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EMS captain > Combined Protocols, IMS, DSI, infection control > Flashcards

Combined Protocols, IMS, DSI, infection control Flashcards

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1
Q

In order to manage a MAYDAY, the IC has to maintain what?

A

Strong command presence
Composure
Self control
Self discipline

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2
Q

All drug overdoses are treated as what type of arrest with the exception of?

A

All OD’s except for Cocaine

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3
Q

The Paramedic development entrance exam includes?

A

ON the first day completing a written test at 80% or above

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4
Q

If fire conditions have not improved after the 10min benchmark. What should happen ?

A

Consider switching to “DEFENSIVE MODE

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5
Q

The Tactical priority of EXTINGUISHMENT requires?

A
  1. 75” line @ 150gpm for most initial fire or one room fire
  2. 5” line @ 200gpm for larger fires or have extended outside the room of Origin.
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6
Q

Command structure assignments for an MCI may include what?

A

Treatment
Transport
Triage
Staging
Rehab
Hazard mitigation

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7
Q

An example of injury while wearing PPE would be?

A

Burns to the hands while wearing gloves.

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8
Q

What is the main role in an ASHER/MCI for Fire Rescue?

A

Fire and medical decisions

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9
Q

What is the Definition of a “Strong Hold” with and ASHER/MCI ?

A

Defensible area within the warm zone that has no windows and all doorways are covered by LE

Also serves a CCP

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10
Q

What are the indications for Esmolol and doses?

A

Immediately after Double sequential
40 mg IV/IO initially over 1 min
Then:
60mg on 15gtts over 10min 1,25gtts/sec

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11
Q

A DNRO applies to who?

A

Cardiac or respiratory arrest
Succumbing to a disease process of a terminal illness

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12
Q

What are the criteria to administer narcan?

A

All OF THE BELOW

RR below 10
Etco2 >45
02 sat < 92%
if not meeting above Supplemental 02 or BVM 2 min

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13
Q

The mode of operations at a fire is defined by _________ and _______ and represents the _________ of the scene.

A

Strategy and tactics

Tempo

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14
Q

The Fire rescue RTF-PEM TEAM leader reports what to the LE RTF-PEM ?

A

Total number of victims
Non ambulatory patients
When ready to move

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15
Q

Who may terminate a student or observers ride time?

A

Operational Captain
EMS captain
BC or DC

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16
Q

What does RTF-PEM stand for?

A

Rescue task Force- Protective element medical

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17
Q

How are expired controlled substances handled by the unit?

A

Unit gives the expired medication to the EMS captain and records “Expired” in the logbook for the case #

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18
Q

A STEALTH report is the ________ _________ and stands for?

A

Final report

Set time

Tone

Execution

Analyze

Lessons learned

Transfer lessons

Hi note.

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19
Q

If a rhythm converts back after electrical therapy was used what setting should be used ?

A

the setting that was successful in converting the rhythm.

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20
Q

Who may terminate a student or observers ride time?

A

Operational Captain
EMS captain
BC or DC

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21
Q

Failed airway in adults or pedi is?

A

Surgical cric >13 yrs of age
Needle Cric < 12 yrs of age

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22
Q

When must controlled substances be inventoried?

A

Begin and end of shift
Custody change
When locked tag seal is changed

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23
Q

Risk Benefit Analysis is 3 components?

A

Do not risk FF lives for lives or property that cannot be saved

Extend vigilant and measured risk to protect and rescue lives

Limited risk to protect salvageable property.

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24
Q

Tactics are defined as?

