4.1 EMS

Question 1

The objectives of basic EMS operations response include:

Answer 1

• Establishing and maintaining proper command and control of emergency operations utilizing incident command system (ICS) procedures
• Ensuring that resources are utilized in a manner that provides the best patient care
• Providing for scene safety
• Efficient communications between crews

Question 2

When the first PFA Unit arrives on scene of a medical:

Answer 2

PFA SHALL assume command

Question 3

Resource ordering and cancelling should be done through the:

Answer 3

IC

Question 4

If the patient is not believed to be critical based on dispatch information:

Answer 4

The PVHEMS Lead, and the PFA Captain and fire fighter (FF) will go to the patient with essential equipment. The PVHEMS Partner and PFA Driver Operator (DO) should be responsible for bringing additional equipment.

Question 5

If Pt is considered critical:

Answer 5

All initial responders may go direct to Pt with essential equipment.

Question 6

The decision to request a medical helicopter or cancel an automatically launched helicopter should be based on the following:

Answer 6

• Best interest of the patient(s)
• Criticality of patient(s)
• Number of patients
• Availability of transport resources
• Time and distance to appropriate medical facility
• Visibility of landing zone
• Direction of Paramedic once at scene and having completed patient assessment.

Question 7

Once PFA units are on scene and the need for a helicopter has been verified:

Answer 7

the IC shall confirm a radio assignment for communication with the helicopter, assign a ground contact and designate a landing zone.

Question 8

On calls where a helicopter needs to land, 8. The IC should consider requesting law-enforcement personnel to:

Answer 8

Block off the landing zone

Question 9

The Ground Contact for med evac helicopters SHALL:l:

Answer 9

• Be designated by the incident name (e.g., “Highway 287 Ground Contact”)
• Clear the intended landing zone of all personnel and equipment
• Relay to the pilot the following information:
 Intended landing-zone location
 Wind direction (direction wind is coming from) and wind speed
 Overhead barriers and ground obstructions/”watchouts”
 Patient update, if possible
• Notify 100 when the helicopter leaves the incident

Question 10

The Landing Zone for med evac helicopters shall be:

Answer 10

• 100 feet away from the incident and secured
• Free of debris and on a hard surface
• Minimum of 100 feet by 100 feet in size
• Free of overhead barriers (power lines) and ground obstructions (signs, posts, etc.)
• Have at least two miles of visibility.

Question 11

All personnel on scene shall adhere to the following safety rules regarding med evac helicopters:

Answer 11

• Be aware that Ground Contact is in charge of safety and the landing zone.
• Stay out of the landing zone during landings and take-offs.
• Wear eye protection, and secure loose articles of clothing and blankets.
• Do not approach helicopter unless signaled to do so by the pilot.
• Approach from the front of the aircraft where the pilot can see you; never approach from the rear of the aircraft.
• Approach in a crouching position.
• Do not raise anything over the level of your head (e.g., intravenous-fluid bags).
• Move and load the patient only under the direction of the flight crew.

Question 12

When any patient-transport device is loaded with a patient:

Answer 12

, at least one member of the responsible EMS agency (PVH or other agencies) shall be in physical contact with and in command of the device.

Question 13

Multiple-patient incidents are classified as those responses involving___________ or more patients, and can involve either ____ or ______patients.

Answer 13

5

Medical or Trauma

Question 14

1st Alarm MCI (Level 1) – Expanded Medical Emergency, with ___ casualties, and at least ____of which are considered in critical condition.

Answer 14

5-15

5

Question 15

2nd Alarm MCI (Level 2) – Major Medical Emergency, with ___casualties, and at least ___ of which are considered critical.

Answer 15

16-50

10

Question 16

3rd Alarm MCI (Level 3) – Medical Disaster, with _______casualties, and at least ____ of which are considered critical.

Answer 16

More than 50

20

Question 17

Size up for MCI should include:

Answer 17

Size-up should include an evaluation of the following conditions:
• Nature/type and scope of incident – initial designation of MCI response (MVA, active shooter, explosion, HAZMAT).
• Approximate number of victims – severity of injuries.
 All involved need to be accounted for
• Pts = injured
• Pt contacts = involved but not injured
• Identify life safety hazards – fire, hazardous materials.
• Routes of ingress and egress.

