CFR-D MANUAL

Question 0

Body Substance Isolation is an approach to infection control whereby all human blood and all human body fluids are considered potentially infectious; therefore precautions must be taken to avoid any contact with blood, body fluids, and all other potentially infectious materials. Which is the most correct procedure from the list below in regards to BSI?

A) Members shall wash their hands as soon as possible after the removal of gloves or other PPE.

B) Members shall avoid contact with contaminated sharps (contaminated objects that can penetrate the skin)

C) Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of occupational exposure.

D) Members are not permitted to wear sneakers or sneaker types of shoes while on duty.

E) All of the above are correct

Answer 0

E) All of the above are correct

CFR-D 3, section 12

Question 1

When a member suspects that they have has a biological exposure (incident) while on duty or during an off duty fire or emergency that they have responded to within the City of New York, the member shall notify their company officer as soon as possible. Upon receiving notification of the exposure incident, the company officer shall: which is the correct point?

A) Review the MD-X3 for accuracy and completeness.

B) Fax only the completed MD-X3 to the Medical Officer on emergency duty through the Medical Leave Desk and to the OSHA office.

C) If unable to complete transmission of the MD-X3 via fax, email the Bureau of Health Services.

D) All are correct

Answer 1

A) Review the MD-X3 for accuracy and completeness.

(CFR-D Ch 3, 4.2)

B - Fax completed MD-X3 AND RESPECTIVE PCR.

C - If unable to fax MD-X3 then CALL BHS.

Question 2

Which point about the hazardous waste (Red bag) disposal policy for CFR-D Companies is incorrect?

A) CFR-D Companies shall drop off Red Bag waste at their CFR-D Depot.

B) Citywide pickups for Red Bag waste shall be at CFR-D Depots.

C) CRF-D Depot Officers shall contact Solid Waste Technologies, Inc. to have the Depots Red Bags picked up for proper disposal.

D) In the event of a missed pickup of Red Bags, the CFR-D Depot Officer shall contact the Resource Center. A work order will be generated and automatically sent to the OSHA Unit who will contact the vendor to expedite pickup.

E) The CFR-D Depot Officer should retain the work order number until the Red Bags have been picked up. The Red Bags should be placed outside company quarters until pickup.

Answer 2

E) The CFR-D Depot Officer should retain the work order number until the Red Bags have been picked up. The Red Bags should be placed outside company quarters until pickup. (INCORRECT)

(CFR-D 3, 12.16)

• DO NOT place Red Bags outside under any circumstances

Question 3

Which is an incorrect procedure for disposable body bags used by fire suppression units?

A) Body bags may be obtained from the Battalion Chief on the scene. If a Battalion Chief is not on the scene, the IC shall call a Battalion Chief to the scene.

B) The victim shall be placed in a disposable body bag and as an additional precaution that bag shall be placed inside another disposable bag.

C) The disposable bags have no handles; they must be placed inside a heavy duty, non-disposable body bag for transport.

D) When the body is inside the transport vehicle, the outer bag shall be removed.

Answer 3

A) Body bags may be obtained from the Battalion Chief on the scene. If a Battalion Chief is not on the scene, the IC shall call a Battalion Chief to the scene. (INCORRECT)

(CFR-D 3, 13.10.1)

• Body bags may be obtained from the DIVISION CHIEF on scene. If a
  DEPUTY CHIEF is not on scene, the IC shall call a BC to the scene

Question 4

Infection control personal protective equipment (PPE) shall be worn by members during those incidents where members could be potentially exposed to blood and other potentially infectious materials. Which is an incorrect item from the list below in regards to infection control PPE?

A) Company commanders shall insure that all members are aware of the location of the infection control equipment on the apparatus.

B) Company Officers, at roll call, shall have members check the location of infection control equipment on the apparatus and the quantity of supplies on hand. A record of this inspection shall be incorporated in the roll call entry.

C) If the location or status of this equipment changes during the tour, the officer shall make a Company Journal Entry to this effect.

D) Home laundering of department issued infection control PPE is permitted.

Answer 4

D) Home laundering of department issued infection control PPE is permitted. (INCORRECT)

(CFR-D 3, 13)

• DO NOT take infection control PPE home.

Question 5

At the start of each tour, the officer shall make out the riding list that includes each member’s CFR-D assignment along with his firefighting assignment and riding position. Which assignment is correct?