A

Deploying and directing resources to an incident to accomplish objectives

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25
How long before the expiration date are crews to notify the EMS captain that the controlled substance is about to expire?
7 days
26
Students may ride at what times?
School Students: 0700-1600 EMR students only 0900-1600
27
The command STAFF positions are?
PIO Safety officer Liaison command staff advisors
28
Who gets notified of an ASHER/MCI incident?
FOO PIO
29
Indications for an advanced airway are:
Airway protection Respiratory failure Prolonged respiratory suppport
30
What are the Air Transport time criteria?
STEMI / Stroke \>40min Trauma \> 25min Extrication \>15min Response time \>10min
31
An IRE is defined as: With regards to any Citizen, patient, fire rescue personnel:
1. Harm caused by action or inaction 2. Caused by equipment failure 3. Immoral, unethical , or illegal action 4. Cause for litigation 5. Poltically sensitive 6. Media scrutinization
32
Definition of “Cold Zone” for an ASHER/ MCI?
Area of no risk Cold “O” no “O” All support operations Unified command Final approach position Staging
33
Name, DOB, phone number and brief narrative are required for which levels of an MCI?
Levels 1 and 2
34
‘Branch” is defined as?
Level having Functional, geographical, or jurisdictional responsibilities Is between Section and division/ group in the operations section Uses Roman numerals or by functional area
35
EMS captains responsibilities for exposure?
Make sure that employee is source tested Make sure state mandates are followed at the ER Notify the Exposure control officer as soon as possible during working hours or if unusual or receives treatment have paged Contact facility for F/U instructions Contact the OHC to make arrangements for F/U or as soon a possible for testing Ensure Exposure form is filled out and turned in by the end of shift Forward the exposure to the Exposure control officer
36
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
37
A “DRE” is defined as:
Events that occur during emergency calls, training, pub ed, emergency or non emergency situations: Potential to cause harm Equipment failure that had potential but did not.
38
A special or campaign event is a planned and organized activity or contest with how many people?
10,000 or more in a defined geographical area.
39
When are risk management reports due?
By the end of shift and forwarded to the appropriate party
40
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
41
The Emergency Operations Area is divided into how many geographical areas?
6
42
Customer complaints concerning communication center go to who?
Communications center supervisor
43
At what two stages of an incident should transfer of command be utilized?
As the emergency escalates Demobilization phase
44
The Paramedic development entrance exam includes?
ON the first day completing a written test at 80% or above
45
An area command is established when ?
To oversee management of multiple incidents handled by separate ICSs Very large incidents that involve multiple ICSs Same area and same type
46
If a patient is too combative for a blood draw and at the discretion of the PM?
Blood draw will not be performed and EMS captain notified.
47
Purpose or Goal or DSI is?
Not to blunt spontaneous ventilation or airway reflexes
48
Contraindications to DSI paralysis is?
Allergy Predicted difficult intubation Inability to ventilate with a BVM Major facial trauma
49
Command staff advisors are?
Technical specialists Distinguished from officers because they lack authority to direct incident activities.
50
A “Strike team or Task force “ person in charge is termed?
Leader
51
Term of : Designed to remove the products of combustion from a fire area and allow cool fresh air to enter?
Ventilation
52
For which of the following fire investigatory incidents shall a Fire investigator be contacted via radio or cell phone?
Juvenile related incidents.
53
Limitations of Student riders?
Only perform or assist in activities where proficiency has been verified by training facility. No riding alone with pt’s in pt compartment Logged in station log book Wear uniform that training facility has issued Not subject to duties outside of agreement
54
The cornerstone to managing an emergency incident is?
Pre- incident planning
55
Evidence that a fire is suspicious in nature or crime related means:
Incendiary fires/ explosive devices Firebombs Stolen vehicles Burglaries
56
What are acceptable forms of ID for DNRO
Drivers license Other photo identification Witness in the presence of the patient
57
Who can enter information on a medical report?
Any crew member as ;long as it’s consistent with the authors level of training and certification.
58
What equipment MUST be in place fro DSI?
Suction unit Cardiac monitor, BP, SPO2, ETCO2
59
TIC operations for the most prominent feature of a FF is ?
SCBA bottle
60
10 minute benchmarks are used under what conditions?
MARGINAL
61
Incident objectives are defined as?
Statements of guidance and direction that are specific , measurable , attainable etc for the selection of appropriate strategies and tactical direction of resources.
62
What are the oral hypoglycemic medications?
Glipizide Glyburide Glimperide
63
Oxygen is to be administered only when?
maintain sp02 of 95% all patients 90% for COPD and asthma.
64
When a “MAYDAY” is called what happens to the Tac channels?
The MAYDAY remains on the original channel and other operations will switch .
65
On a confirmed LPG/NG leak where does the “Hot zone” start
Where the 4 gas monitor has LEL readings above 0
66
Who’s responsible for restraining an patient for a blood draw?
LE
67
“Division” is defined as?
A geographical area Is between the Branch and unit levels
68
Rehab 24 hours post fire incident refer to as?
Carbon monoxide and cyanide exposures
69
Guidelines for Operational Capt and Lt with Students/ observers?
Let to obtain proper paperwork for student Safe place to observe with seat belt Introduce person to others in the station Familiarity with apparatus Log person in station logbook Log person on ePCR’s for calls and treatments performed
70
The following SHALL NEVER be performed on patients with a DNRO?
Artificial respiration BVM ET tube Supraglottic A/W Chest compressions Defibrillation
71
What is the secondary site for chest decompression
2 or 3 rd intercostal space mid clavicular
72
What is the term used for incidents under the authority of an area commander that are multi- Jurisdictional ?
Unified Area Command
73
74
The exposure control manual provides information on 5 areas. What are they?
Risk Prevention Determination Care and cleaning Biomedical waste
75
Definition of Protection in place is based upon?
Risk assessment of the incident
76
The 10 min benchmark is based on what 3 scientific factors?
Building to stay together Victim survivability FF air supply when working
77
What is the o2 setting for initial arrest
8L/min for 6 min on oxygen port
78
Who’s responsible for restraining an patient for a blood draw?
LE
79
Blood Draws are performed when ?
Request of LE
80
What is the fire flow formula?
Lx W / 3 x % involved
81
Notification of a serious injury meeting criteria get reported to who and when?
Bureau of,fire standards and training- FF Safety and health section within 4 hours.
82
The DNRO identification device must be signed by who if the patient cannot provide consent?
Surrogate Proxy court order Power of attorney
83
The term MAYDAY should be used when a FF is?
Lost Trapped Disoriented Air emergency Serious injury In need of immediate help
84
The IC or ISO shall determine if it is safe for what to happen when atmospheric monitoring?
1. FF remove their respiratory protection 2. Occupants to enter the structure 3. Fire investigators to enter any structure
85
Observers paperwork differs from students in one way?
Application signed by FR HIPPA compliance officer
86
Where are psychiatric pts transported?
stable- closest facility unstable- closest ED for stabilization.
87
Extensions for paramedic probation are ?
Done by the EMS captain and documented on a professional development form for 18month. If the extension period is still less than satisfactory then the EMS captain. Recommends the person be referred to the medical services division and medical director for further evaluation. All documentation to be sent to the compliance officer
88
What are acceptable forms of ID for DNRO
Drivers license Other photo identification Witness in the presence of the patient
89
What does ASHER/ MCI stand for?
Active Shooter Hostile Event Response- Mass casualty incident
90
How must green or restricted items the the EMS captain can order be handled?
Submitted in IBEM
91
Purpose or Goal or DSI is?
Not to blunt spontaneous ventilation or airway reflexes
92
“INITIAL “ Exposure control requires what hose line and how much GPM?
1.75” and 200
93
Documentation of blood draw will include what?
Name and badge number of Officer Kit sealed Y/ N PM name Site Number of tubes drawn Date and time Who sample was turned over to
94
Atmospheric monitors are carried on which vehicles
Engines Aerials Rescues BC EMS captain Special ops
95
When must controlled substances be inventoried?
Begin and end of shift Custody change When locked tag seal is changed
96
Evaluation material for the paramedic development course include what?
Medical protocols EMS related SOGs Exposure control manual PDC skill sheets Pharmacology ECG interpretation Scenario based assessments on Praxctical application of protocols and or patient assessment
97
What is the command staff person in charge termed as?
Officer
98
Where do decompression CO, H2S and CN poisonings go?
Hyberbaric chamber @ st mary's hospital.
99
Adult who can refuse treatment criteria?
\>18 yrs old AAOx4 Clinically sober Hypoxia\< 94 on room air COPD \< 90 Syncope Head injury w/ LOC \>100.5 Sever pain Hypotension Stroke
100
The MCI transport log has what information on it?
Patient METTAG ID Destination hospital Transport unit number
101
What are the common means of reporting CQI events?
Field personnel vis chain of command Reportable events Hospitals via complaint as a performance improvement process Patients vis a complaint to the agency
102
What type of pts' meeting trauma alert criteria transported by AIR to St. mary's?
Pregnant (visibly pregnant or by hx of gestation \>20wks)
103
Security of all medical supplies applies to what type?
All non controlled substances , medications, fluids , and medical equipment.
104
“Task Force” is defined as ?
Resources that are DIFFERENT in kind and type
105
primary and secondary arrest pt's go to which facilites?
primary- STEMI facility secondary- Closest faclility
106
Type III construction is what?
Ordinary construction where the interior structural elements are entirely or partially of wood OF SMALLER DIMENSIONS
107
Span of control is defined as?
The number of subordinates for which a supervisor is responsible for Ratio of supervisors to individuals Acceptable spread is 3-7
108
What are the oral hypoglycemic medications?
Glipizide Glyburide Glimperide
109
What are the post intubation medications that can be used for DSI?
Ketamine Versed Fentanyl Adult: 200mg 5mg 100mcg. (Contraindication of pregnancy near term \>32 weeks) Pedi: 2mg/kg 0.1mg/kg 1mcg/kg (Contraindication of \<6mo.)
110
The IC shall be advised immediately during an ASHER/ MCI when ?
Fire rescue personnel are requested to or are found in the “HOT or Exclusion “ zones
111
Extensions for paramedic probation are ?
Done by the EMS captain and documented on a professional development form for 18month. If the extension period is still less than satisfactory then the EMS captain. Recommends the person be referred to the medical services division and medical director for further evaluation. All documentation to be sent to the compliance officer
112
If a parent or guardian refuses a physical exam what must be documented?
Visual exam Mental status General appearance Work of breathing Circulation to skin
113
Pedi Ketamine for pain is indicated for what age and pain scale?
\< 3 yrs and 7 or greater pain
114
Post intubation placement is ?
ETCO2 continually- initially, continuously, and upon transfer of care Wave form with no less than 3 boxes Auscultation of bi-lateral breath sounds Placement of a gastric tube
115
Per CQI, A near miss is defined as?
Incident that had the potential to harm a patient as a result of care rendered by EMS personnel BUT DID NOT actually harm the patient.
116
When should incident command be terminated?
When the incident has de-escalated to a point where all units have returned to service.
117
Tactics are __________ and \_\_\_\_\_\_\_\_\_.
Specific Measurable
118
The Highest INCIDENT Priority is = \_\_\_\_\_\_\_\_ The Highest TACTICAL priority is =\_\_\_\_\_\_\_\_\_.
LIFE SAFETY RESCUE
119
For exterior LPG/NG leaks on above ground containers - they should be cooled with what?
2 1/2” line at 200gpm
120
What is the time frame employees can be held to complete target solutions and other identified training?
1 week
121
‘Branch” is defined as?
Level having Functional, geographical, or jurisdictional responsibilities Is between Section and division/ group in the operations section Uses Roman numerals or by functional area
122
Post exposure treatments are for which diseases?
AIDS, HIC, Hep B, Hep C, Menningcoccal meningitis, TB
123
The Aldridge-Benge FF safety act in Florida instituted what?
Signage for Roofs and truss floors to indicate construction type that is “LIGHT FRAME TRUSS “
124
The following SHALL NEVER be performed on patients with a DNRO?
Artificial respiration BVM ET tube Supraglottic A/W Chest compressions Defibrillation
125
The following incidents REQUIRE an assistant safety officer?
Hazardous material Dive team operations Open water incidents Rehab when assigned
126
Which extremity is to be avoided with vascular access in chest pain?
Right hand and wrist.
127
Students may ride at what times?
School Students: 0700-1600 EMR students only 0900-1600
128
How are new employees selected for the paramedic development course?
Based on Senority
129
Who are responsible for checking the TIC?
All company officers and chief officers in custody of the TIC.
130
The heat stress index Is made up from ?
1. Air Temperature 2. Air Speed 3. Humidity 4. Radiation - direct sun light
131
When can a body be covered with a sheet?
When no suspicion of a crime scene
132
What is the difference between “Safe Haven” and “Safe Place”
Safe haven is referencing new borns Safe Place is for teenagers
133
Which critical incident factor mnemonic is used for the “INITIAL “ Situation evaluation
BELOW
134
In mutual aid circumstances whose protocols should be followed?
The transporting agency.
135
If a student or observers ride time is terminated who is then notified?
Deputy chief of operations is notified.
136
The following SHALL NEVER be performed on patients with a DNRO?
Artificial respiration BVM ET tube Supraglottic A/W Chest compressions Defibrillation
137
The command sequence consists of:
Incident priorities Situation evaluation IAP Evaluation of IAP Demobilization Termination
138
Who and where does PPE go if an injury occurs on an emergency incident?
