EMT - Chapter 39: incident Management

The function of the National Incident Management System (NIMS) is to:

A. prepare for, prevent, respond to, and recover from domestic incidents.

B. facilitate a standard method of incident command for natural disasters.

C. prepare for the potential of a nuclear attack against the United States.

D. educate city and county governments regarding foreign terrorist attacks.

A. prepare for, prevent, respond to, and recover from domestic incidents.

Interoperability, an important feature of the NIMS, refers to the ability of:

A. the federal government to intervene during any large- or small-scale incident involving terrorism.

B. EMS systems and fire departments in the same jurisdiction to effectively work as a team.

C. county and state law enforcement agencies to acquire information and pass it along to EMS personnel.

D. agencies of different types or from different jurisdictions to communicate with each other.

D. agencies of different types or from different jurisdictions to communicate with each other.

The purpose of the incident command system (ICS) is to:

A. reduce overall mortality and morbidity from large-scale mass-casualty incidents and to restore key

infrastructure.

B. ensure responder and public safety, achieve incident management goals, and ensure the effective use of

resources.

C. quickly and efficiently respond to natural disasters and terrorist incidents, regardless of the complexity of

the incident.

D. protect the public from the effects of large- and small-scale disasters and to minimize the financial impact

from such incidents.

B. ensure responder and public safety, achieve incident management goals, and ensure the effective use of

resources.

The term used when individual units or different organizations make independent and often inefficient

decisions regarding an incident is called:

A. freelancing.

B. undermining.

C. logistical chaos.

D. single command.

A. freelancing.

A supervisor who has more than seven people reporting to him or her:

A. is more beneficial to the overall effort than a supervisor with fewer personnel because his or her team can

accomplish more tasks.

B. should regularly report to the incident commander (IC) to inform him or her of the functions that his or her

team is performing.

C. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks

to another person.

D. should assign a specific task to each person reporting to him or her and regularly follow up to ensure that the

tasks were carried out.

C. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks

to another person.

During a motor vehicle collision involving multiple patients, the IC would MOST likely:

A. maintain responsibility for all of the command functions.

B. designate a safety officer, but retain other command functions.

C. delegate all of the command functions to the appropriate personnel.

D. relinquish command when a senior EMS provider arrives at the scene.

B. designate a safety officer, but retain other command functions.

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

A. The unified command system is one in which one person is in charge, even if multiple agencies respond to a

disaster or mass-casualty incident.

B. Ideally, the unified command system is used for short-duration, limited incidents that require the services of

a single agency from one jurisdiction.

C. In a unified command system, there are separate ICs for fire, police, EMS, and any other agencies that

respond to the incident.

D. Under the unified command system, plans are drawn up in advance by all cooperating agencies that assume

a shared responsibility for decision making.

D. Under the unified command system, plans are drawn up in advance by all cooperating agencies that assume

a shared responsibility for decision making.

If an incident increases in scope and complexity, the IC should consider:

A. ceasing all operations until a revised plan is established.

B. maintaining responsibility for all of the command functions.

C. relinquishing command to someone with more experience.

D. requesting a second IC to assist him or her.

C. relinquishing command to someone with more experience.

Command functions under the ICS include all of the following, EXCEPT:

A. triage officer.

B. safety officer.

C. liaison officer.

D. public information officer

A. triage officer.

At a very large incident, the __________ section is responsible for managing the tactical operations usually

handled by the IC on routine EMS calls.

A. logistics

B. operations

C. planning

D. finance

B. operations

The development of an incident action plan is the responsibility of the:

A. planning section.

B. logistics section.

C. operations section.

D. finance section.

A. planning section.

A critical function of the safety officer is to:

A. determine the most efficient approach to extricate a victim.

B. stop an emergency operation whenever a rescuer is in danger.

C. monitor emergency responders for signs of stress and anxiety.

D. brief responders during the demobilization phase of an incident.

B. stop an emergency operation whenever a rescuer is in danger.

Historically, the weak point at most major incidents has been:

A. accountability.

B. lack of personnel.

C. incident briefing.

D. communication.

D. communication.

In preparing for a disaster, EMS systems should have enough supplies for at least a ______ period of selfsufficiency.