A) “A” - Airway - FF responsible for manually stabilizing the patients spine (if trauma is suspected) while opening the airway, maintaining the airway, and administering oxygen if needed.

B) B - “Boss” - The Officer in charge, who must complete the PCR.

C) C - “Checker” - FF responsible for conducting the patient assessment and performing any hands on care. In response to a cardiac arrest, this FF begins ventilations and carries the oxygen bag.

D) “D” - Defib - In response to a cardiac arrest, this FF checks the pulse and begins compressions.

E) The chauffeur must always remain with the apparatus.

Answer 5

A) “A” - Airway - FF responsible for manually stabilizing the patients spine (if trauma is suspected) while opening the airway, maintaining the airway, and administering oxygen if needed. (INCORRECT)

(CFR-D 2, 2.1)

A - Correct

B - The Officer in charge ENSURES PCR is completed.
Defib/Documentor fills out PCR.

C - Checker takes pulse, begins compressions

D - Defib hooks up defibrillator and fills out PCR.

E - Chauffeur or NON CFR TRAINED MEMBER stays with rig. (ECC
may need to be inside performing CFR if he is one of two certified
members)

Question 6

While discussing proper staffing of CFR-D units, members made several comments. Which comment was incorrect?

A) Officer shall ensure that at least 2 CFR-D FFs will be working each tour. Officers shall notify their Battalion for needed details prior to the start of the tour.

B) In order to be in service as a CFR-D unit, there shall be a minimum of 2 trained members with current CFR-D certification.

C) If during the tour, a CFR-D unit staffing is reduced to one trained FF and one trained Officer, the company will be out of service for CFR-D responses.

D) If during the roll call, the Officer in charge determines that their dis not at least 2 CFR-D certified members, the company shall not respond to any CFr-D calls. The company may still be dispatched for calls received directly from the public to assist civilians.

E) If during the roll call the Officer in charge determines that there are not at least 2 CFR-D certified members, the Officer shall notify the dispatcher and Battalion and enter the event in the company journal.

Answer 6

C) If during the tour, a CFR-D unit staffing is reduced to one trained FF and one trained Officer, the company will be out of service for CFR-D responses. (INCORRECT)

• The company will remain available with one CFR-D trained FF and
  one CFR-D trained Officer.
• MUST BEGIN TOUR WITH AT LEAST 2 CFR FFS
• ONCE TOUR STARTS, IF ONE MEMBER TAPS OUT, YOU CAN STILL RESPOND TO EMS CALLS AS LONG AS YOU HAVE ONE CFR-D TRAINED FF AND ONE CFR-D TRAINED OFFICER.

Question 7

While approaching the scene of a reported person unconscious on a street corner, the Officer in charge took several actions. Which one was wrong?

A) The scene was observed for the safety of the crew. The safety of the patients and bystanders was not considered, because it was the responsibility of the NYPD.

B) The number of patients involved was identified.

C) The Officer ensured that Body Substance Isolation (BSI) procedures were used and personal protective gear was on.

D) The need for additional resources was determined.

Answer 7

A) The scene was observed for the safety of the crew. The safety of the patients and bystanders was not considered, because it was the responsibility of the NYPD. (INCORRECT)

(CFR-D 2, 3.6.1)

• Observe safety of crew AS WELL AS BYSTANDERS AND PATIENTS.

Question 8

Engine 100 receives an EMS response for a person with chest pains in Apartment 5G at 220 Smith St. When Engine 100 arrives at the location of the call, they notice an FDNY EMS ambulance parked in front of the “H-Type” MD. A police officer on scene tells the Officer of Engine 100 transmits a 10-91 via Dept. Radio and returns to quarters. Were the actions of Engine 100 in accordance with FDNY policy?

A) Yes, because the Officer ensured that Engine 100 had responded to the same location as EMS.

B) No, because the Officer did not confer with EMS to ensure both units had responded to the same incident.

C) Yes, because units will always receive the MDT message “EMS on scene, enter 10-91 and go 10-8” whenever EMS has arrived prior to the CFR-D unit for any CFR response.

D) No, because the Officer did not confer with EMS to ensure both units had responded to the same location.

Answer 8

B) No, because the Officer did not confer with EMS to ensure both units had responded to the same incident.

(CFR-D 2, 3.8.1)

• INCIDENT (not location)

Question 9

Members encounter a patient in respiratory arrest, with a CUPS status of C, and an ambulance is not on the scene. Which action would not be required in this instance?