BC secures PPE and training AMS safety division
139
If a parent is consenting by phone to not have minor treated or transported and no one can sign the refusal form what happens?
Minor to be transported to the appropriate emergency department
140
Report writing will be in accordance with which type of code?
“Dispatched code”
141
METTAG number, basic information and tx information are required for what level MCI?
3 or above
142
Spinal motion restriction for what criteria?
focal neurologic deficit pain to the neck or back distracting injury AMS w/ an MOI intoxication w/ MOI
143
The IC shall be advised immediately during an ASHER/ MCI when ?
Fire rescue personnel are requested to or are found in the “HOT or Exclusion “ zones
144
Gravida and Para definitions
Gravida- previous pregnancies Para- Number of Live births
145
What gas type and pipe size does not contain mercaptan?
Natural gas in sizes 18” or greater
146
For percuteanous needle sticks how to care for them?
10 min washing with soap and water or 10% iodine or chlorine compounds until soap and water are available
147
Natural gas lines are what sizes?
Commercial 1-4” Residential 1/2-3/4”
148
On a confirmed LPG/NG leak where does the “Hot zone” start
Where the 4 gas monitor has LEL readings above 0
149
ET tubes shall be confirmed how? 3 methods.
visualization esophageal intubation detector (if available) continuous EtCo2
150
“Group “ is defined as?
Functional areas Is between a branch and unit
151
When must controlled substances be inventoried?
Begin and end of shift Custody change When locked tag seal is changed
152
During multi-jurisdictional incidents how can communication be accomplished?
Compatible systems Representative Dissemination of radios Merging of companies
153
What does MICCR stand for?
Minimally Interrupted cardio-cerebral resusitation
154
What are the 5 components of REHAB?
1. Rest 2. Energy nutrition 3. Hydration 4. Accommodation for weather 5. BLS and ALS monitoring
155
Definition of “Warm Zone” for ASHER/ MCI?
Area with “LITTLE” risk RTF-PEM teams operate CCP operates here
156
When declaring an MCI what 2 things must be included?
LEVEL and TYPE
157
The definition of “Capacity “ is?
The ability to understand the benefits, risks, and alternatives to a proposed tx or intervention.
158
Preeclampsia is defined as?
SBP \>160 DSP \> 110 with : AMS Headache Visual disturbances PE
159
Station supply orders may be modified by who?
Medical warehouse personnel or by station medical supply audit.
160
What shall be documented in the pcr for refusals of treatment?
Refusal can result in death or disability They were AAOx4- clinically sober w/ no life or potential life threatening conditions Have the capacity to refuse
161
The only time to give ventilations in the pre-oxygenate phase is?
Patient becomes apneic.
162
TICs are used for:
Search and rescue Fire Attack Overhaul HAZMAT Vehicle accidents
163
Customer complaints concerning communication center go to who?
Communications center supervisor
164
The development of the IAP is based off of what?
Incident priorities which include LIPE
165
What are the oral hypoglycemic medications?
Glipizide Glyburide Glimperide
166
What shall be recorded on the controlled substance inventory log?
Total amount in Mg, MCG, etc NDC or Lot number Expiration date
167
“CAN “ Progress reports should briefly detail ?
Actions that are being taken Actions that. Have been completed.
168
Limitations of Student riders?
Only perform or assist in activities where proficiency has been verified by training facility. No riding alone with pt’s in pt compartment Logged in station log book Wear uniform that training facility has issued Not subject to duties outside of agreement
169
Definition of apenic in DSI?
Respirations \< 4/min
170
Ryan White act notification is for what time frame?
Within 48hrs of notification of patient diagnosis
171
The ONLY useful purpose for a TAC stick is:
To identify energy sources that were not previously aware of
172
Safety officer responsibility for an MCI are to do 3 things:
1. Request LE 2. Provide physical security 3. Exclusion zone
173
The term “MAYDAY” should be used when ?
Lost Trapped Disoriented Seriously injured Air emergency ‘In need of immediate help
174
Expired medications shall not be held in quarantine for more than?
30 days
175
Examples of Natural hazards are?
Severe Weather- Hurricane, tropical storm, lightening Floods Agricultural pests and ds. Fire Communicable ds. - H1N1, Eboli
176
What is the initial treatment for bradycardia in peds?
Oxygenation / Ventilation Neonate: 1 q 3 for 30 sec Infant: 1 q 3 for 1 min
177
The ISO with regards to atomospheric monitoring SHALL ensure:
Levels are safe before allowing personnel to remove SCBA during overhaul Benefits outweigh risks with OV Respiratory protection is used accordingly
178
The Fire rescue RTF-PEM supervisor is established by who and works on which TAC channels
IC and 7a or 8/a and 14a or 15a.
179
For exterior LPG/NG leaks on above ground containers - they should be cooled with what?
2 1/2” line at 200gpm
180
Divisions and group persons who are in charge are termed what?
Supervisors
181
Time frame for post exposure prophylaxis?
Within 2 hours
182
Where are adulterated or expired medications kept?
In a designated “quarantine “ are within the supply closets.
183
What MUST be obtained on a vehicle accident?
A police report AND obtain insurance from other driver
184
What are the 4 zones for ASHER/MCI?
Exclusion Hot Warm Cold
185
What is a customer inquiry?
Inquiry - Request for information - Lost item Securing property Gratitude Obtain inform
186
Battalion level procurement of equipment will go through who?
Medical supplies warehouse.
187
Power CQI, an ERROR is defined as?
Failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim
188
If a student or observers ride time is terminated who is then notified?
Deputy chief of operations is notified.
189
Adult Cocaine OD get treated with what?
Versed
190
Time for Breech birth actions
if not delivered in 3 minutes
191
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
192
Which patients receive fluids despite having rales?
Septic pneumonia patients
193
When using the Hand Tevy method, what is used for the PRIMARY reference point?
age
194
EMS CQI Reportable events are?
Airway or ventilation issues or errors Electrical therapy issues or error Deviation from EMS protocols with out justification Advanced procedure issues or errors: Paralytic use, pleural decompression, Cricothyrotomy Repetitive minor issues that cannot be resolved on a supervisor level Any other issue or error that causes harm or has significant potential to do so.
195
Who is responsible completing and submitting the DRE form and where does it go?
First person to report event and uploaded to sharepoint.
196
Clearance from the OHC prior to returning to work must of,had what types of conditions?
1. work related injury that resulted in being off duty from WC or LD 2. Out patient surgery or hospitalization
197
Loss of life/ injury definition for fire investigator call out?
Fire or explosion related deaths Fire or explosion related injuries which require transport by FR.
198
Pt's that have not reached puberty shall be classified as how?
pediatric pts.
199
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
200
First time students on ride alongs must provide the following items:
Written verification of name, year/ class and status in program. Background check and criminal hx Written verification of. Proficiency in BSI Have stethoscope, eye protection, mask and fit tested. Written confirmation of vaccinations Written verification of skill proficiency
201
What is the FAP definition for ASHER/ MCI?
Final Approach position- is the outside area where the RTF-PEM team enters the warm zone
202
H2s has an almond like Oder detectable at what levels?
1-5ppm and 60-70% of the population
203
Per CQI and Adverse event is defines as ?
Incident causing injury or other medical condition to a patient as a result of treatment rendered by EMS personnel.
204
A valid DNRO shall be:
Signed by the competent patient or patients representative Signed by the licensed Florida physician Be on original canary yellow or copied on similar colored paper.
205
When it is deemed necessary to have follow up testing who contacts the employee and when?
EMS captain , Exposure control officer, or OHC within 24 hours
206
What cases are mandated to be reported to the CDC?
Contagious ds AIDS HBV TB
207
Natural gas has an LEL of?
5.3-14%
208
Who is the clearinghouse for citizens complaints?
Operations and administrative services
209
PEA is defined as?
an organized rhythm \> 20 BPM
210
Pregnant minors can refuse transport only for?
Only if the condition if the condition is related to the pregnancy. If not, then no refusal. Ie. Broken leg.
211
The fire rescue RTF- PEM TEAM leader reports what to the Fire rescue RTF-PEM group supervisor
PAR levels - going in and out of the warm zone - going in and out of structures in the warm zone - Changing floors or levels with in the warm zone
212
Guidelines for Operational Capt and Lt with Students/ observers?
Let to obtain proper paperwork for student Safe place to observe with seat belt Introduce person to others in the station Familiarity with apparatus Log person in station logbook Log person on ePCR’s for calls and treatments performed
213
Differences in Croup and Epiglottitis?
Chonic vs Acute sick for a few days vs Sudden onset low grade fever vs high grade fever not toxic looking vs drooling and tripod
214
After securing the malfunctioning stretcher- Where does the item get reported to ?
Assetworks as a HIGH priority
215
If the reporting system is down how shall the incident report be documented?
Should be documented on the a “field report”
216
Medications should be delivered when in cardiac arrest ?
ASAP after rhythm check and circulated for 2 min
217
Per CQI and Adverse event is defines as ?
Incident causing injury or other medical condition to a patient as a result of treatment rendered by EMS personnel.
218
Who may ride as an observer?
Local Dr’s, nurses, PA’s, Nurse practitioners, and other medical students or professionals. EMT’s or paramedics with other local agencies from their chief on letterhead Individuals seeking employee or are in training Others approved by the fire rescue administrator and FR HIPPA compliance officer
219
EtCO2 monitoring will be performed on which pts?
Respiratory distress AMS Sedated / pain medication seizure pts ketamine pts
220
An IRE is reported immediately to whom?
Supervisor
221
What is the minimum size hose line and nozzle for confirmed LPG/NG leak?
1 3/4” with a fog nozzle
222
Natural gas lines are what sizes?
Commercial 1-4” Residential 1/2-3/4”
223
Where do companies leaving rehab report to?
Staging
224
If a student or observers ride time is terminated who is then notified?
Deputy chief of operations is notified.
225
The communications center shall announce benchmarks every?
10 min
226
Adult BP maintain BP for Head injuries is what?
SBP 110-120
227
If the sending facility physician refuses to administer paralytics for a trauma transfer then what?
Crew must contact the EMS Captain and follow the advanced A/W protocol, and accompany pt to the receiving facility.
228
What are the medical NO-GO criteria?
SBP\< 100 Pulse \>100 with ANY of the following: Temp \> 101 SBP\> 180 DBP\>100 SPCO\>0 ALS S/S.
229
What are the amiodarone contraindications
Qtc \>500 Blocks Bradycardia Hypotension cardiogenic shock
230
A “DRE” is defined as:
Events that occur during emergency calls, training, pub ed, emergency or non emergency situations: Potential to cause harm Equipment failure that had potential but did not.
231
Half mask cartridge respirators with organic vapor filters can be used when 2 conditions apply?
OV only and 02 is normal
232
What shall be documented for refusals of Transport?
Death Disablity, AAOx4, Clinically sober, impaired judgement, capacity, assessment, exam, 2 set v/s. Not being transported may result in death or disability AAOx4- clinically sober, with no life or potential life threatening conditions to impair judgment Capacity Patient assessment Physical exam 2 sets of V/S
233
An IAP planned operational period is how long?
12-24 hours
234
Definition of a “FORMAL AAR”
Battalion HQ or HQ CQI or Chief Detailed and analysis Scheduled with 30-90 days post
235
The incident safety officer will have the 1st EMS captain on all __________ \_\_\_\_\_\_\_\_\_\_ and _____________ \_\_\_\_\_\_\_\_\_\_provide what to whom?
Working fires and Hazmat incidents their rainbow sensor to the Rehab unit.
236
Students will arrive at ride time with what equipment?
Stethoscope Eye protection Respiratory protection Clinical and skills documentation able to perform. Copy of state EMT and BLS cards.
237
What are the precautions with Ketamine in seizure patients?
Respiratory distress- need for an advanced airway HTN Schiziophrenia
238
Who has the responsibility to call for a fire investigator?
IC
239
What pages in the ERG are used for LPG and Natural gas leaks?
20-25 and orange guide sections 115-116.
240
MCI types are classified as:
CBRNE Shootings MVC’s Plane crashes Collapse
241
When filling out risk management forms supervisors must sign forms using what?
Full first and last names AND employee ID
242
What are Half mask cartridge respirators w/ organic vapors particularly used for?
Wildland fires D/O operating at the pump panel ISO Post fire activities
243
What is the priority order for REHAB?
RHEBA 1. Rest 2. Hydration 3. Energy nutrition 4. BLS and ALS 5. Accommodation for weather.
244
The Paramedic Development course is for?
New employees and Those needing remediation
245
Exposure protection should be accomplished with ?
Ground monitors Mounted deck guns
246
The rehab unit works under which command branch?
Logistics
247
What are acceptable forms of ID for DNRO
Drivers license Other photo identification Witness in the presence of the patient
248
A patient exists when ?
medical complaint, obvious injury, appears in distress Suggestive of acute illness or injury Such as: HX, MOI, appearance Lack of capacity
249
An “After Action Review” is required for what level MCI?
Level 3 or higher
250
The following SHALL NEVER be performed on patients with a DNRO?
Artificial respiration BVM ET tube Supraglottic A/W Chest compressions Defibrillation
251
Unstable Vtach
Adult : Cardio version 100, 200, 300. 360J Pedi : 0.5J/kg and 2j/kg
252
The THREAT acronym for an ASHER/ MCI stands for what ?
Threat Supression Hemorrhage Control Rapid extrication Assessment Transport
253
Post intubation placement is ?
ETCO2 continually- initially, continuously, and upon transfer of care Wave form with no less than 3 boxes Auscultation of bi-lateral breath sounds Placement of a gastric tube
254
12 lead cables will remain on the pt until when?
turned over the ED staff when transporting.
255
Who gets notified of exposure to communicable ds.?
EMS captain and notify Medical services division.
256
Emergency Evacuation is for?
Evacuation of a scene or area in imminent danger
257
One a controlled substance is removed from the container how long till it needs to be re-sealed?
Immediately following or as soon as reasonably possible
258