A. 24-hour

B. 48-hour

C. 72-hour

D. 96-hour

C. 72-hour

As the first-arriving senior EMT at the scene of an incident, you should perform a scene size-up and then:

A. establish command.

B. begin the triage process.

C. call for additional resources.

D. quickly identify the walking wounded.

A. establish command.

Which of the following statements regarding communications at a disaster or mass-casualty incident is

correct?

A. Each command group should utilize a separate radio frequency.

B. Ten-codes or signals should be used when communicating via radio.

C. When possible, all communication should occur via two-way radio.

D. If possible, use face-to-face communications to minimize radio traffic.

D. If possible, use face-to-face communications to minimize radio traffic.

Which of the following duties or responsibilities does NOT fall within the realm of the medical branch of

the ICS?

A. triage

B. transport

C. treatment

D. extrication

D. extrication

As a triage supervisor, you:

A. must prepare patients for transport before they leave the triage area.

B. must not begin treatment until all patients have been triaged.

C. are responsible for providing initial treatment to all patients.

D. should communicate with area hospitals regarding their capabilities.

B. must not begin treatment until all patients have been triaged.

Which of the following is NOT a responsibility of the treatment supervisor?

A. primary assessment

B. secondary triage

C. patient packaging

D. communication with the medical branch director

A. primary assessment

When victims involved in a mass-casualty incident are moved to the treatment area:

A. definitive care is provided and preparations for transport will be made.

B. secondary triage is performed and the appropriate treatment is rendered.

C. they will be rapidly assessed and prioritized according to their injuries.

D. all uninjured patients are placed in a holding area and closely observed.

B. secondary triage is performed and the appropriate treatment is rendered.

The ____________ supervisor is responsible for notifying area hospitals and determining their availability

and capabilities.

A. triage

B. medical

C. treatment

D. transportation

D. transportation

The __________ area is where incoming ambulances meet and await further instructions at the scene of a

mass-casualty incident.

A. triage

B. support

C. staging

D. transportation

C. staging

When a rehabilitation area is established at the scene of a mass-casualty incident, it should:

A. be in a location that prevents visualization of the scene itself.

B. be mandated that responders participate in a defusing session.

C. provide rehabilitative services to both responders and patients.

D. be staffed by the treatment supervisor and at least one physician.

A. be in a location that prevents visualization of the scene itself.

Which of the following MOST accurately describes a mass-casualty incident?

A. an incident that involves more than five critically injured or ill patients

B. an incident where patients have been exposed to hazardous materials

C. an incident in which at least half of the patients are critically injured

D. an incident that greatly taxes or depletes a system's available resources

D. an incident that greatly taxes or depletes a system's available resources

Which of the following is probably NOT a mass-casualty incident?

A. a motor vehicle crash with two critically injured patients and two ambulances

B. a loss of power to a hospital or nursing home with ventilator-dependent patients

C. an apartment fire with one patient and the possibility of others trapped in the building

D. a rollover crash of a school bus with eight children who have injuries of various severity

A. a motor vehicle crash with two critically injured patients and two ambulances

You and your partner are the first to arrive at the scene of a motor vehicle accident. As you approach the

scene, you can see multiple patients, some walking and others who are still in their vehicles. You should:

A. establish an incident command post until you are relieved of your duties.

B. declare a mass-casualty incident and request additional resources.

C. begin rapidly triaging all patients before requesting additional help.

D. immediately move all ambulatory patients to a designated area.

B. declare a mass-casualty incident and request additional resources.

Which of the following questions is of LEAST pertinence when the EMT is determining whether or not to

declare a mass-casualty incident and activate the ICS?

