The use of emergency escorts is generally discouraged, unless you are traveling through a busy intersection.

Answer 19

A) Many drivers will only see the first emergency vehicle and assume that it is clear once that vehicle has passed.

Ans: A
Page: 2185-2186
Type: General Knowledge

Question 20

20. The decision to use lights and siren when transporting a patient to the hospital is MOST dependent upon:
    A) your EMS system’s protocols.
    B) the number of vehicles on the road.
    C) judgment on the part of the paramedic.
    D) the opinion of the receiving physician.

Answer 20

C) judgment on the part of the paramedic.

Ans: C
Page: 2181
Type: General Knowledge

Question 21

21. When you are dispatched to an emergency, it is MOST important to:
    A) take a route that will ensure a fast response time.
    B) use GPS to ensure accurate navigation to the scene.
    C) use your lights and siren to warn other motorists.
    D) determine which route will be used to arrive safely.

Answer 21

D) determine which route will be used to arrive safely.

Ans: D
Page: 2180
Type: General Knowledge

Question 22

22. When parking the ambulance off the side of the highway in dry weather:
    A) the entire ambulance should be positioned off of the gravel.
    B) the heat from underneath the vehicle could start a grass fire.
    C) you should place safety cones at all four points of the vehicle.
    D) it is generally considered safe to turn off your warning lights.

Answer 22

B) the heat from underneath the vehicle could start a grass fire.

Ans: B
Page: 2183
Type: General Knowledge

Question 23

23.  Safe practices when parking your emergency vehicle on a roadway at night include all of the following, EXCEPT:
A)  using your emergency flashers.
B)  leaving the headlights on.
C)  wearing a reflective vest.
D)  turning off the strobe lights.

Answer 23

B) leaving the headlights on.

Ans: B
Page: 2183-2184
Type: General Knowledge

Question 24

24. Which of the following statements regarding loading and securing a patient in the back of the ambulance is correct?
    A) Whether the patient is lying on the stretcher or sitting on the bench seat, he or she must be properly seat-belted.
    B) All patients transported in the back of the ambulance must be secured on the stretcher, even if they request otherwise.
    C) It generally takes a minimum of three people to safely load an average-sized adult on the stretcher into the ambulance.
    D) All patients should initially be loaded into the ambulance on the stretcher, but they can move to the bench seat once loaded.

Answer 24

A) Whether the patient is lying on the stretcher or sitting on the bench seat, he or she must be properly seat-belted.

Ans: A
Page: 2178-2179
Type: General Knowledge

Question 25

25. The paramedic should NOT operate an emergency vehicle if he or she: A) has worked more than 12 straight hours. B) is a personal acquaintance of the patient. C) is taking a cold remedy or an analgesic. D) just finished an intense exercise regimen.

Answer 25

C) is taking a cold remedy or an analgesic. Ans: C Page: 2180 Type: General Knowledge

Question 26

26. An ambulance operator's cushion of safety can be maintained by: A) carefully passing other motorists on the right. B) using the siren only when at an intersection. C) checking for tailgaters behind the ambulance. D) staying at least 10 feet behind other vehicles.

Answer 26

C) checking for tailgaters behind the ambulance. Ans: C Page: 2181 Type: General Knowledge

Question 27

27. General principles for backing up an ambulance include: A) using one spotter for each side of the ambulance. B) keeping the window up to avoid any distractions. C) not using audible warning devices so you can hear. D) stopping the vehicle if you lose sight of your spotter.

Answer 27

D) stopping the vehicle if you lose sight of your spotter. Ans: D Page: 2182 Type: General Knowledge

Question 28

28. When transporting a small child on the stretcher, you should: A) place the child on a backboard, even in the absence of trauma. B) use a pediatric transport securing device whenever possible. C) place the child on a parent's lap and secure them both with straps. D) secure the child as usual, using the adult straps on the stretcher.