A) The Officer asked the dispatcher for an ETA of the responding ambulance.

B) The dispatcher was advised to relay the seriousness of the patient’s condition to the responding EMS units.

C) Packaging efforts were begun while the patient received ventilators support.

D) Members performed a focused physical exam.

Answer 9

D) Members performed a focused physical exam. (INCORRECT)

(CFR-D 2, 3.9.3)

• Physical Exam for PATIENTS THAT ARE POTENTIALLY STABLE OR
  STABLE (P & S)

Question 10

Which of the following units is back in service for fire duty but not available for CFR-D responses following a CFR-D response?

A) Engine 100, whose Nozzle FF requires decontamination after getting blood on his arm at a CFR-D response.

B) Engine 200, who had its defibrillator malfunction while attempting to revive a patient in cardiac arrest.

C) Engine 300, who used its suction device, and now it required decontamination.

D) Engine 400, who had a member get blood on the sleeve of his bunker coat, which required decontamination.

Answer 10

B) Engine 200, who had its defibrillator malfunction while attempting to revive a patient in cardiac arrest.

(CFR-D 2, 3.16.1)

A, C & D - All require DECONTAMINATION. Any time Decon is
necessary you can’t be in service for EMS. Tell Battalion and
Dispatcher you can’t go on EMS runs.

Question 11

While responding to a report of a person in carina arrest, Engine 333 is flagged down by a pedestrian who states that his mother is having difficulty breathing. Which action taken by Engine 333 should be corrected?

A) The Officer notified the dispatcher of the verbal alarm.

B) Members followed the pedestrian around the corner to his house, where his mother was sitting on the porch.

C) After determining that woman on the porch was breathing adequately following a patient assessment, Engine 333 transmitted a 10-37-3 and proceeded to the location of the original alarm.

D) Engine 333 remained on the scene of the verbal alarm until relieved by EMS.

Answer 11

C) After determining that woman on the porch was breathing adequately following a patient assessment, Engine 333 transmitted a 10-37-3 and proceeded to the location of the original alarm. (INCORRECT)

(CFR-D 2, 3.18)

• For CFR-D runs, if while responding you are flagged down for a
  different EMS run, you will make an effort to contact this second
  patient and discontinue responding to the original alarm (Ambulance
  will be responding to original call). Once contact has been made and
  treatment given, do not leave the scene until relieved by EMS or until
  the patient walks away.
• This applies for CFR-D runs, not regular runs.

Question 12

Which situation would not require a CFR-D unit to transmit a signal 10-99?

A) Confirmed cardiac/respiratory arrest (Company performing CPR/Defibrillation)

B) Any situation where the Officer determines that the unit will likely be on the scene for 30 minutes or more.

C) Confirmed choking

D) Any CFR-D response where EMS reports no units available when the CFR-D unit requests an ETA for EMS.

Answer 12

C) Confirmed choking.

(CFR-D 2, 3.19)

• 10-99 not required for confirmed choking

Question 13

Which choice correctly indicates conditions where members would not attempt resuscitation of a non breathing/cardiac arrest patient?

1. Obvious Death
2. Dependent Lividity
3. Rigor Mortis
4. Decomposition
5. Valid Do Not Resuscitate Order (DNR)
6. Living Will presented
7. Upon orders of a Health Care Proxy

A) 1, 2, 3, 6, 7

B) 3, 4, 5, 6, 7

C) 1, 2, 3, 4, 5

D) 1, 2, 3, 4, 5, 6, 7

Answer 13

C) 1, 2, 3, 4, 5

(CFR-D 2, 4.4)

WHEN WOULD UNITS NOT BEGIN RESUSCITATION ORDERS:

“LORD DNR”

L - Lividity
O - Obvious Death
R - Rigor Mortis
D - Decomposition

DNR - Valid DNR

Question 14

Squad 400 responded to a report of a person unconscious in front of 408 Green Street. After searching the area and not finding the patient, Squad 400 took several actions. Which action was wrong?

A) The Officer reviewed the response printout for additional information.

B) After rechecking the information and no patient was located, the Officer verified the information with the dispatcher.

C) After re-verifying the dispatch information, Squad 400 attempted to contact neighbors and the building superintendent of 408 Green Street.

D) After all efforts to locate the patient proved unsuccessful, the Officer entered a 10-91 via the MDT and returned to service. The officer completed a PCR to document the units efforts to locate the patient.