A. What will happen if there are more than two patients that require emergency care?

B. How long will it take for additional resources to arrive at the scene once requested?

C. How many paramedics are able to respond to the scene and provide advanced care?

D. How many seriously injured patients can be effectively cared for in my ambulance?

C. How many paramedics are able to respond to the scene and provide advanced care?

You have a critically injured patient in the back of your ambulance, ready to be transported. There are other

injured patients at the scene and it will be approximately 10 minutes before other ambulances will arrive.

Law enforcement personnel are at the scene. You should:

A. transport the critically injured patient to a trauma center.

B. direct a police officer to monitor the patients as you transport.

C. remain at the scene until at least one other ambulance arrives.

D. assign the least injured patient the task of caring for the others.

C. remain at the scene until at least one other ambulance arrives.

In order to accomplish the goal of primary triage, it is important to:

A. take no more than 2 minutes to determine the patient's status.

B. keep the triage assessment brief and the patient categories basic.

C. begin life-saving care immediately upon detecting critical injuries.

D. perform a rapid assessment on all patients who appear to be unstable.

B. keep the triage assessment brief and the patient categories basic.

After primary triage, the triage supervisor should communicate all of the following information to the

medical branch officer, EXCEPT:

A. the total number of patients that have been triaged.

B. the recommended transport destination for each patient.

C. recommendations for movement to the treatment area.

D. the number of patients that are in each triage category.

B. the recommended transport destination for each patient.

Injuries or conditions that would be classified as first priority (red tag; immediate) include all of the

following, EXCEPT:

A. severe medical problems.

B. fractures of multiple long bones.

C. any airway or breathing difficulty.

D. uncontrolled or severe hemorrhage.

B. fractures of multiple long bones.

Which of the following patients should be assigned an immediate (red tag) category?

A. 22-year-old male with blunt abdominal trauma, tachycardia, pallor, and diaphoresis

B. 29-year-old female with a back injury and numbness and tingling in her extremities

C. 31-year-old male with an open fracture of the forearm and minimal external bleeding

D. 36-year-old female with an open brain injury, agonal breathing, and a slow pulse rate

A. 22-year-old male with blunt abdominal trauma, tachycardia, pallor, and diaphoresis

You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following

patients should be assigned the highest (red) triage category?

A. a 50-year-old male with an open head injury and no pulse

B. a 49-year-old female with diabetes and difficulty breathing

C. a 36-year-old female with back pain and numb extremities

D. a 29-year-old male with bilaterally closed femur deformities

B. a 49-year-old female with diabetes and difficulty breathing

A patient who has experienced a back injury, with or without spinal cord damage, would be triaged with a

__________ tag during a mass-casualty incident.

A. red

B. green

C. black

D. yellow

D. yellow

Burn patients without airway compromise and patients with multiple bone or joint injuries should be marked

with a __________ triage at a mass-casualty incident.

A. red

B. yellow

C. green

D. black

B. yellow

A patient in respiratory arrest at the scene of a mass-casualty incident would typically be classified as a

fourth priority (black tag; expectant) patient, unless:

A. he or she has signs of an injury to the cervical spine.

B. he or she has external signs of severe thoracic trauma.

C. there are at least three other patients in respiratory arrest.

D. there are enough resources to provide care for him or her.

D. there are enough resources to provide care for him or her.

You and your partner arrive at the scene where a truck has crashed into a small building, injuring eight

people. You immediately request additional ambulances and begin the triage process. The first patient that

you triage is a young female who is unconscious and apneic. She has an open head injury and her pulse is

weak and thready. You should:

A. assess the severity of her open head injury.

B. place a red tag on her and continue triaging.

C. begin ventilating her with a bag-mask device.

D. assign her a low priority and continue triaging.

D. assign her a low priority and continue triaging.

A tour bus has overturned, resulting in numerous patients. When you arrive, you are immediately assigned

to assist in the triage process. Patient 1 is a middle-aged male with respiratory distress, chest pain, and a

closed deformity to his right forearm. Patient 2 is a young female who is conscious and alert, but has

bilateral femur fractures and numerous abrasions to her arms and face. Patient 3 is an older woman who

complains of abdominal pain and has a history of cardiovascular disease. Patient 4 is unresponsive, is not

breathing, has a weak carotid pulse, and has a grossly deformed skull. What triage categories should you

assign to these patients?