Answer 28

B) use a pediatric transport securing device whenever possible. Ans: B Page: 2181 Type: General Knowledge

Question 29

29. The MOST important factor to consider when determining if transport of a trauma patient via helicopter is appropriate is: A) the patient's hemodynamic status. B) delays in ground transport due to traffic. C) the injury mechanism that was involved. D) the need for definitive airway management.

Answer 29

A) the patient's hemodynamic status. Ans: A Page: 2186 Type: General Knowledge

Question 30

30. In contrast to rotary-wing air ambulances, fixed-wing air ambulances: A) are mainly used to transport patients over long distances. B) can get the patient to a definitive care trauma center faster. C) cannot fly safely when inclement weather is within 30 miles. D) are the preferred transport method for acutely injured patients.

Answer 30

A) are mainly used to transport patients over long distances. Ans: A Page: 2186 Type: General Knowledge

Question 31

31. Air ambulances are advantageous for all of the following reasons, EXCEPT: A) the ability to access remote areas. B) faster transport to definitive care. C) the availability of specialized equipment. D) more experience of the flight paramedics.

Answer 31

D) more experience of the flight paramedics. Ans: D Page: 2187-2188 Type: General Knowledge

Question 32

32. In which of the following situations should a helicopter generally NOT be utilized? A) A patient in cardiopulmonary arrest who has been unresponsive to defibrillation B) Spinal injury in which the terrain over which the patient must be carried is rough C) Suspected internal hemorrhage in a hypotensive patient who lives in a rural area D) Motor vehicle crash involving a patient whose extrication will take 45 minutes

Answer 32

A) A patient in cardiopulmonary arrest who has been unresponsive to defibrillation Ans: A Page: 2187 Type: General Knowledge

Question 33

``` 33. Which of the following disadvantages of using an air ambulance should concern you the LEAST when utilizing it for a critically injured patient? A) Aircraft cabin size B) Current weather conditions C) The cost that will be incurred D) The presence of uneven terrain ```

Answer 33

C) The cost that will be incurred Ans: C Page: 2188 Type: General Knowledge

Question 34

34. A helicopter landing zone should be: A) marked with a strobe light at the front and rear of the proposed site. B) 100 feet by 100 feet in size and on a surface that is firm, level, and free of debris. C) 50 feet by 50 feet in size and in an area that is at least 50 feet from the ambulance. D) at least a quarter of a mile from the ambulance to avoid injury from flying debris.

Answer 34

B) 100 feet by 100 feet in size and on a surface that is firm, level, and free of debris. Ans: B Page: 2189 Type: General Knowledge

Question 35

35. When assisting with a helicopter landing at night, you should: A) leave your headlights on to signify your location. B) avoid shining a spotlight up at the descending aircraft. C) place a single strobe light in the center of the landing zone. D) refrain from parking the ambulance under overhead wires.

Answer 35

B) avoid shining a spotlight up at the descending aircraft. Ans: B Page: 2191 Type: General Knowledge

Question 36

36. After a helicopter lands and continues to keep its rotor blades active, you should: A) post a firefighter near the tail rotor to keep bystanders away. B) approach the aircraft from the front and keep the pilot in view at all times. C) slowly approach the left side of the aircraft while keeping your head down. D) not approach the aircraft until the pilot or a crew member signals you to do so

Answer 36

D) not approach the aircraft until the pilot or a crew member signals you to do so Ans: D Page: 2189-2190 Type: General Knowledge

Question 37

``` 37. The killing of pathogenic agents by directly applying a chemical made for that purpose is called: A) cleaning. B) disinfection. C) sterilization. D) high-level disinfection. ```

Answer 37

B) disinfection. Ans: B Page: 2179 Type: General Knowledge

Question 38

38. You are operating an ambulance in emergency mode on a two-way street. The driver in front of you will not yield accordingly. You should: A) remain behind the vehicle and anticipate that the driver may slam on the brakes. B) carefully pass the vehicle on the right-hand shoulder if it is safe to do so. C) turn your lights and siren off and use the PA system to alert the driver. D) shine a spotlight into the vehicle's side view mirror to attract the driver's attention.