All IVP medications for an arrest are followed by what?
10ml saline Flush
259
“Base’ is defined as ?
The coordination and administer logistic functions Only 1 per incident The staging of resources prior to entering on a high rise fire
260
A significant exposure is deveined as :
Needle stick or sharps: Blood or fluid containing visible blood Semen Vaginal fluids CSF Synovial fluid Peritoneal fluid Pleural fluid Pericardial Fluid Amniotic fluid Mucous membranes Abrased or abraded skin Airborne contagions
261
Rehab 6 hours post fire incident is in reference to ?
Cardiac arrest and WILL be treated for cyanide exposure
262
A valid DNRO shall be:
Signed by the competent patient or patients representative Signed by the licensed Florida physician Be on original canary yellow or copied on similar colored paper.
263
3rd Trimester complications include
Placenta previa-painless vaginal bleeding bright red Abrupto PLacenta-severe pain sudden onset Uterine rupture- - intense abd pain and Vaginal bledding
264
Who is responsible for securing and maintaining scene integrity for a fire investigation?
Operations personnel. Not LE
265
What is the “Section” person in charge title?
Chief
266
Who can place an unit OOS for an IRE?
BC or equivalent supervisor
267
Definition of Accidential fire with substantial monetary loss or structural damage?
Monetary fire loss of $70,000 or structural damage exceeding 20% Any suspicious or crime related incident regardless of dollar value.
268
What has to be “Clearly” written on the tag for a stretcher malfunction?
OUT OF SERVICE- DO NOT USE
269
A valid DNRO shall be:
Signed by the competent patient or patients representative Signed by the licensed Florida physician Be on original canary yellow or copied on similar colored paper.
270
What information is needed to finalize a medical report?
“Report author” HIPPA or PPA signed Signature of patient or witness “Transfer of care “ by hospital staff MRN Any students or observers must be listed.
271
If SPCO is above what level?
\>20%
272
If theft or loss of a controlled substance from the EMS captains stock- how is it handled?
The same as a unit loss except the EMS captain contacts the division chief of medical services 1st.
273
TIC operations: our eyes work by seeing contrast by objects that are illuminated by either. _______ or. \_\_\_\_\_\_\_\_\_\_.
Sun or another from of light
274
Propane has an LEL of?
2.1-9.5%
275
Refusal breakdown chart?
Refusals: Adults Minors Pregnancy Diabetics Treatment refusal: Death or disability AAOx4 w/ no life or potential life threatening condition to impair judgment Have Capacity Transport refusal: Death or disability AAOx4 w/ no life or potential life threatening condition to impair judgment Have capacity Patent assessment Physical exam 2 sets of V/S Meet all previous criteria for refusal
276
What information is to be entered on a level 1 or 2 MCI?
Name DOB Phone number Brief narrative
277
What is the most important V/S to stabilize?
CORE temperature
278
Who has the responsibility to call for a fire investigator?
IC
279
Treatment for an LVAD ?
locate emergency bag take all equipment to ER verify device is working by lack of pulse or measurable BP. LIsten for continuous humming. Hypotensive Fluids 1L Compressions if unresponsive and unable to restart device or not working.
280
A valid DNRO shall be:
Signed by the competent patient or patients representative Signed by the licensed Florida physician Be on original canary yellow or copied on similar colored paper.
281
IF an employee fails the PDC entrance exam what happens?
Returned to shift as soon as possible Cannot re try until next scheduled PDC IF the employee fails the 2nd time- must wait 24 month before applying again.
282
TIC’s are assigned to which apparatus?
Every Engine, rescue, EMS captain , and BC.
283
Definition of the “exclusion zone”?
Risks outweigh the benefits No FF operations allowed
284
What must the employee have in order to go to the OHC?
A completed employee injury /illness report. Form FRH-302
285
The Situational Evaluation or “Size Up” is based on what?
Critical incident factors
286
What are the 5 fire operations benchmarks?
Primary complete - ALL CLEAR Secondary complete- ALL CLEAR Water on fire Fire under control Fire out- OVERHAUL OPERATIONS ARE COMPLETE
287
Under the safe haven law, Law enforcement should not be contacted unless?
Signs of physical abuse are present at the time of surrender.
288
What are the contraindications for Ceftriaxone or rocephin?
Allergy to cephalosporins Neonates birth to 30 days
289
After securing the malfunctioning stretcher- Where does the item get reported to ?
Assetworks as a HIGH priority
290
Draw out the command sequence
291
Storing of medication on the rescue truck need to be kept at what temperature?
65-80 degrees Fahrenheit
292
Minimum par levels with controlled Substances can be found where?
PBC portal/ PBCFR/medical services under the quick link- Controlled substances minimum quantities.
293
What are the most likely transmission routes from TB?
Persistent cough \>2 weeks with one of the following - Anorexia - weight loss - fever - hx of drug use - night sweats - bloody sputum
294
which pt's are required to have a 12 and 15 lead performed?
chest, Arm, neck, back, jaw, shoulder, epigastric pn or discomfort palpitations syncope, lightheadness, general weakness, fatigue SOB, CHF, or hypotension unexplained diaphoresis or nausea.
295
What are the 5 mandatory functions of incident command?
Assumption , confirmation, and positioning of incident command Initiate and monitor personnel accountably Situation Evaluation which means “SIZE UP” Initiate , maintain band control the communications process Develop and IAP
296
What is the primary site for chest decompression?
5th intercostal space mid axillary
297
Finger Thoracostomy is done when ?
known or suspected injury to the chest and or abd
298
The 10 min benchmark timeframe include what 3 things?
Notification Response deployment
299
Intelligence / Investagtory function purpose is what?
to determine the cause or source of the incident
300
The preferred location for observers to ride is:
Battalion HQ’s unless otherwise specified in the approval process.
301
What is the fire flow formula?
L x W / 3 x % involved
302
The medical warehouse temperature is kept at ?
70-76 degrees Fahrenheit
303
CO poisoning is at what level?
35ppm
304
What factor has the most impact on the outcome of a fire incident?
The initial attack hose line
305
When must an employee be required to complete a medical exam and fitness assessment?
Prior to returning to full duty from any injury or illness or any leave greater than 6 months
306
1st arriving unit responsibilities on a ASHER/MCI?
Establish command Set LEVEL 2 staging Set up command at Staging Establish a unified command with LE.
307
DSI paralysis indications are?
Apneic Status epilepticus Trismus EMS captain or flight crew discretion
308
Stable SVT treatment is?
Adults 12mg Adenosine Pedi- 0.2mg Adenosine
309
The following incidents REQUIRE an assistant safety officer?
Hazardous material Dive team operations Open water incidents Rehab when assigned
310
“Base’ is defined as ?
The coordination and administer logistic functions Only 1 per incident The staging of resources prior to entering on a high rise fire
311
Damage of a controlled substance from a a unit is handled how?
Notification t o the EMS captain Property loss form and tracking number “Broken/ damaged” written in the case# spot The EMS captain notifies the division chief of medical services
312
Any functions within the ICS that remain un delegated remain with whom?
IC
313
Adult hypotension is defined as?
systolic BP\> 90.
314
Who do assistant safety officers report to?
Directly to the Incident safety officer
315
How often is injury tracking analyzed
On a quarterly basis
316
During an MCI command needs to be updated with what information?
Number of patients Patient categories Additional resources needed.
317
EMS CQI Reportable events are?
Airway or ventilation issues or errors Electrical therapy issues or error Deviation from EMS protocols with out justification Advanced procedure issues or errors: Paralytic use, pleural decompression, Cricothyrotomy Repetitive minor issues that cannot be resolved on a supervisor level Any other issue or error that causes harm or has significant potential to do so.
318
A complete set of v/s consists of what and done how often?
Pulse,- Rate rhythm quality Respirations-Rate and Quality Temp Pulse ox BP- cap refill ETC02 BGL Priority 3 - at least 2 sets Priority 2- q 5min.
319
The definition of an HSP?
Hazard specific plan that outlines a mitigation strategy for 12 hazards
320
What type of work related injuries must be reported?
All injuries no matter how minor
321
Sager splints are used on what type fx?
Closed Mid shaft femur only
322
To fix perfusion in adult and infants for DSI what is used?
Adults: 1L saline Infants: 20ml/Kg If neither work - push press epi- 1:100,000 at 1ml/min. Max 30 ml . Concentration is 10mcg/ml
323
When should manual BP's be taken?
Initially and to confirm any abnormal or significant change in an automatic BP.
324
Definition of Perimeter?
The most distant control point for the incident.
325
Unified command will use which management system?
NIMS- National incident Management system
326
How much NS admin for Decompression sickness?
500ml
327
Who gets notified for vehicle accidents?
BC
328
A post exposure treatment written statement is to be completed by what time frame?
Within 15days
329
Response code levels to an ASHER/MCI by Fire Rescue are?
Code 3 with lights and sirens until unit crosses the LE perimeter./
330
Responders at an active shooter event should realize?
Secondary devices Actions against responders Implement PPE Caution with tactical actions Preserve evidence
331
The Command post should be set up so the IC has how many views of the incident?
2- TWO
332
When treating a possible TB patient what should happen ?
N95 on employees Oxygen to patient or if not needed N95 for patient Air vents open -no recirculating
333
How many of hours of work may be sustained if \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_, _________ and hours\_\_\_\_\_\_\_\_\_\_.
Rest Hydration Energy nutrition At least 4 hours
334
“Section” is defined as?
One of the 5 major functional areas under the NIMS system IS between command and branch areas
335
A report of the department’s exposures are sent to who and how often?
Wellness coordinator- Annually.
336
When should LEVEL 2 staging be established? 4 items.
Multiple alarm incidents Level 2 or greater MCI Airport III index or greater Other incident where multiple resources should be supervised
337
For Trauma patients not to be resuscitated what criteria is needed?
Apneic Fixed dialted pupils asystole NEED ALL 3 or injuries incompatible with life
338
Strategy is defined as?
General course of action or direction to accomplish incident objectives
339
it is more important to maintain what levels for COPD and asthma patients?
SPo2 at 90%
340
The IC is responsible for ensuring that assignments during an incident are based on what?
Incident priorities
341
What are the doses for rocuronium for adult and pediatrics?
Adults 100mg Pediatric 1mg/kg
342
What are the contraindications for the "ResQpod"
Pt less than 1 yr old Pt's with a pulse Cardiac arrest due to trauma during passive oxygenation
343
What is the contraindications for push pressor epi?
Hypotension secondary to blood loss.
344
Students will arrive at ride time with what equipment?
Stethoscope Eye protection Respiratory protection Clinical and skills documentation able to perform. Copy of state EMT and BLS cards.
345
Observer dress code is:
White shirt- SS or LS Black, dark blue pants Black closed shoes w/ dark socks
346
Heat stroke is classified as ?
Temp \> 103 or AMS
347
Special events , dignitary details with regard to controlled substances are handled how?
Receive written authorization from the division chief of medical services or designee.
348
Rules of engagement for an IC is to conduct a n initial risk assessment and implement what and how?
Safe action plan: Size up Rescue profile Risk assessment
349
Responsibility for,returning to work is who’s?
The employee to notify the BC/ supervisor
350
How are explained discrepancies handled with controlled substances?
Report to Lt or operational captain Single line strike though with initials next to change
351
Once assigned to Safety officer what are the duties?
Don appropriate vest and PPE Ensure no entry into the hot zone as a single person Ensure all control zones are established or adjust as necessary Ensure exclusion zones are recognized Rehab Atmospheric monitoring Remain on scene until relieved by the IC or designee Document actions as to the incident reporting guide any accidents injuries or unsafe acts or safety concerns should follow the CQI Communicate with EMERGENCY TRAFFIC the exclusion zone
352
A valid DNRO shall be:
Signed by the competent patient or patients representative Signed by the licensed Florida physician Be on original canary yellow or copied on similar colored paper.
353
Who gets contacted with finding of an investigation with regards to citizens complaints?
DC get contacted for findings of Citizens complaints
354
The county established a framework to ensure PBC is prepared to respond and recover from hazardous incidents?
Comprehensive Emergency Management Plan
355
What percent is active cooling better than passive cooling?
50-60% more
356
When must a fire investigator be called?
1. Fire is suspicious or crime related- 2. Loss of injury or life 3. accidental fire w/ substantial monetary loss or structural damage. 4. Juvenile related incidents 5. Explosive devices/ explosion 6. Undetermined
357
The 5 gas monitor will be used when ?
Incidents where combustion processes have taken place In areas with close proximity to any fire- wildland, structure, vehicle, training, or dumpster
358
The preferred location for observers to ride is:
Battalion HQ’s unless otherwise specified in the approval process.
359
For which of the following fire investigatory incidents shall a Fire investigator be contacted via radio or cell phone?
Juvenile related incidents.
360
A safety office should have a working knowledge of what?
Safety concerns for fire rescue in typical incidents Fire behavior Building construction EMS
361
What medical items are on a 1 for 1 swap through the medical warehouse?
Specialized items that include life pak cables and sensors
362
Definition of a “PAR” level?
The “ideal quantity of each controlled substance carried by a unit in order to maintain sufficient operations.
363
Employees filling forms for PTSD fill out what forms?
The same as employee injury
364
What is the TACTICAL priority of protecting property from damage?
Salvage
365
Reporting fire conditions are what 4 types?
Nothing showing Smoke showing with - light, moderate, or heavy Flames showing Working fire
366
Development of the IAP includes?
Mode of operation Tactical priorities Scene control Tasks
367
Limitations of Student riders?
Only perform or assist in activities where proficiency has been verified by training facility. No riding alone with pt’s in pt compartment Logged in station log book Wear uniform that training facility has issued Not subject to duties outside of agreement