A. Patient 1, immediate (red); Patient 2, minimal (green); Patient 3, delayed (yellow); Patient 4, expectant

(black)

B. Patient 1, delayed (yellow); Patient 2, immediate (red); Patient 3, delayed (yellow); Patient 4, immediate

(red)

C. Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant

(black)

D. Patient 1, delayed (yellow); Patient 2, delayed (yellow); Patient 3, minimal (green); Patient 4, immediate

(red)

C. Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant

(black)

The FIRST step in the START triage system is to:

A. focus on the patients who are unconscious.

B. scan the area for patients with severe bleeding.

C. move all walking patients to a designated area.

D. get a quick head count of all the patients involved.

C. move all walking patients to a designated area.

According to the START triage system, what should you do if you encounter an unresponsive patient who is

not breathing?

A. Open the airway and reassess breathing status.

B. Assign the patient in the "immediate" category.

C. Ventilate the patient for 2 minutes and reassess.

D. Triage the patient as "expectant" and move on.

A. Open the airway and reassess breathing status.

According to the START triage system, which of the following patients should be triaged as an immediate

priority (red tag)?

A. conscious with a respiratory rate of 24 breaths/min

B. unresponsive with a respiratory rate of 34 breaths/min

C. apneic, despite manually opening the airway

D. conscious, in severe pain, with radial pulses present

B. unresponsive with a respiratory rate of 34 breaths/min

According to the START triage system, what should you do if a patient is found to have a respiratory rate of

24 breaths/min?

A. Administer high-flow oxygen.

B. Triage the patient as delayed.

C. Assess for bilateral radial pulses.

D. Assess his or her neurologic status.

C. Assess for bilateral radial pulses.

You are triaging patients at the scene of a multiple vehicle crash when you encounter a young male who is

unresponsive and is not breathing. After you open his airway, he begins to breathe at a rapid rate. According

to the START triage system, you should:

A. assist his ventilations with a bag-mask device and perform a rapid scan of his entire body.

B. move him to the treatment area so he can receive a more comprehensive assessment of his status.

C. move to the other patients, but reassess him in 5 minutes to determine if he is still breathing.

D. tag him as immediate (red), place him in the recovery position, and move to the next patient.

D. tag him as immediate (red), place him in the recovery position, and move to the next patient.

The JumpSTART triage system is intended to be used for children younger than _____ years or who appear

to weigh less than _____.

A. 5, 50 lb

B. 6, 70 lb

C. 7, 90 lb

D. 8, 100 lb

D. 8, 100 lb

According to the JumpSTART triage system, infants or children not developed enough to walk or follow

commands, including children with special needs:

A. are treated immediately in the primary triage area and then transported.

B. are initially triaged on the basis of whether or not they have distal pulses.

C. should be taken to the treatment area for immediate secondary triage.

D. are the first to be transported, regardless of the severity of their injuries.

C. should be taken to the treatment area for immediate secondary triage.

According to the JumpSTART triage system, if a pediatric patient is not breathing, you should:

A. immediately check for a pulse.

B. triage him or her as expectant.

C. give five rescue breaths and reassess.

D. open the airway and reassess breathing.

A. immediately check for a pulse.

According to the JumpSTART triage system, if a pediatric patient has a respiratory rate of 40 breaths/min,

you should:

A. look for posturing.

B. assess for a distal pulse.

C. assess neurologic status.

D. assign an immediate category.

B. assess for a distal pulse.

While triaging patients at the scene of a building collapse, you encounter a young child who is conscious,

alert, and breathing; has bilateral radial pulses; and has points to his severely angulated leg, which is not

bleeding. According to the JumpSTART triage system, you should:

A. quickly bind his legs together to stabilize the fracture, and continue triaging.

B. assign him a delayed (yellow) category and continue triaging the other patients.

C. evacuate him to a designated area and assign him a minimal (green) category.

D. apply high-flow oxygen, obtain baseline vital signs, and continue triaging.

B. assign him a delayed (yellow) category and continue triaging the other patients.

Which of the following statements regarding transport of patients from a mass-casualty incident or disaster

site is correct?

A. Delayed-priority patients should be transported five at a time.

B. Immediate-priority patients should be transported two at a time.

C. Walking wounded patients should be taken to the closest hospitals.

D. Patients who are in cardiac arrest should clearly be transported first.

B. Immediate-priority patients should be transported two at a time.

Unlike a mass-casualty incident, a natural disaster:

A. often requires personnel to remain on scene for several days.

B. exists when there are more than 100 critically injured patients.

C. is typically short-lived and does not require as much manpower.

D. usually does not require the ICS process.

A. often requires personnel to remain on scene for several days.

Upon arriving at the scene of a possible hazardous materials (HazMat) incident involving several patients,

you should:

A. retrieve all critical patients.

B. rope off the entire perimeter.

C. carefully assess the situation.

D. divert traffic away from the scene.

C. carefully assess the situation.

General principles for approaching a potential HazMat incident include:

A. parking the ambulance in a location that is upwind and downhill.

B. taking standard precautions before entering any HazMat scene.

C. asking for wind direction from dispatch and entering downwind.

D. maintaining a safe distance and viewing the scene with binoculars.

D. maintaining a safe distance and viewing the scene with binoculars.

Which of your senses can be safely used to identify a HazMat incident?

A. sight and sound

B. sound and smell

C. smell and sight

D. sight and touch

A. sight and sound

Which of the following statements regarding storage containers and hazardous materials is correct?

A. Red phosphorus from a drug laboratory is found in a blue container that is clearly labeled.

B. In most cases, there is no correlation between the color of the container and the possible contents.

C. Steel utility drums are used to contain acids, bases, and other corrosive chemicals and substances.

D. The Emergency Response Guidebook tells you the type and color of container used to store hazardous

materials.

B. In most cases, there is no correlation between the color of the container and the possible contents.

A carboy is a container that would MOST likely be used to store and transport:

A. explosives.

B. corrosives.

C. flammable liquids.

D. combustible materials.

B. corrosives.

Placards and labels on a storage container are intended to:

A. advise responders of the appropriate neutralizing measures.

B. broadly classify chemicals as being explosive or non-explosive.

C. provide specific information about the chemical being carried.

D. give a general idea of the hazard inside that particular container.

D. give a general idea of the hazard inside that particular container.

Which of the following chemicals requires identification with a placard, regardless of how many pounds the

shipment weighs?

A. air-reactive solids

B. flammable liquids

C. water-reactive solids

D. nonflammable gases

C. water-reactive solids

The reference used as a base for your initial actions at a HazMat incident is/are:

A. the bill of lading.

B. your local EMS protocols.

C. the material safety data sheet (MSDS).

D. the Emergency Response Guidebook.

D. the Emergency Response Guidebook.

Which of the following statements regarding hazardous materials is correct?

A. Most hazardous materials are odorless and colorless, even when a substantial leak or spill has occurred.

B. Some substances are not hazardous by themselves, but become toxic when mixed with another chemical.

C. Identifying the presence of a hazardous material is generally very easy because of the consistent use of

placards.

D. A package or truck need only contain small quantities of a hazardous chemical before it must bear a placard

or label.