Answer 14

D) After all efforts to locate the patient proved unsuccessful, the Officer entered a 10-91 via the MDT and returned to service. The officer completed a PCR to document the units efforts to locate the patient. (INCORRECT)

(CFR 2, 4.7)

• The Officer should enter a 10-92 because there was NO PATIENT.
  Filling out a PCR is not necessary because no patient care was
  provided, however a mark in journal should be made.

Question 15

There are situations where a CFR-D unit has located a patient, but cannot gain access. Which of the following is incorrect concerning gaining access?

A) If a unit locates a patient, but cannot gain access, forced entry may be the only option. If forcible entry is used, the Officer should request police response for security and have the dispatcher advise EMS of the situation.

B) If others within the premise deny access to the patient, the Officer shall immediately request police department assistance.

C) If the police department has been requested due to members denied access to a patient, the police department will determine the appropriate action to take.

D) If a unit has performed forcible entry to obtain access to a patient, EMS may be used to safeguard the premises until the arrival of the police department.

Answer 15

D) If a unit has performed forcible entry to obtain access to a patient, EMS may be used to safeguard the premises until the arrival of the police department. (INCORRECT)

(CFR-D 2, 4.8)

• CANT USE EMS to safeguard premises
  You are allowed to turn over to PD / Owner / Responsible Person.

Question 16

There are several situations that are infrequently encountered, but it is important that all Officers are familiar with the proper procedure to follow. Which choice is correct concerning these situations?

A) If a patient refuses medical aid (RMA), the CFR-D unit shall leave after ensuring that the patient is alert and oriented. A PCR is not required in this situation.

B) If a patient exhibiting altered mental status or appears to be an EDP refuses medical treatment, the Officer should request police assistance and remain on scene until EMS arrives.

C) If a physician is on scene of a CFR-D response when EMS is not yet on scene and offers his assistance, members should refuse the assistance in a pre-hospital setting.

D) If a physician is on scene and EMS has not yet arrived, members should follow all instructions given by the physician, and can provide any type of medical treatment as long as it is directed by the physician.

Answer 16

B) If a patient exhibiting altered mental status or appears to be an EDP refuses medical treatment, the Officer should request police assistance and remain on scene until EMS arrives.

(CFR-D 2, 4.9)

A - If patient is RMA, CFR-D unit shall WAIT FOR EMS to arrive and a
PCR IS REQUIRED.

B - Correct

C - May ACCEPT a doctors assistance in the pre-hospital setting.

D - Can accept doctors help, however CFR-D Unit CANNOT
PERFORM ABOVE THEIR SCOPE OF TRAINING.

Question 17

A CFR-D unit arrives on the scene of a medical emergency and NYPD ESU has already initiated patient care. Which of the following choices is correct concerning the actions taken by the unit?

A) After ESU told the Officer that Fire Department assistance was not required, the Officer transmitted signal 10-91 and went 10-8.

B) After ESU told the Officer that Fire Department assistance was not required, the Officer ensured a PCR was completed.

C) The CFR-D Unit will assume responsibility for patient care if ESU is not equipped with a defibrillator.

Answer 17

A) After ESU told the Officer that Fire Department assistance was not required, the Officer transmitted signal 10-91 and went 10-8.

(CFR-D 2, 4.13)

B - No patient care provided = NO PCR

C - ESU has a HIGHER LVL OF TRAINING for patient care. If they tell
you that your assistance is not required, then you can leave the
scene.

• If ESU is on scene first, they assume responsibility of patient
• If we are on scene first, we assume responsibility of patient, however
  because ESU is a higher level of pre hospital care, we can transfer
  responsibility to them. (If they don’t have a defibrillator we will retain
  patient care responsibilities)

Question 18

A CFR-D unit may telephone a FDNY/EMS telemetry physician if they need medical advice, or a parent refuses to allow treatment to a minor for a non-urgent illness or injury. Which is the incorrect choice concerning the use of this resource?

A) The telemetry phone number shall be posted on the chart holding the CFR-D units PCR forms.

B) Before calling telemetry, the unit shall have completed the primary survey and CUPS status determination.

C) The unit shall note all instructions given by telemetry on the PCR.

D) Telemetry can only be used for medical consultation.

Answer 18

D) Telemetry can only be used for medical consultation. (INCORRECT)

(CFR-D 2, 5.3)

• Telemetry used for medical consultation OR access to international
  languages.