368
Radio transmissions use what model?
Military order model
369
Upon arrival the student or observer MUST report to who?
Operational captain and then paired with the LT.
370
Unstable bradycardia is defined as?
Adult: \>50 BPM w. hypotension Pedi: \>50 w/ AMS and age hypotension
371
Indications for an advanced airway are:
Airway protection Respiratory failure Prolonged respiratory suppport
372
Operational periods should be no longer than ?
24 hours
373
Who are responsible for the accurate inventory, distribution, transfer, documentation, and record keeping of all controlled substances on a unit?
All department protocoled Paramedics assigned to a unit.
374
The Fire rescue RTF-PEM supervisor is established by who and works on which TAC channels
IC and 7a or 8/a and 14a or 15a.
375
Area command oversees management of \_\_\_\_\_\_\_\_\_\_\_while an EOC coordinates\_\_\_\_\_\_\_\_\_\_ ___________ and _______________ \_\_\_\_\_\_\_\_\_.
Incidents Support functions and resource support.
376
On a confirmed LPG/NG leak where does the “Hot zone” start
Where the 4 gas monitor has LEL readings above 0
377
The Drager X am 5000 monitors which substances?
O2 Flammability CO H2S OV
378
When 2 or mare staging areas are being used that are identified how?
Function or location
379
Measures to be taken immediately after a significant exposure?
Clean the wound Notify the EMS captain Accompany the source patient to the hospital Fill out the hospitals exposure log book using the Case number Report to the OHC immediately or the next business day Discontinue and treatment after being notified by the OHC of a negative result.
380
The definition of a newborn to be left at a fire station is defined as?
7 days old or less left by the parent
381
TIC limitations:
Cannot see into a windowless building- need temperature differences Cannot see under water Cannot see through windows or glass Cannot see through highly reflective materials - stainless, steel, mirrors, windows
382
Who is allowed to deviate from the protocols?
Ems captains and Trauma hawk Personnel
383
Orders and decision making shall be performed where?
At the lowest level within the organization
384
Definition of Accidential fire with substantial monetary loss or structural damage?
Monetary fire loss of $70,000 or structural damage exceeding 20% Any suspicious or crime related incident regardless of dollar value.
385
Upon arrival the student or observer MUST report to who?
Operational captain and then paired with the LT.
386
Distribution of controlled substances from the EMS captain to a unit are signing in what spaces in the book?
EMS captain signs Given/ Issued by and Unit sign received by section .
387
How is a fire investigator requested?
The IC requests through the communications center.
388
If allows to return to work with the BCs permission when must the employee go,to the OHC for clearance?
Before the next work day
389
After securing the malfunctioning stretcher- Where does the item get reported to ?
Assetworks as a HIGH priority
390
What is the minimum size hose line and nozzle for confirmed LPG/NG leak?
1 3/4” with a fog nozzle
391
STEMI alert criteria?
2mm elevation smiley face concave in any leads 2mm elevation frown face convex on V2 and V3 1mm elevation frown face convex in any leads
392
For both adult and peds with pacing, what can be given if normotensive and no IV?
Versed- 5mg IN/IM only 0.2mg/kg IN/IM only
393
Examples of the “CONFINEMENT tactical priority would be?
Preventing fires into un burned areas Time to conduct a rescue Protect exit stairways and corridors
394
Who fills,out report for minor injuries and where does it go?
Immediate supervisor and forwarded to BC
395
STEALH stands for?
Set time Tone Execution Analyze Transfer lessons learned Hi note
396
The DNRO identification device must be signed by who if the patient cannot provide consent?
Surrogate Proxy court order Power of attorney
397
When can air transport NOT be used?
Pt weighing \> 500lbs or 227kg Pt that cannot lay supine combative and cannot be physically restrained Hazmat contaminated pts
398
Common Natural gas lines that are 24” are found where in PBC?
Along the turnpike Port of palm beach to West county energy center owned by FPL
399
What make critical incident factors critical?
Ability to line up incident factors in priority based on consequences
400
Treatment for RRWCT is?
Stable :Adult 1g cacl2 100mg bicarb Pedi: 20mg/kg cacl2 1meq/kg bicarb
401
Under the safe place law, when should law enforcement be contacted?
1. Child is followed by and angry parent to the fire station 2. Abuse is ssuspected 3. Suicidal/ homicidal 4. Teen is hallucinating and out of control
402
What information is needed to finalize a medical report?
“Report author” HIPPA or PPA signed Signature of patient or witness “Transfer of care “ by hospital staff MRN Any students or observers must be listed.
403
What are the criteria for someone to request a "Free Standing" ED?
Stable Patients informed if admitted they will be transferred. sign "Emergency Transport Disclaimer"
404
What is the minimum size hose line and nozzle for confirmed LPG/NG leak?
1 3/4” with a fog nozzle
405
When can an arrest be called?
EMS captain on scene persisent asystole for \>15min ALS interventions Etco2\< 10 H and T's or reversible causes treated 1 defib 500 ml NS Normothermic support group
406
Reportable events are defined as:
An occurrence during emergency calls, training, pub ed, emergency or non emergency situations
407
IF trauma hawk is taken out of service where are the controlled substances kept?
In a department issued lockable safe
408
If a parent or guardian refuses a physical exam what must be documented?
Visual exam Mental status General appearance Work of breathing Circulation to skin
409
An example of injury while wearing PPE would be?
Burns to the hands while wearing gloves.
410
When using the TAC stick the user should start on which sensitivity?
HIGH and move to lower ones later.
411
The ICS 5 major functional areas are?
Command Operations Planning Logistics Finance/ Admin
412
An assistant safety officer may be assigned by the IC for rehab under what incidents?
Physical labor of \> 2 hours Excessive rotation of companies Incidents that require defined hourly work periods Hire rise fires not controlled by a single company Wildland fires Hazmat incidents Confined space incidents
413
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
414
What is the tine frame for not considering a stroke not an Alert
Witnessed greater than 24 hours
415
How does a reservist get entered in the causality page?
RESERVIST1 is the ID number PBCFR is the first name RESERVIST was the last name
416
What if the death criteria are not there what can be used?
Known down time of \>30min Apneic Without mechanism for Hypothermia Asystolic Fixed and dilated pupils
417
Examples of “EXPOSURES” are
Near fire building Attached to fire building Near but protected Threatened by flying brands, heat or toxic gases
418
Students will arrive at ride time with what equipment?
Stethoscope Eye protection Respiratory protection Clinical and skills documentation able to perform. Copy of state EMT and BLS cards.
419
Who can establish a LEVEL 2 staging area?
IC Operations section chief
420
What is the minimum size hose line and nozzle for confirmed LPG/NG leak?
1 3/4” with a fog nozzle
421
Who can revoke a DNRO?
Patient Surrogate Proxy Court order Power of attorney
422
Type III construction is what?
Ordinary construction where the interior structural elements are entirely or partially of wood OF SMALLER DIMENSIONS
423
Eclampsia is defined as ?
S/S of pre + seizures or coma
424
TIC operations with victim or FF in structure fire will appear ?
Dark
425
Who’s responsibility is it to assign a safety officer?
IC
426
“Mayday” definition is?
Lost Trapped Disoriented Seriously injured Experiencing an Air emergency In need of immediate help
427
TO have an effective progress report , the report need to be ?
Timely Complete Consise
428
What forms are required by students to ride - legal documents?
Copy of Student/ observer ride time Release of Liability and covenant not to sue. Indemnification agreement HIPPA confidentiality agreement Insurance coverage
429
What is the dress code for Student riders?
Designated uniform by training facility Badge or other identifying means
430
Assuming command can happen by what 2 means?
Non collaborative/Face to face Radio communications of “assuming command”
431
What is the fire formula for multiple floors?
L x W /3 x % involved = GPM/ min x number of floors
432
TASKS are defined as ?
Specific assignments that are typically performed by one company or small group working together.
433
If the paramedic who signed the controlled substance log can longer keep possession and no relief is available who do they go to?
Lieutenant or operational captain or designee
434
Who is responsible for securing and maintaining scene integrity for a fire investigation?
Operations personnel. Not LE
435
Who may terminate a student or observers ride time?
Operational Captain EMS captain BC or DC
436
Definition of a “INFORMAL BATTALION AAR”
Battalion HQ or FS Company officer of chief IN DEPTH Scheduled ASAP
437
What must the employee have in order to go to the OHC?
A completed employee injury /illness report. Form FRH-302
438
What are acceptable forms of ID for DNRO
Drivers license Other photo identification Witness in the presence of the patient
439
Extensions for paramedic probation are ?
Done by the EMS captain and documented on a professional development form for 18month. If the extension period is still less than satisfactory then the EMS captain. Recommends the person be referred to the medical services division and medical director for further evaluation. All documentation to be sent to the compliance officer
440
Vtach stable treatment?
Adult : Amiodarone 150mg in 50 15gtts Pedi: 5mg/kg in 50 15 gtts
441
What makes a Vtach patient unstable?
Contraindications to Amiodarone: Sinus bradycardia 2/3 degree blocks cardiogenic shock hypotension QTC \>500
442
Who get notified when a newborn infant is surrendered at a fire station?
PIO
443
Who maintains the list of resources that may be beneficial in an MCI?
FOO
444
Positioning for DSI is?
Ear to the sternal notch Head parallel with the ceiling Stretcher elevated 15-30 degrees
445
The 5 gas monitor will be used when ?
Incidents where combustion processes have taken place In areas with close proximity to any fire- wildland, structure, vehicle, training, or dumpster
446
Where is the fire rescue RTF-PEM group supervisor located?
Next to the Tactical LE officer in the “Cold Zone”
447
When using the TAC stick the user should start on which sensitivity?
HIGH and move to lower ones later.
448
What is the purpose of paramedic development?
Provide a uniform process for new employees attempting to work as a paramedic Address development for paramedics requiring remediation
449
What are the control zones?
Exclusion Zone- Risk outweighs benefit Hot Zone- HI risk Warm zone- Little risk Cold zone- no risk
450
Who has the responsibility to call for a fire investigator?
IC
451
If there is no logistics branch who does the rehab unit report to?
IC
452
Definition of Student in regards to ride times?
Enrolled in an education program at an accredited facility that has an agreement with fire rescue. To include: EMT and paramedic programs Emergency medical responder Training programs at secondary school of palm beach county.
453
Unstable SVT treatment is ?
AMS- Adult 100, 200, 300, 360J Pedi: 0.5J/kg and 2J/kg
454
Definition of “Verification” for exposure?
Determining whether a reported exposure is and “Actual” or perceived health threat.
455
Factors that influence potential exposures are?
Distance Radiant head Wind
456
Customer complaints regarding fire safety includes what types?
Codes Overcrowding Parking in fire lanes
457
Definition of an MCI?
One that exceeds the capabilities of the first arriving units?
458
LEVEL 2 staging is defined as:
Formal process directed by the IC or Operations section chief where responding units are assigned a specific location in anticipation of future deployment.
459
The first arriving unit responsibilities to an MCI are what ?
Establish Command 360 Establish exclusion zone Declare LEVEL and TYPE MCI Initial triage Assign incoming units based on LIPE Additional resources Staging officer
460
Observers unable to keep ride times:
MUST notify the recruitment and human resource development officer in advance.
461
If an employee cannot,obtain clearance to return to work because the OHC is closed what happens?
The BC MAY allow the employees to return to work if not I’ll and without limitations but must still receive clearance from the OHC before the next day
462
How is the 1st notification made in the chain of command for complaints?
Verbally to the DC or supervisor. If not available then BC.for the complaints battalion.
463
Which pt's shall have a BGL checked?
Diabetics AMS seizure stroke syncope, lightheadedness, dizziness poisoning cardiac arrest
464
What are three protocols where on 500ml NS are used?
Decompression sickness Calling an arrest. 2nd \> 15% or 3rd \> 5% degree burns
465
Who is responsible for a “FORMAL WRITTEN IAP?
Planning section chief
466
Expired medications shall not be held in quarantine for more than?
30 days
467
What are acceptable forms of ID for DNRO
Drivers license Other photo identification Witness in the presence of the patient
468
MInor CQI errors include?
Spelling or topographical errors TIme delays without patient harm Lack of detail Intracranial- report inconsistencies Protocol deviation without patient harm or potential.
469
An IRE is defined as: With regards to any Citizen, patient, fire rescue personnel:
1. Harm caused by action or inaction 2. Caused by equipment failure 3. Immoral, unethical , or illegal action 4. Cause for litigation 5. Poltically sensitive 6. Media scrutinization
470
Definition of Juvenile related incidents for fire investigation?
Suspected to be the result of juvenile involvement in the ignition process
471
A protective action Zone is identified for what?
Evacuation Protected in place
472
The FUP in a ASHER/MCI is defined as?
Forming Up Position where FR and LE meet to form a team
473
474
Pediatric pts are age what?
less than 18.
475
During a “MAYDAY” the ISO should request what?
An additional safety officer
476
How does a reservist get entered in the causality page?
RESERVIST1 is the ID number PBCFR is the first name RESERVIST was the last name
477
What is the primary goal with an active shooter event?
Ensure joint command and communications from FR and LE to minimize the risk and maximize safety for all response personnel.
478
Type III construction is what?
Ordinary construction where the interior structural elements are entirely or partially of wood OF SMALLER DIMENSIONS
479
Definition of apenic in DSI?
Respirations \< 4/min
480
When treating Heat stroke?
Cool First, transport second
481
What is the other term for Tactical Priorites? Part of the development of the IAP
“Overview”
482
