PCTH - PPE

Question 1

What percentage of freight trains carry hazardous/dangerous material? How about transport trucks?

Answer 1

35%; 10%

Question 2

What are the 5 routes into the body for hazardous exposure?

Answer 2

inhalation
ingestion
injection
radiation
absorption

Question 3

True or False. Paramedics can utilize poison control as a resource while on scene.

Answer 3

False - we never call poison control because we cannot follow their directives if it’s outside our scope

Question 4

The severity of hazardous exposure is determined by what 3 factors?

Answer 4

1) time - how long the patient was exposed
2) concentration - strenghth or purity of material (which you can get from the workplace, patient, bystanders etc.)
3) dose - how much entered the body

Question 5

What is the definition of poison/toxin?

Answer 5

anything that changes the way the body works/functions

Question 6

What are the acute effects on your body after hazardous exposure?

Answer 6

1) local effects: burns, burning sensation, swelling, etc
2) systemic effects: respiratory, circulatory collapse

both can lead to death

Question 7

What are the chronic effects on your body after hazardous exposure?

Answer 7

cancer
chronic respiratory conditions
organ failure
birth defects

Question 8

What are the 4 levels of protection that can be designated regarding a call. What 2 factors are these levels of designations based on?

Answer 8

A, B, C, D

Factors:

1. level of respiratory protection
2. level of skin protection

Question 9

The highest level of response to hazardous exposure is ____. What sort of protection is needed?

Answer 9

A;

• greatest level of skin, respiratory, and eye protection needed
• the material has been identified
• SCBA (respirator) mask used
• TYPICALLY: paramedics do not operate in these environments unless trained

Question 10

What is required in Level B response to hazardous exposure?

Answer 10

• highest level of respiratory protection
• lesser level of skin, eye, mucous membrane protection
• these are where the chemical are not known to be absorbed through skin
• SCBA and protective clothing needed

Question 11

What is required in Level C response to hazardous exposure?

Answer 11

• APR: full or half face air purifying respirator mask (use filters/sorbent materials to remove harmful substances)
• coveralls
• concentration and type of airborne substance is known, no danger with skin contact or absorption

Question 12

What is required in Level D response to hazardous exposure?

Answer 12

• no hazards in the atmosphere so things used are helmet, goggles, work gloves, coveralls, escape mask
• disosable gown
• N95/respirator

Question 13

The only level of response paramedics will work in is level ____.

Answer 13

D

Question 14

What can you do if you don’t know what the hazardous material is or potential for exposure?

Answer 14

1) try and approach upwind - parking ~800m from scene until safe to approach
2) if hazardous/radioactive material suspected, withdraw
3) obtain placard number
4) notify CACC of material encountered
5) use of allied agencies
6) do not attempt patient rescue/recovery until safe
7) initiate care/transport when safe
8) utilize MCI guidelines when necessary
9) clean up - as per decontamination procedures

Question 15

What are the 3 immediate tasks that EMS personnel are responsible for during hazardou exposure?

Answer 15

1) isolate the area - do not allow equipment, personnel into the area and do not rescue patients from area
2) identify material - from a safe distance (use CACC info, NAERG book, other agencies)
3) recognize immediate dangers/deontamination requirements (what level of PPE is required)

Question 16

All of the following are potential responsibilities of a paramedic except for:

a) performing specialized duties if trained (i.e. HAZMAT)
b) triaging of decontaminated patients
c) evacuation procedures
d) assist with decontaminating area/patients
e) transportation of decontaminated patients

Answer 16

d) assist with decontaminating area/patients - WE DO NOT DO THIS

Question 17

Another term of detergent suicide is:

Answer 17

Hydrogen Sulfide Suicide

Question 18

Hydrogen sulfide suicides typically occur where?

Answer 18

• confined spaces (vehicles, closets, small bathrooms)
• may have biohazard signs posted around
• duct tape/materials used to contain gas in space

Question 19

What is H2S gas (hydrogen sulfide)?

Answer 19

• a toxic, flammable, and colourless gas
• immediately dangerous to life and health levle of 100PPM
• causes extremely rapid CNS and respiratory depression
• heavier than air and so will collect along floor/ground

Question 20

What are the two modes of entry for H2S gas?

Answer 20

primarily inhalation
sometimes ingestion

Question 21

What are the ingredients needed to make H2S gas?

Answer 21

acid source
sulfur source

Question 22

At 10ppm exposure to H2S gas, what can occur?

Answer 22

beginning of eye irritation

Question 23

At 50-100ppm exposure to H2S gas, what can occur?

Answer 23

slight conjunctivitis and resp tract irritation after one horu

Question 24

At 100ppm exposure to H2S gas, what can occur?

Answer 24

• coughing, eye irritation, loss of sense of smell after 2-15 minutes
• altered respiration, pain in eyes, drowsiness after 15-30 minutes followed by throat irritation after one hour
• several hours exposure results in gradual increase in sx severity and death may occur within the next 48 hours

Question 25

At 200-300ppm exposure to H2S gas, what can occur?