Answer 38

A) remain behind the vehicle and anticipate that the driver may slam on the brakes. Ans: A Page: 2181 Type: Critical Thinking

Question 39

39. While responding to an emergency scene, you approach a sharp turn in the road. What should you do? A) Corner the turn at its widest point, unless you see an oncoming vehicle. B) Carefully apply the brakes while cornering the turn at your current speed. C) Slow the vehicle to the posted speed limit and avoid braking during the turn. D) Slow the vehicle's speed and smoothly pump the brakes will making the turn.

Answer 39

C) Slow the vehicle to the posted speed limit and avoid braking during the turn. Ans: C Page: 2184 Type: Critical Thinking

Question 40

40. A man tells you that he will be following the ambulance in his personal vehicle as you transport his wife to the ambulance. You should: A) discourage him from doing this and advise him that it is safer to ride in the ambulance. B) advise him to drive at normal speeds and ensure that he knows where the hospital is located. C) explain that it would be a better idea for him to wait at home until the hospital contacts him. D) advise him to turn on his emergency flashers and keep at least 500 feet behind you at all times.

Answer 40

B) advise him to drive at normal speeds and ensure that he knows where the hospital is located. Ans: B Page: 2186 Type: Critical Thinking

Question 41

41. While responding to a call for a pediatric cardiac arrest, you approach a school bus with its red warning lights on. You should: A) turn your emergency lights and siren off and carefully proceed past the bus at a slow speed. B) use your PA system to advise the students to remain on the bus as you carefully pass it on the left. C) carefully pass the bus on the right, if possible, so the children exiting the bus will be able to see you. D) wait for the bus driver to turn off the red warning lights and close the door before carefully passing.

Answer 41

D) wait for the bus driver to turn off the red warning lights and close the door before carefully passing. Ans: D Page: 2186 Type: Critical Thinking

Question 42

42. You are driving in the right-hand lane while transporting a patient to the hospital in nonemergency mode. In your side view mirror, you notice that a small truck is tailgating you. What should you do? A) Maintain your current speed and advise the dispatcher to contact the police. B) Turn on your emergency lights, move to the left lane, and allow the truck to pass. C) Increase your speed to increase the distance between you and the tailgating truck. D) Gently tap your brakes to alert the driver that he or she is following too close behind you.

Answer 42

A) Maintain your current speed and advise the dispatcher to contact the police. Ans: A Page: 2181 Type: Critical Thinking

Question 43

43. As you approach the scene of a car crash, you see two badly damaged vehicles that are off the road to the right. Where should you park the ambulance? A) 100 feet before the crash site on the left side of the road B) 100 feet past the crash site on the left side of the road C) 100 feet past the crash site on the right side of the road D) 100 feet before the crash site on the right side of the road

Answer 43

C) 100 feet past the crash site on the right side of the road Ans: C Page: 2182 Type: Critical Thinking

Question 44

44. An ambulance and a fire engine are responding to a motor-vehicle crash when both emergency vehicles approach a red light. After the fire engine clears the intersection and proceeds, the operator of the ambulance should: A) turn off all lights and sirens and wait for the red light to turn green. B) come to a complete stop and then proceed after looking in all directions. C) remain close behind the fire engine to ensure visibility of both vehicles. D) use a different siren tone while entering the intersection at a slow speed.

Answer 44

B) come to a complete stop and then proceed after looking in all directions. Ans: B Page: 2186 Type: Critical Thinking

Question 45

``` 45. A helicopter has just landed to transport your critically injured patient to the hospital. The helicopter is configured so that the patient must be loaded from the rear of the aircraft. Unless otherwise directed by the flight crew, you should approach the aircraft from the: A) left. B) rear. C) right. D) front. ```

Answer 45

D) front. Ans: D Page: 2189-2190 Type: Critical Thinking