Who sets the running par level at the battalion for controlled substances?
The EMS captain.
483
Limitations of Student riders?
Only perform or assist in activities where proficiency has been verified by training facility. No riding alone with pt’s in pt compartment Logged in station log book Wear uniform that training facility has issued Not subject to duties outside of agreement
484
Natural gas lines are what sizes?
Commercial 1-4” Residential 1/2-3/4”
485
What is the purpose of paramedic development?
Provide a uniform process for new employees attempting to work as a paramedic Address development for paramedics requiring remediation
486
Significant exposures are defined as and are what type?
Exposure through a needle stick , sharps to the following body fluids: Blood or and body fluid containing visible blood Semen Vaginal secretions CSF Synovial fluid Peritoneal fluid Plueral fluid Pericardial fluid Amniotic fluid. Body fluids to mucus membranes Chapped or a braided skin Exposure to Airborne contagions
487
Primary goal of any airway or respiratory emergency is maintaining?
Ventilation Oxygenation Perfusion
488
A person known to be in the structure with conditions tenable for a person WITHOUT protective gear is termed what?
Salvageable Life
489
Special events , dignitary details with regard to controlled substances are handled how?
Receive written authorization from the division chief of medical services or designee.
490
The Pre-oxygenation step includes?
Maintaining of SP02 for 3min: Positioning head NC @ 15L/min BVM w/ peep @ 10cm/h20 BVM with face seal
491
The DNRO identification device must be signed by who if the patient cannot provide consent?
Surrogate Proxy court order Power of attorney
492
What shall be documented in the pcr for refusals of treatment?
Refusal can result in death or disability They were AAOx4- clinically sober w/ no life or potential life threatening conditions Have the capacity to refuse
493
What are the common means of reporting CQI events?
Field personnel vis chain of command Reportable events Hospitals via complaint as a performance improvement process Patients vis a complaint to the agency
494
What type of arrests are to be transported to a trauma center?
Electrouctions and lighning strikes
495
Offensive mode should be used when ?
Salvageable life No evidence of structural failure or hostile fire event
496
What are STEMI disqualifiers?
LBBB LVH Early Repolarization Pacemaker with QRS \> .12
497
Who can place an unit OOS for an IRE?
BC or equivalent supervisor
498
Who and where does PPE go if an injury occurs on an emergency incident?
BC secures PPE and training AMS safety division
499
RRWCT is defined as?
\> 0.20 or 5 boxes
500
To fix perfusion in adult and infants for DSI what is used?
Adults: 1L saline Infants: 20ml/Kg If neither work - push press epi- 1:100,000 at 1ml/min. Max 30 ml . Concentration is 10mcg/ml
501
When must an employee be required to complete a medical exam and fitness assessment?
Prior to returning to full duty from any injury or illness or any leave greater than 6 months
502
What kind of lock can be used for the EMS captains Storage container of controlled substances?
Key, coded, or biometric lock
503
For expediency of an IRE notification is made how?
By telephone or face to face to the BC.
504
When can you insert a gloved hand into the vagina for a birth?
Breech birth Prolapsed cord
505
Emergency traffic can be used with what 3 situations?
By a company that has an immediate communication Imminent danger while in the exclusion zone Changing modes of operation from offensive to defensive or vice versa
506
Minors refusal criteria?
Parent or legal guardian \<18 yrs old if Married emancipation military Parent or guardian by phone w/ person on scene willing to sign
507
AEIOU TIPS ?
Alcohol, Epilepsy, Insulin, OD, underdose Trauma, infection, pyschosis, stroke
508
On a situation in which is NOT under control yet the ICS should have no more than how many personnel operating under them ?
5- FIVE
509
The 3 sensitivities for the TAC are?
HIGH LOW FRONT
510
Bradycardia is defined as?
\< 50 BPM
511
Who do assistant safety officers report to?
Directly to the Incident safety officer
512
How are the collected expired controlled substances handled?
Hand delivered to an authorized member of the medical services division for proper disposal.
513
Command presence is conveyed how?
look Act Speak Carry yourself
514
Special events , dignitary details with regard to controlled substances are handled how?
Receive written authorization from the division chief of medical services or designee.
515
What are the time frames for rehab?
20 min X 2 for a total of 40 minutes. After 40 minutes BLS/ALS tx, and transport or referral to OHC
516
Disposal, Destruction of controlled substances are handled how by a unit?
Draw upon Unused medication and dispose of it “as directed by the medical services division,. Record disposal in log book using 2 different employees.
517
Additional backboards can be requested from who?
Support 81 Rescues in staging Inventory specialist
518
Who has the ultimate responsibility for an ASHER/MCI (Active shooter hostile event response)?
Law Enforcement
519
Post intubation medications are MANDATORY for any?
ET tube or Igel
520
Who is allowed to take or contact the complaint?
Lieutenant or higher officer
521
What is the warning for rocuronium with patients?
Asthmatic patients may have a drop in BP that may result in Cardiac arrest.
522
What equipment MUST be in place fro DSI?
Suction unit Cardiac monitor, BP, SPO2, ETCO2
523
Storing of medications in the station supply room are to be kept at what temperature?
70-75 degrees
524
An incident Support plan is for what type of incidents?
Mass fatality / MCI General population shelters Continuity of operations plan
525
How are UNexplained discrepancies handled for the EMS captains stock?
Notification to the division chief of medical services
526
Auto PEEP is what?
When Air goes in before a patient is allowed to exhale.
527
The DNRO identification device must be signed by who if the patient cannot provide consent?
Surrogate Proxy court order Power of attorney
528
Customer complaints with regards to matters of fire safety are ha fled by?
Community risk reduction and notification to DC or BC
529
All medication errors and immediate and delayed outcomes for errors gets reported to who?
EMS captain
530
Extensions for paramedic probation are ?
Done by the EMS captain and documented on a professional development form for 18month. If the extension period is still less than satisfactory then the EMS captain. Recommends the person be referred to the medical services division and medical director for further evaluation. All documentation to be sent to the compliance officer
531
Pacing for a peds starts at what?
80 BPM
532
If allows to return to work with the BCs permission when must the employee go,to the OHC for clearance?
Before the next work day
533
EMS CQI Reportable events are?
Airway or ventilation issues or errors Electrical therapy issues or error Deviation from EMS protocols with out justification Advanced procedure issues or errors: Paralytic use, pleural decompression, Cricothyrotomy Repetitive minor issues that cannot be resolved on a supervisor level Any other issue or error that causes harm or has significant potential to do so.
534
Decision making for setting up isolation or control zones is based on :
Potential to harm: 1. Life 2. Critical systems 3. Property
535
Human Caused Hazards are:
Domestic security Workplace/ School violence Mass migration
536
The IC role is a position of ?
ROLE
537
Examples of Technological Hazards are?
Transportation incidents Hazardous materials Nuclear power plant Dike failure
538
The initial isolation zone becomes the hot zone when?
The product is confirmed and additional references are used to confirm the distances.
539
PBCFR used which Rehab standard for Heat stress index?
WBGT- Wet bulb globe temperature
540
What are acceptable forms of ID for DNRO
Drivers license Other photo identification Witness in the presence of the patient
541
What are acceptable forms of ID for DNRO
Drivers license Other photo identification Witness in the presence of the patient
542
What are the doses for rocuronium for adult and pediatrics?
Adults 100mg Pediatric 1mg/kg
543
What is the term used for the staging of resources prior to entering the incident scene?
BASE
544
For termination of resuscitation efforts who does the scene get turned over to?
Law enforcement Or CARES team.
545
What is the criteria for unstable Afib/ flutter
Hypotension only
546
Who ensures confidentiality with exposure reports for the employee?
EMS captain Exposure control officer
547
How can a DNRO be revoked?
By writing Physical destruction Failure to produce Orally expressing a contrary intent
548
The Pre-oxygenation step includes?
Maintaining of SP02 for 3min: Positioning head NC @ 15L/min BVM w/ peep @ 10cm/h20 BVM with face seal
549
Exterior water application from the exterior during offensive operations should done how?
Directly into the fire compartment Directed at the ceiling No more than 15 sec Used with a solid or straight stream pattern
550
Incidents identified by the EMS CQI officer level containing an EMS CQI reportable event are handled how?
Emailed to the appropriate EMS captain to be handled.
551
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
552
12 leads will be repeated how often?
q 10min
553
When will the passport accountability system be utilized?
2 or more units assigned to an IDLH incident
554
Strategies are _______ and equivalent to \_\_\_\_\_\_\_\_\_.
General Goals
555
What is the dress code for Student riders?
Designated uniform by training facility Badge or other identifying means
556
Termination efforts can be done when?
EMS captain OS persistent asystole for 15 min Etco2\< 10mmHg No hypothermia 1 defibrillation @ 360j. 500ml NS All ALS interventions have been completed and reversible causes addressed. Social support group is in place for family if needed.
557
Fire rescue has an agreement with who for purchasing all pharmaceutical supplies and medications?
Health care district of Palm beach county.
558
When does NTG get withheld in CHF patients?
febrile patients or nursing home with pneumonia
559
When two or more incidents are on the same street then how are they differentiated?
Using a hundred block number or some other designator
560
Type IV construction is?
Heavy timber- interior structures are made of SOLID or LAMINATED WOOD
561
Lidocaine in an IO for pedi dwell?
2 min
562
What is the time frame for decompression sickness?
48 hours
563
When are statements with regards to citizens complaints necessary?
Statements are needed : 1. Damage or loss of property 2. Poor treatment 3. Patient wishes- ie. Not securing residence or wrong transport location 4. When the officer needs statements
564
Who fills,out report for minor injuries and where does it go?
Immediate supervisor and forwarded to BC
565
LVAD patients go to which facility
JFK
566
Active atmospheric monitoring is used when ?
Firefighter is actively monitoring an atmosphere to detect the presence of a leak Investigating residential or commercial alarm activations to determine hazards
567
A valid DNRO shall be:
Signed by the competent patient or patients representative Signed by the licensed Florida physician Be on original canary yellow or copied on similar colored paper.
568
Incidents identified by the EMS CQI officer level containing an EMS CQI reportable event are handled how?
Emailed to the appropriate EMS captain to be handled.
569
Per CQI and Adverse event is defines as ?
Incident causing injury or other medical condition to a patient as a result of treatment rendered by EMS personnel.
570
The difference between the drager X am 2500 and 5000 is ?
The 500o does OV monitoring for Ethylene oxide
571
What is the order for clearance by the OHC prior to returning to work?
Obtain the day before returning to work and if unable notify the BC/supervisor they are reporting to,the OHC for clearance .
572
The IC should request how many TAC channels?
3 TAC channels: 1. RTF-PEM 2. Medical 3. Staging
573
What type of alerts go by air if ground transport is greater than what time?
40mminutes: Decompression Sickness STROKE STEMI
574
Who are responsible for the accurate inventory, distribution, transfer, documentation, and record keeping of all controlled substances on a unit?
All department protocoled Paramedics assigned to a unit.
575
The exposure control officer works under who?
Chief of training and safety division
576
Pedi cocaine OD get treated with what?
Versed
577
Evaluation of the IAP is done how often?
AT LEAST every 10 min
578
Refusal breakdown chart?
Refusals: Adults Minors Pregnancy Diabetics Treatment refusal: Death or disability AAOx4 w/ no life or potential life threatening condition to impair judgment Have Capacity Transport refusal: Death or disability AAOx4 w/ no life or potential life threatening condition to impair judgment Have capacity Patent assessment Physical exam 2 sets of V/S Meet all previous criteria for refusal
579
Confinement is defined as?
The stopping of the progression of the fire
580
Contraindications to DSI paralysis is?
Allergy Predicted difficult intubation Inability to ventilate with a BVM Major facial trauma
581
DSI paralysis indications are?
Apneic Status epilepticus Trismus EMS captain or flight crew discretion
582
Cardiac arrest pt's with the use of a "Lucas" device will be placed on what?
Scoop stretcher and elevated 15 degrees.
583
The TAC stick has 4 indicators?
Detects AC current only Provides warning in audible beeps and flashes Warning signals increase in strength as amplitude increases Warning signal s make it possible to locate the signal quickly
584
When does bilateral decompression get performed?
Arrest due to penetrating chest trauma
585
Definition of “DEMOBILIZATION”
Release and Return of resources that are no longer needed.
586
Who can participate in ride alongs ?
Students and observers
587
Definition of Juvenile related incidents for fire investigation?
Suspected to be the result of juvenile involvement in the ignition process
588
What are the 6 rights to medications?
Right Patient Right medication Right Dose Right Route Right time and Frequency Right indication
589
What is the warning for rocuronium with patients?
Asthmatic patients may have a drop in BP that may result in Cardiac arrest.
590
Per CQI, A near miss is defined as?
Incident that had the potential to harm a patient as a result of care rendered by EMS personnel BUT DID NOT actually harm the patient.
591
A written exposure treatment opinion includes what ?
Results of the medical evaluation Verification that the employee has been informed about any medical condition resulting from the exposure.
592
Power CQI, an ERROR is defined as?
Failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim
593
What is the other term for “Size up”? It is part of the command sequence
Situation evaluation
594
Who has the ultimate responsibility for an ASHER/MCI (Active shooter hostile event response)?
Law Enforcement
595
Compressions for an LVAD device are ?
Not using the LUCAS The Right of the sternum.
596
Who holds the records for citizens complaints and inquiries?