Answer 25

marked conjunctivitis and resp tract infection after one hour exposure

Question 26

At 500-700ppm exposure to H2S gas, what can occur?

Answer 26

loss of consciousness and possible death in 30 minutes to one hour of exposure

Question 27

At 700-1000ppm exposure to H2S gas, what can occur?

Answer 27

loss of consciousness and possible death in 30 mins to 1 hour of exposure

Question 28

At 1000-2000ppm exposure to H2S gas, what can occur?

Answer 28

immediate unconsciousness, with early cessation of respiration and death in a few minutes

Question 29

The half life of H2S gas is:

Answer 29

12-37 hours in the air, but varies depending on photoactive pollutants and temperature (so sunlight and ambient air temp \*in very cold/dry winter conditions it can be 37+ hours

Question 30

Why is sense of smell not a reliable means to detect H2S gas?

Answer 30

because the H2S gas can cause olfactory paralysis meaning that olfactory nerves accommodate to the odor and therefore are not able to detect the presence of the chemical after a short period of time - occurs when exposed to 150+ppm and happens quickly (but prior to this, may smell like sewer gas/rotten eggs)

Question 31

What would be the appropriate PPE for dealing with H2S gas?

Answer 31

- SCBA (self contained breathing apparatus) for unsafe levels of H2S gas (for FD) - chemically protective clothing not required with H2S gas alone but if liqufied gas, can cause frostbite through direct contact - safety line during rescue for retrieval purposes

Question 32

With H2S gas, decontamination responsibilities are done by who

Answer 32

FD, do not put any contaminated materials in ambulance

Question 33

What are antineoplastic drugs?

Answer 33

- used to treat cancer (chemotherapy) and can be liquid or pill form - typically excreted in body fluids up to 48h post treatment

Question 34

Exposure to antineoplastic drugs could cause what symptoms?

Answer 34

- skin, eye, and mucous membrane irritation - headaches, nausea, dizziness

Question 35

Define universal precuations

Answer 35

Process of assessing the risk in a given situation and then taking steps to reduce risk of exposure i.e. giving the paramedic the info, skills/procedures to reduce risks, and necessary PPE

Question 36

How can communicable diseases spread? (4)

Answer 36

1) bloodborne diseases: Hep B/C, HIV, AIDS, ebola 2) spread via resp system: TB, influenza, measles, COVID 3) spread via fecal-oral route: hep A, C. diff 4) direct contact: scabies, lice

Question 37

Which of the follow are prevention measures for paramedics? 1) frequent hand washing 2) proper vaccinations 3) patient isolation 4) use of PPE 5) all of the above

Answer 37

all of the above

Question 38

What guiding principles are in place for universal precautions for paramedics

Answer 38

1) all workplaces are to have standard OHS programs in place 2) use of universal precautions 3) universal precautions designed to be used routinely in all situations of risk 4) employer is responsible for education of employees re: universal precautions 5) immunization as per Ambulance Act

Question 39

If hospitals are unable to disclose PHI re: a patient's health or prognosis, what other avenues are available for paramedics when it is concerning potential exposure to communicable diseases?

Answer 39

1) universal precautions 2) mandatory guidelines for the Public Health Department (they have responsibility of immediate notification of possible exposure) 3) guidance from Designated Officer who is trained to assess exposures, and work with the public health department

Question 40

An ambulance services' roles and responsibilities re: infectious exposure and universal precautions include which of the following: 1) assigning a designated officer to assess exposure reports and notify employees of possible exposure 2) ensuring completiong of "Employer's Report of Injury/Disease Form 7" WSIB Form 3) providing equipment/training to employees to prevent possible exposure 4) all of the above

Answer 40

4) all of the above

Question 41

True or False. You can adjust your other PPE with contaminated gloves because your other PPE is considered a layer of protection.

Answer 41

False: avoid doing this, don't adjust anything that is on you with dirty gloves

Question 42

When should a helmet be used while on duty?

Answer 42

1) all MVCs, extrications 2) industrial establishments where head protection is mandatory 3) all construction sites 4) fire stand-bys 5) traversing through heavy foliage 6) severe weather conditions 7) air ambulance response to on-site emergencies 8) according to local policy

Question 43

When should a reflective vest be used?

Answer 43

Anytime you are exposed to uncontrolled traffic

Question 44

What PPE is to be utilized for a patient with a positive COVID-19 screen (or if patient is negative COVID-19, but has fever or resp illness/distress)?

Answer 44

- gloves - gown - goggles/safety glasses - face shield - surgical mask - patient receives surgical mask

Question 45

What PPE is to be utilized for cardiac arrests, unconscoius calls, and AGMPs?

Answer 45

- N95 mask or MSA advantage 420 - safety glasses - face shield - gown - gloves