Question 18

. The first two critical Unit Leaders on MCI are ____and ______.

Answer 18

Triage

Transport

Question 19

When responding with multiple agencies on differing radio frequencies:

Answer 19

A comms channel should be secured and communicated

Question 20

If a helicopter is necessary:

Answer 20

Designate Ground Contact Officer

Question 21

Benchmarks for MCI:

Answer 21

• 360 complete or not complete (state reason if not complete)
• Declare appropriate MCI level
• Identify ingress/egress route
• All Patients triaged
• All patients transported and/or accounted for

Question 22

Medical Group Supervisor (implement at second alarm level) is responsible for:

Answer 22

• Coordinating triage, treatment and transportation of patients, and notifying appropriate hospital(s) of patient arrivals.
• Appointing unit leaders and assign support staff.
• Coordinating all medical operations.
• Accounting for all personnel assigned to this group.
• Requesting additional resources and supplies as necessary.

Question 23

Triage Unit Leader is responsible for:

Answer 23

• Quickly locating/triaging every victim (Rapid Trauma Exam) – using Respirations, Perfusion, and Mental Status (RPM) method - ensuring the use of triage tags.
• Identifing extrication/rescue needs – coordinates with Rescue Group Supervisor.
• Communicating priority of patients to Transport Unit Leader.
• Delivering patient care on priority basis.
• Formulating triage strategy – triage victims where they are found, or collect victims and move them to a designated patient collection area (funnel technique).
• Requesting and assigning shuttle teams.
• Organizes and directs movement of victims to transport units or to where transport unit leader’s designated location.
• Designating patient treatment areas (re-triage) and request/assign a Treatment Unit Leader.
• Assigning EMS and other medical personnel to PT care

Question 24

Transport Unit Leader, which should be an EMS Supervisor, is responsible for:

Answer 24

• Coordinating the transportation of patients and notifying appropriate hospital(s) through EMSystems of patient arrivals. During MCI’s, the system allows real-time information exchange between the Transport Unit Leader and area facilities by providing a means for distributing information to all facilities simultaneously through the System Alert mode. In addition, EMSystems provides accurate, timely information to facilitate getting patients to the correct facility in a timely manner and allow transport units to keep patients within the appropriate hospital system whenever possible.
• Establishing and employing the proper patient-transport strategy.
• Coordination with Triage Unit Leader to identify how many patients require transport.
• Request own transport channel to organize transport units
• Requesting resources (additional ambulances/helicopters/buses) – this is influenced by transport time – how long is a cycle and how many patients can be transported. Rule is a one red and one yellow per transport.
• Ingress/Egress/Ambulance loading zone.
• Establish staging, equipment stockpile area, and helicopter landing zone.
• Assignment of patients to transport units.
• Maintaining MCI transportation form. Consider a scribe to accomplish this.
• Assignment of hospital destinations – request capability reports.
• Responsible for Patient/Crew/Ambulance/Hospital assignments.

Question 25

Treatment Unit Leader is responsible for:

Answer 25

• Maintaining a secure treatment area.
• Coordinating delivery of patient care to victims awaiting transportation.
• Identifing need for additional personnel, supplies, and other resources for patient care (communicate needs to the Triage Unit Leader or Medical Group Supervisor).
• Assuring re-assessment of victims (and re-triage, as necessary).
• Directing movement of reclassified victims.
• Assigning priority of patient transport and communicate to the Transportation Unit Leader.

Question 26

Once assigned as a group/division supervisor:

Answer 26

Don the appropriate vest

Question 27

If responding to MCI from quarters:

Answer 27

Take backboards that are at the station

Question 28

Who in the area has an MCI trailer?

Answer 28

Thompson Valley

Question 29

Who’s responsible for calling Full Trauma Team Activation?

Answer 29

The first responding unit, member, Incident Commander (IC) or IC’s designee.

Question 30

Who’s responsible for contacting ED, verifying destination and FTTA?

Answer 30

Transporting crew

Question 31

Who’s responsibility is it to call a Limited Trauma Team Activation?

Answer 31

Transporting Crew

Question 32

Air Transport may be considered if:

Answer 32

1. It’s an extended extrication (20+)

2. If air transport can save more than 15 minutes.