Fire rescue administrative secretary
597
What is the primary goal with an active shooter event?
Ensure joint command and communications from FR and LE to minimize the risk and maximize safety for all response personnel.
598
MInor CQI errors include?
Spelling or topographical errors TIme delays without patient harm Lack of detail Intracranial- report inconsistencies Protocol deviation without patient harm or potential.
599
Ventilatory rates are the following?
Adults- Pulse 1 q6 No pulse 1 q10 ICP 30-35mmhg Pediatrics Pulse 1 q3 No Pulse 1 q6 ICP- 30-35mmHg
600
During which incidents is the TAC stick particularly useful?
Night operations and post storm area searches.
601
The TAC stick shall only be used to?
Identify an energized source so an exclusionary zone can be created
602
MCI levels are what numbers?
1- 1-10 2-11-20 3.21-100 4.101-1000 5.greater than 1000.
603
Power CQI, an ERROR is defined as?
Failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim
604
Once assigned to Safety officer what are the duties?
Don appropriate vest and PPE Ensure no entry into the hot zone as a single person Ensure all control zones are established or adjust as necessary Ensure exclusion zones are recognized Rehab Atmospheric monitoring Remain on scene until relieved by the IC or designee Document actions as to the incident reporting guide any accidents injuries or unsafe acts or safety concerns should follow the CQI Communicate with EMERGENCY TRAFFIC the exclusion zone
605
When an atmospheric monitor alarms who SHALL be informed?
IC
606
Paramedic probation consists of:
18 month probation period which can me ended at any time with an EMS captains approval. Memorandum with task book to be sent from the EMS captain to the compliance officer
607
What type of work related injuries must be reported?
All injuries no matter how minor
608
Follow up testing from exposure is done at what intervals?
Initially, 3mo, 6mo, 1 year
609
ASHER/MCI incidents with fire are what mode of operation?
Defensive
610
What is the sequence for Combative pts and Ketamina
400mg IM BVM or supplemental 02 for Laryngospasms 0.5mg Atropine for Salivations x3 Ice packs, 1L cold saline and 100meq Sodium Bicarb
611
Incidents identified by the EMS CQI officer level containing an EMS CQI reportable event are handled how?
Emailed to the appropriate EMS captain to be handled.
612
How many attempts to realign for anatomical position
2
613
One a controlled substance is removed from the container how long till it needs to be re-sealed?
Immediately following or as soon as reasonably possible
614
A lightweight floor construction exposed to fire becomes unstable in how long?
3 minutes
615
Diabetics can refuse transport if ALL the following are met?
Baseline, Levels, Food, Adult, oral Regained baseline mental status Blood sugar has returned to normal levels Immediate access to food A competent adult is present and willing to assume care Meets criteria to for a general refusal. Not taking oral hypoglycemic medications
616
Exposure to an Airborne contagion other than TB should be documented on ?
FR exposure form
617
A valid DNRO shall be:
Signed by the competent patient or patients representative Signed by the licensed Florida physician Be on original canary yellow or copied on similar colored paper.
618
Reportable events are defined as:
An occurrence during emergency calls, training, pub ed, emergency or non emergency situations
619
How are safety officers general y assigned?
To a geographical or functional area.
620
Guidelines for Operational Capt and Lt with Students/ observers?
Let to obtain proper paperwork for student Safe place to observe with seat belt Introduce person to others in the station Familiarity with apparatus Log person in station logbook Log person on ePCR’s for calls and treatments performed
621
Examples of “TASKS’ are?
Establishing a water supply Advancing a hose line into a structure Primary search RIC Vertical ventilation Medical
622
Jump start triage initial is ?
Breathing NO- open A/W - breathing - IMMEDIATE Breathing NO- open A/W - NO PULSE - DECEASED Breathing NO-open A/W- Pulse - 5 breaths-no- DECEASED Breathing NO- open A/W- Pulse- 5 breaths- Yes- IMMEDIATE Breathing YES- \<15 or \>45- IMMEDIATE
623
The " P" in Jump start triage means what ?
posturing
624
What are the determination of death criteria
1. Lividity 2. Rigor mortis 3. tissue decomposition 4. Valid DNRO
625
An “INFORMAL BEBREIFING AAR?
Tail board or FS Company officer/ chief Simple discussion
626
the Definition of the CCP in an ASHER/MCI?
Casualty Collection Point- in the warm zone where patients are triaged and treated.
627
What is considered a "SECONDARY" arrest?
CHF, drowning, FBAO, OD, Hanging, lightning strike- DC current., Trauma, CN, 3rd Trimester pregnancy
628
FAST ultrsound is done for
Blunt or penetrating trauma the ABD or thorax Undifferentiated hypotension in trauma
629
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
630
Where can the par level for a controlled substance for each unit be found?
Front cover of the units controlled substance logbook And EMS captains logbook
631
Anything with exposed wood or metal supports in regards to constructions is considered?
LIght weight construction
632
The only time to give ventilations in the pre-oxygenate phase is?
Patient becomes apneic.
633
The TAC stick has 4 indicators?
Detects AC current only Provides warning in audible beeps and flashes Warning signals increase in strength as amplitude increases Warning signal s make it possible to locate the signal quickly
634
What is the purpose of paramedic development?
Provide a uniform process for new employees attempting to work as a paramedic Address development for paramedics requiring remediation
635
For employees returning to full duty who must clearance be obtained from other than the OHC/?
Compliance officer and training division.
636
Observers paperwork differs from students in one way?
Application signed by FR HIPPA compliance officer
637
What are the common gasses between the drager atmospheric monitors
O2 Flammability CO
638
For expediency of an IRE notification is made how?
By telephone or face to face to the BC.
639
What categories do ASHER/ MCI patients get categorized to using TECC? (MCI level)
Immediate and Delayed
640
Summary of a patient is when the following are met?
Any medical complaint, injury or distress Suggestive acute injury or illness Lack of capacity MVC with more than : Minor Damage no restraints air bags Steering wheeL occupant injuries appearance and behavior not normal Fall that cannot get up on their own Public assists with acute ambulatory issues
641
Definition of HOT zone with ASHER/MCI?
HIgh risk area No FF operations allowed
642
The GENERAL STAFF is made up of?
Operations Chief Planning Chief Logistics Chief Finance/ Admin Chief Intelligence/ investigation Chief
643
Companies should be placed in rehab when ?
Worked for 45min Used 2 air bottles consecutively Rehab chart
644
Electrocution and LIghtning strikes are what type of arrests
Primary b/c of A/C current Secondary due to DC current
645
The transfer of incident command what items?
Mode of operations Current situation Current unit locations Current assignments What has been done What is planned
646
A safety office shall be appointed on the following incidents?
HWH-hazardous, Wildland, high hazard Incident becomes so large, complex, or dangerous that reasoned safety is potentially threatened. Hazardous or potentially hazardous environments: Structure fires Special operations incidents Large multi casualty incidents Wild land fires with 4 or more units or during extreme weather. Any high Hazard Training: Live burn evolutions Smoke drills Dive rescue Extrication Elevated victim rescue above or Below grade operations confined space rescue
647
H ow are lost or stolen controlled substances handled from a unit?
Notification to the EMS captain Property loss form and tracking number Law Enforcement report attached EMS captain then to notify the Division chief of medical services EMS captain to Ensure all paperwork is completed
648
Documentation for LPG/NG response on the technician is?
Name Phone number ID or employee number
649
Flail chest sis defined?
2 or more adjacent ribs are fractured
650
Pregnant 3rd trimester trauma alerts get transported how?
Left side, 4-6 inches of padding to Right side Maintain BP for peripheral pulses
651
What is the dress code for Student riders?
Designated uniform by training facility Badge or other identifying means
652
Only those person who have completed and approved Incident safety officer course ________ be used as a safety officer.
SHOULD
653
Who may terminate a student or observers ride time?
Operational Captain EMS captain BC or DC
654
What is the fire flow formula?
Lx W / 3 x % involved
655
What are the common means of reporting CQI events?
Field personnel vis chain of command Reportable events Hospitals via complaint as a performance improvement process Patients vis a complaint to the agency
656
How is a fire investigator requested?
The IC requests through the communications center.
657
How are new employees selected for the paramedic development course?
Based on Senority
658
What is the contraindications for push pressor epi?
Hypotension secondary to blood loss.
659
People on the ground are patients when?
Unable to get up without assistance Gets up but does not have capacity
660
What are the special populations for Ketamine and the dose?
Age 65 and older \<50kg Head trauma Already took sedatives 200mg
661
What kind of lock can be used for the EMS captains Storage container of controlled substances?
Key, coded, or biometric lock
662
What resources are used to begin at a CBRNE incident?
ERG WISER
663
What was the perimeter for the Oklahoma City bombing?
20 square blocks
664
What is the resource that uses the ERG and NIH combined for CBRNE?
WISER
665
1st Arriving EMS captain “SHOULD”?
BE the incident safety officer Ensure the following items are brought to the FUP - Forming up Position - Available RTF- PEM kits - Available SKEDS -Available TQ’s -Available Mega movers -Available Trauma rapid response kits
666
Intercrainial pressure and herniation signs are?
GCS decline of 2 or more points sluggish or non reactive pupil Paralysis or weakness on 1 side of the body Cushings Triad
667
What is the most dangerous time during a fire incident?
When changing from an offensive to defensive mode.
668
When must a fire investigator be called?
1. Fire is suspicious or crime related- 2. Loss of injury or life 3. accidental fire w/ substantial monetary loss or structural damage. 4. Juvenile related incidents 5. Explosive devices/ explosion 6. Undetermined
669
Observer dress code is:
White shirt- SS or LS Black, dark blue pants Black closed shoes w/ dark socks
670
Significant exposures are defined as and are what type?
Exposure through a needle stick , sharps to the following body fluids: Blood or and body fluid containing visible blood Semen Vaginal secretions CSF Synovial fluid Peritoneal fluid Plueral fluid Pericardial fluid Amniotic fluid. Body fluids to mucus membranes Chapped or a braided skin Exposure to Airborne contagions
671
What are the incidents priorities?
LIPE Life safety Incident stabilization Property conservation Evidence preservation
672
For Area command of the same type and same area with 2 or more what are the examples?
HAZMAT Oil spills Wildland fires
673
RTF-PEM teams are committed by the IC only when ?
Threat to life Benefits outweigh risks
674
First time students on ride alongs must provide the following items:
Written verification of name, year/ class and status in program. Background check and criminal hx Written verification of. Proficiency in BSI Have stethoscope, eye protection, mask and fit tested. Written confirmation of vaccinations Written verification of skill proficiency
675
Reportable adverse, near miss, or errors are sent to who?
EMS CQI officer
676
How are new employees selected for the paramedic development course?
Based on Senority
677
How is a fire investigator requested?
The IC requests through the communications center.
678
Observers unable to keep ride times:
MUST notify the recruitment and human resource development officer in advance.
679
What are the requirements to get into the Paramedic development course?
Current ACLS card Current state of Florida or National paramedic certification Complete sign off skill sheets Complete IV skill sheet
680
The person in charge of a “unit” is termed?
Leader
681
The Paramedic Development course is for?
New employees and Those needing remediation
682
Sepsis alert criteria?
Adult not pregnant suspected or documented infection Hypotension AMS Tachypnea - RR\>22 or ETco2 \< 25mmHg
683
1st and 2nd trimester complications include?
Ectopic Spontaneous bleeding hypotensive
684
Torsades de point stable treatment?
2g mgso4 in 50 60gtts Pedi : 40mg in 50 60gtts
685
Per CQI, A near miss is defined as?
Incident that had the potential to harm a patient as a result of care rendered by EMS personnel BUT DID NOT actually harm the patient.
686
Definition of Student in regards to ride times?
Enrolled in an education program at an accredited facility that has an agreement with fire rescue. To include: EMT and paramedic programs Emergency medical responder Training programs at secondary school of palm beach county.
687
EMS captains responsibility post significant exposure are?
Make sure exposed employee requests patient source testing at the hospital Consult with the ER physician Notify the exposure control officer during normal hours unless employee receives post exposure treatment- Then have the communications center page the control officer at any time
688
Upon transferring of command the IC notifies who?
Communications center General staff members Command staff members All incident personnel
689
Who is responsible completing and submitting the DRE form and where does it go?
First person to report event and uploaded to sharepoint.
690
The command STAFF positions are?
PIO Safety officer Liaison command staff advisors
691
How long does Lidocaine dwell in an IO for an adult?
1min
692
Hi rise operation staging is where?
2 floors below the fire floor
693
According to the ERG for for an “UNKNOWN “ hazard is?
100 meters or 330 ft in all directions Found on Guide 111.
694
Primary search should be based on which areas in order?
Location of reported victim Most severely threatened area Largest number of victims Remainder of the fire area Exposed areas
695
Who processes Controlled substance orders?
Operations division
696
The only persons to communicate during a mayday emergency are?
IC RIT/RIG RIG supervisor Mayday FF
697
Medical supply warehouse record keeping inventory items are stored where?
On the “G:” drive in the support services folder
698
An example of injury while wearing PPE would be?
Burns to the hands while wearing gloves.
699
“Division” is defined as?
A geographical area Is between the Branch and unit levels
700
For exterior LPG/NG leaks on above ground containers of 1000lb or greater they should be cooled with what?
Ground monitor flowing minimum 500gpm
701
What shall be documented for refusals of Transport?