B. Some substances are not hazardous by themselves, but become toxic when mixed with another chemical.

The MOST appropriate location to park your ambulance at a HazMat incident is:

A. downwind at least 200′ from the scene.

B. downhill at least 100′ from the incident.

C. uphill at least 25′ from the incident site.

D. upwind at least 100′ from the incident.

D. upwind at least 100′ from the incident.

After recognizing that an incident involves a hazardous material, you should contact the hazardous materials

team and then:

A. don standard equipment before gaining access to any patients.

B. not allow anyone within 25′ to 50′ of the incident scene.

C. take measures to ensure the safety of yourself and others.

D. identify the chemical using the Emergency Response Guidebook.

C. take measures to ensure the safety of yourself and others.

You are approaching an overturned tanker truck to assess the driver, who appears to be unconscious. As you

get closer to the vehicle, you note the smell of noxious fumes and find that you are in the midst of a vapor

cloud. What should you do?

A. Remain where you are and perform a visual assessment of the patient.

B. Cover your face with your shirt and quickly extricate the injured driver.

C. Exit the area immediately and gather information for the HazMat team.

D. Realize that you are in the danger zone and prevent others from entering.

C. Exit the area immediately and gather information for the HazMat team.

During a HazMat incident, you are working in the treatment area. As patients are removed from the danger

zone, you should:

A. remain where you are and have the patients brought to you.

B. quickly decontaminate the patients and begin assessing them.

C. perform a rapid assessment and then have them decontaminated.

D. retrieve patients from the decontamination area and begin treatment.

A. remain where you are and have the patients brought to you.

Which of the following activities occurs in the warm zone?

A. command

B. personnel staging

C. decontamination

D. medical monitoring

C. decontamination

The process of removing or neutralizing and properly disposing of a hazardous material is called:

A. neutralization.

B. decontamination.

C. antidotal treatment.

D. chemical containment.

B. decontamination.

Which of the following is NOT a role of the EMT at the scene of a HazMat incident?

A. rehabilitation

B. decontamination

C. transportation

D. triage and treatment

B. decontamination

Level _____ hazardous materials would cause irritation on contact but only mild residual injury, even

without treatment.

A. 0

B. 1

C. 2

D. 3

B. 1

A Level 4 hazardous material:

A. causes temporary damage or injury unless prompt medical care is provided.

B. requires protective gear to ensure that no part of the skin's surface is exposed.

C. is mildly toxic but still requires the use of a self-contained breathing apparatus (SCBA).

D. requires specialized gear designed for protection against that particular hazard.

D. requires specialized gear designed for protection against that particular hazard.

Following proper decontamination, a 30-year-old male is brought to you. He is semiconscious and has rapid,

shallow respirations. A quick visual assessment reveals no obvious bleeding. You should:

A. begin some form of positive-pressure ventilation.

B. ask a fire fighter what the patient was exposed to.

C. administer 100% oxygen via a nonrebreathing mask.

D. perform a rapid assessment to locate critical injuries.

A. begin some form of positive-pressure ventilation.

A 49-year-old man has been removed from his overturned tanker, which was carrying a hazardous material.

The tank ruptured and he was exposed to the material. When rescue personnel bring him to the

decontamination area, they note that he is unconscious and has slow, shallow breathing. They should:

A. decontaminate the patient as they would any other patient and then move him to the area where EMTs are

waiting.

B. cut away all of the patient's clothing and do a rapid rinse to remove as much of the contaminating matter as

they can.

C. defer the decontamination procedure and bring the patient directly to awaiting EMS personnel for

immediate treatment.

D. request that EMS personnel don standard precautions, enter the warm zone, and begin immediate treatment

of the patient.

B. cut away all of the patient's clothing and do a rapid rinse to remove as much of the contaminating matter as

they can.

Your work uniform is an example of what level of protection?

A. Level A protection

B. Level B protection

C. Level C protection

D. Level D protection

D. Level D protection