Death Disablity, AAOx4, Clinically sober, impaired judgement, capacity, assessment, exam, 2 set v/s. Not being transported may result in death or disability AAOx4- clinically sober, with no life or potential life threatening conditions to impair judgment Capacity Patient assessment Physical exam 2 sets of V/S
702
The DNRO identification device must be signed by who if the patient cannot provide consent?
Surrogate Proxy court order Power of attorney
703
A single resource unit is termed ?
Boss or Leader
704
What are the oral hypoglycemic medications
Glipizide, Glyburide, Glimepiride
705
Under the “Safe Haven “ parents may not be pursued unless?
The parents are seeking to reclaim the new born infant
706
Observer dress code is:
White shirt- SS or LS Black, dark blue pants Black closed shoes w/ dark socks
707
The rehab tracking worksheet has what recorded on them ?
Pulse BP Temp Respirations SP02 SPCO SPMET
708
“Strike team” is defined as ?
Resources of the “SAME” Kind and TYPE
709
When must a fire investigator be called?
1. Fire is suspicious or crime related- 2. Loss of injury or life 3. accidental fire w/ substantial monetary loss or structural damage. 4. Juvenile related incidents 5. Explosive devices/ explosion 6. Undetermined
710
What gas and how much is required for both drager monitors to operate correctly?
02 and 10% above
711
When should post exposure testing occur?
1-2 hours preferably at the OHC or Hospital
712
What is the distance to be considered an exposure?
30 ft
713
Contraindications for Finger Thoracostomy?
Unwitnessed arrest with blunt trauma Devestating head trauma loss of Cardiac output \> 10 min
714
Critical incident factors include which mnemonics?
BELOW COAL WAS WEALTH
715
Once assigned to Safety officer what are the duties?
Don appropriate vest and PPE Ensure no entry into the hot zone as a single person Ensure all control zones are established or adjust as necessary Ensure exclusion zones are recognized Rehab Atmospheric monitoring Remain on scene until relieved by the IC or designee Document actions as to the incident reporting guide any accidents injuries or unsafe acts or safety concerns should follow the CQI Communicate with EMERGENCY TRAFFIC the exclusion zone
716
Propane has an LEL of?
2.1-9.5%
717
What type of arrest is a third trimester female considered?
Secondary - and displace the uterus to the left
718
When referring to the structure the Alpha side is considered ?
The front Or address side
719
Rotations of medications are to happen on what day ? AND who is responsible the inspection ?
On the first day of each month and the operational captain or designee
720
The TAC stick does not?
Read DC current Or pick up shielded AC voltage
721
PBCFR used 3 types of After action reviews?
Informal debriefing AAR Informal Battalion AAR Formal AAR
722
Motor vehicle accident criteria for a patient?
Greater than minor damage No restraint used Air bag deployed Steering wheel damage Other occupants have injuries Appearance and behavior not normal
723
When does a ResQpod get placed?
all cardiac arrest patients that are greater than 1yr old.
724
Reportable adverse, near miss, or errors are sent to who?
EMS CQI officer
725
Written documentation of follow up testing for an exposure should follow when ?
Within 48hours
726
The DNRO identification device must be signed by who if the patient cannot provide consent?
Surrogate Proxy court order Power of attorney
727
What are the 3 modes of fire operations?
Investigating Offensive mode Defensive mode
728
What is the dose of MGSO4 in Torsades?
adults- 2g in 50 ml 60gtts wide open pedi- 40mg/kg in 50ml 60gtts wide open
729
Parents under the “Safe Haven “ law can regain custody as longs as what?
The infant shows no signs of abuse
730
What are the 12 hazards outlined by the HSP?
Severe weather Floods Agricultural pests ds. Fire Communicable ds Transportation Incidents Hazmat Nuclear power plant Dike failure Domestic security Workplace/ school violence Mass migration
731
Who is responsible for securing and maintaining scene integrity for a fire investigation?
Operations personnel. Not LE
732
which cardiac arrest patients MUST be transported
Witnesed
733
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
734
Torsades de point unstable is defined as and treated how?
Hypotension: defib 200, 300, 360 defib 2J/kg and 4J/kg
735
Public assists are patients when?
Inability to ambulate is chronic
736
Approximately how many parking spaces does it take for each fire apparatus?
8 spots
737
Vtach is defined as?
No p waves QRS \> .12 Concordance in all leads Neg QRS V6 Neg in 2, 2, AVF and positive in AVL, and AVR
738
Duties of the intelligence/ inv branch are?
Collecting and analyzing and sharing information Informing incident operations to protect live and safety of response personnel Interfacing with counterparts outside the ICS to improve situational awareness,
739
Who may ride as an observer?
Local Dr’s, nurses, PA’s, Nurse practitioners, and other medical students or professionals. EMT’s or paramedics with other local agencies from their chief on letterhead Individuals seeking employee or are in training Others approved by the fire rescue administrator and FR HIPPA compliance officer
740
Employees with work related injuries must be cleared by the OHC before what?
Traveling out of the area.
741
How are safety officers general y assigned?
To a geographical or functional area.
742
Which critical incident mnemonic is used for the “ONGOING”fire ground operations
COAL WAS WEALTH
743
What must TCA ODs be treated with immediately ?
Sodium Bicarb
744
The following SHALL NEVER be performed on patients with a DNRO?
Artificial respiration BVM ET tube Supraglottic A/W Chest compressions Defibrillation
745
indications for Hyperkalemia for CaCl2?
Peaked T waves Sine wave WCT RRWCT severe bradycardia high degree blocks
746
Students unable to keep ride times :
MUST notify the clinical coordinator of their facility in advance And coordinator MUST notify the recruitment and human resource development officer
747
FAST ultrasounds can be performed to identify?
Intrabdominal hemorrage Intrathoracic hemorrage pericardial hemorrage PEA motion
748
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
749
Students unable to keep ride times :
MUST notify the clinical coordinator of their facility in advance And coordinator MUST notify the recruitment and human resource development officer
750
Where can the intelligence /inv function fit into the the ICS system ?
Command staff - Staff advisor Planning section as a unit Operations section as a branch General staff as a section
751
When does notification of an injury need to,be reported to the state?
1. one or more FF are hospitalized for,more than 24hrs 2. LODD 3. serious injury related to an equipment failure.
752
Damage of a controlled substance from a a unit is handled how?
Notification t o the EMS captain Property loss form and tracking number “Broken/ damaged” written in the case# spot The EMS captain notifies the division chief of medical services
753
Type V construction is?
Wood Frame- structural elements are made of ENTIRELY wood.
754
Ultrasunds in traumatic arrests are done when?
observation of cardiac motion in PEA
755
What are considered the fire ground simplex channels?
14A/ 15A with a radius of 1mile
756
Ketamine for seizures is what and what contraindications?
Adults :100mg- pregnancy penetrating eye non traumatic chest pain Pedi \>3yrs: 1mg/kg
757
If the hospital or the physician do not comply with state mandates for exposure testing what happens?
Contact the EMS captain who will contact the medical director if necessary.
758
In order to sign a refusal for transport Fire rescue personnel SHALL?
Exhaust all reasonable efforts have been exhausted Inform the patient that if at any time they change mind or condition deteriorates/ changes they should call 911
759
Distribution of controlled substances from the EMS captain to a unit are signing in what spaces in the book?
EMS captain signs Given/ Issued by and Unit sign received by section .
760
Evidence that a fire is suspicious in nature or crime related means:
Incendiary fires/ explosive devices Firebombs Stolen vehicles Burglaries
761
Who carries a rainbow sensor ?
EMS captains and SPLOPS
762
What gas type and pipe size does not contain mercaptan?
Natural gas in sizes 18” or greater
763
The person in charge of a “branch “ is termed what?
Director
764
The cyano kit uses how much? at what rate?
5g diluted in 200ml and at 5 gtts/sec
765
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
766
“Mayday” definition is?
Lost Trapped Disoriented Seriously injured Experiencing an Air emergency In need of immediate help
767
What makes RRWCT unstable ?
hypotension
768
Head injuries ETCO2 is?
30-35mmhg
769
Primary goal of any airway or respiratory emergency is maintaining?
Ventilation Oxygenation Perfusion
770
Who does station medical supply ordering?
Support services
771
How does the newborn infant get entered in the PCR if it is unclear the safe haven law?
“Safe Haven Baby”
772
What forms are required by students to ride - legal documents?
Copy of Student/ observer ride time Release of Liability and covenant not to sue. Indemnification agreement HIPPA confidentiality agreement Insurance coverage
773
Who can effect a change in incident management in extreme situations - who , why and How?
Anyone Safety Notifying the IC
774
With refusals, who may help convince a patient?
Family members Friends Physician EMS captain Medical director
775
NIMS components are?
Command and management Preparedness Resource management Communications and info management Supporting technologies Ongoing management and maintenance
776
Mad as a hatter Red as a beet Dry as bone refer to S/S of ?
TCA OD
777
Damage from the EMS captains stock are handled how?
Notification to Chief of medical services Property loss and tracking number
778
Documentation for LPG/NG response on the technician is?
Name Phone number ID or employee number
779
The “S” in CANS arrival report means?
Statement of command to include command name , location, and mode.
780
What is a customer complaint?
Misconduct Taking of property of value Dissatisfaction with policy or procedures
781
Criteria for chest decompression
Absent or diminshed LS BP\< 90 Respiratory distress or difficulty with BVM
782
The tactical priorities are:
RECEOVS Rescue Exposure Confinement Extinguishment Overhaul Ventilation Salvage
783
What patients my be examined, treated, or transported without their consent?
Suspected medical conditions that are likely to be incapacitated from intoxication or other medical conditionsl
784
Who are responsible for checking the TIC?
All company officers and chief officers in custody of the TIC.
785
Where should the SCBA refill are be located?
Near the “Drop Zone” in the WARM zone
786
An IRE is reported immediately to whom?
Supervisor
787
What level MCI and why should be set for ASHER/MCI ?
Level 2 due to unknown amount of victims
788
What kind of lock can be used for the EMS captains Storage container of controlled substances?
Key, coded, or biometric lock
789
Who may terminate a student or observers ride time?
Operational Captain EMS captain BC or DC
790
Right to know is applicable for the source patient if?
Patient was transported to the hospital Blood drawn for routine medical need.
791
Extensions for paramedic probation are ?
Done by the EMS captain and documented on a professional development form for 18month. If the extension period is still less than satisfactory then the EMS captain. Recommends the person be referred to the medical services division and medical director for further evaluation. All documentation to be sent to the compliance officer
792
Positioning for DSI is?
Ear to the sternal notch Head parallel with the ceiling Stretcher elevated 15-30 degrees
793
Injury tracking is entered by who ? And then forwarded to who?
Training and safety division Wellness coordinator
794
What term is used to declare the scene is clear of all personnel of an area that was in imminent danger?
Emergency evacuation - all clear
795
Who are responsible for the accurate inventory, distribution, transfer, documentation, and record keeping of all controlled substances on a unit?
All department protocoled Paramedics assigned to a unit.
796
The following SHALL NEVER be performed on patients with a DNRO?
Artificial respiration BVM ET tube Supraglottic A/W Chest compressions Defibrillation
797
Washing mucous membranes from significant exposure how?
Irrigate with normal saline or water for 10-15min
798
Reportable adverse, near miss, or errors are sent to who?
EMS CQI officer
799
Is the action taken to expose hidden fire and to assure complete extinguishment?
Overhaul
800
Who can participate in ride alongs ?
Students and observers
801
what is Trauma alert criteria for peds with BP?
\< 50
802
Common Natural gas lines that are 24” are found where in PBC?
Along the turnpike Port of palm beach to West county energy center owned by FPL
803
A technical specialist in charge is termed?
Specialist
804
Where is the fire rescue RTF-PEM group supervisor located?
Next to the Tactical LE officer in the “Cold Zone”
805
All safety officers will have the authority to ?
Identify and correct safety and heath hazards To alter,suspend, or terminate un -safe acts that involve an imminent hazard to personnel Inform the IC of the 2 items above
806
What are the options for a minor injury requiring treatment?
1. shall report to the OHC for further evaluation 2. if OHC is closed then may go to the nearest hospital or wait till OHC opens.
807
Loss of life/ injury definition for fire investigator call out?
Fire or explosion related deaths Fire or explosion related injuries which require transport by FR.
808
Who is equipped with the drager X-am 5000 5 gas monitor
EMS captains
809
Definition of an “After Action review “
An analysis of the events that transpired during an incident and a review of the actions used to mitigate it.
810
A DNRO applies to who?
Cardiac or respiratory arrest Succumbing to a disease process of a terminal illness
811
What other documentation is needed post resuscitation termination of efforts?
EKG strip to PCR ETCO2 to PCR for advanced airway placement
812
What does the MARCH acronym mean?
Massive hemorrage Airway control Respiratory Circulation Head injury / Hypothermia
813
TIC operations a victim or FF will appear what color?
White
814
MInor CQI errors include?
Spelling or topographical errors TIme delays without patient harm Lack of detail Intracranial- report inconsistencies Protocol deviation without patient harm or potential.
815
Stroke pt with transport times greater than 20 min go where?
depends- if all other criteria are met; 1. transport time to comprehensive is \> 20 min 2. onset time \< 2hr 3. no tpa exclusions 4. no severe headache Primary center, if not all met, comprehensive center.
816
The IMS manual meets what national requirements?
NFPA 1561 Presidential directive 5
817
Natural gas has an LEL of?
5.3-14%
818
What are normal atmospheric conditions
O2- 21% LEL -0% CO- 0 PPM H2S- 0 PPM
819
All intubated interfacility transfers must be ______ and ______ by the sending facility.
paralyzed and sedated.

EMS captain (25 decks)

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