Question 19

When a unit finds a minor suffering from life-threatening injuries or illnesses, what would be the correct action to take?

A) Do not provide treatment if the parent/guardian refuses to give consent.

B) Provide treatment if it is apparent that a delay in treatment, even if minimal, would jeopardize the minor’s life.

C) Only provide treatment after consulting with FDNY/EMS telemetry.

D) Only provide treatment if EMS is on scene and has assumed the role of higher care provider.

Answer 19

B) Provide treatment if it is apparent that a delay in treatment, even if minimal, would jeopardize the minor’s life.

(CFR-D 2, 6.1.1)

A - You WILL PROVIDE TREATMENT to a minor who has life 
      threatening injuries (even if guardian refuses consent)

B - Correct

C - IF NON-LIFE THREATENING only provide treatment after consulting with FDNY/EMS telemetry.

D - Provide treatment even if EMS is not on scene for life threatening
injuries.

Question 20

Which choice is incorrect concerning Do Not Resuscitate (DNR) Orders?

A) Supplemental oxygen may be provided to a patient with a valid DNR order.

B) A signed order shall be followed unless it has been revoked verbally or in writing.

C) A DNR bracelet is not valid in a pre-hospital setting.

D) A nursing home DNR does not have to utilize the NYS Out Of Hospital DNR form, it only required a physician’s signature.

E) A DNR order need not have a current date.

Answer 20

C) A DNR bracelet is not valid in a pre-hospital setting. (INCORRECT)

(CFR-D 2, 6.2.2)

• DNR Bracelet IS VALID.
• Choice A = CFR-D units will not perform CPR on a patient with a DNR
  Order, however they may provide other forms of treatment
  (supplemental oxygen).

Question 21

Whenever EMS and Fire Units are operating at an incident, the ranking Fire Officer is the IC. In which choice would the IC be operating incorrectly?

A) The IC evaluated the scene for the safety of all patients and operating personnel.

B) The IC was guided by the highest level pre-hospital medical provider for patient care decisions.

C) The IC issued orders regarding patient care to EMS personnel.

D) The IC maintained the responsibility of obtaining accurate patient care information.

Answer 21

C) The IC issued orders regarding patient care to EMS personnel. (INCORRECT)

(CFR-D 2, 8.3)

• IC (Fire Officer) DOES NOT give orders to EMS personnel, WE ARE
  GUIDED by highest level of training at the scene.

Question 22

All of the following are accurate statements about resuscitation efforts at a CFR-D response except which one?

A) CFR-D units shall not attempt resuscitation if there are any signs of lividity, obvious death, rigor mortis, or decomposition in the patient.

B) The presence of a valid DNR would prevent CRR-D units from initiating CPR.

C) A PCR must be completed for a DOA to document that the company properly examined the patient.

D) If a DNR is present and no CPR initiated, a PCR need not be completed since there was no care given.

Answer 22

D) If a DNR is present and no CPR initiated, a PCR need not be completed since there was no care given. (INCORRECT)

(CFR-D chapter 2)

• “LORD DNR”
  • PCR MUST BE COMPLETED FOR DOA to document patient was
    properly examined by CFR-D units.

Question 23

Which point listed below regarding the infection control program is incorrect?

A) A “casual” exposure is contact but without eye, mouth, other mucous membrane, non-intact skin, or parenteral contact (by injection) with blood or other potentially infectious materials.

B) A “non casual” at risk exposure is eye, mouth, other mucous membrane, non-intact skin, or parenteral contact (by injection) with blood or other potentially infectious materials.

C) The fact that a patient is infected or assumed to be infected with a communicable disease is a valid reason to withhold certain medical treatment due to an increased risk of infection.

D) Members are not permitted to wear sneakers or sneaker type shoes while on duty. Members who have open lesions and who have direct patient care responsibilities shall report to their company officer and refrain from patient care activities until evaluated by a BHS physician.

Answer 23

C) The fact that a patient is infected or assumed to be infected with a communicable disease is a valid reason to withhold certain medical treatment due to an increased risk of infection. (INCORRECT)

(CFR-D 3, 3.1)

• NOT A VALID REASON, CFRs must treat all patients.

Question 24

You are a lieutenant working a day tour in E-99. The proby comes to you and tells you that the infectious waste container in the back of quarters is fill and needs to be disposed of. E-98 is the CFR Depot in the battalion. Which action taken is correct?

A) Bring the infectious waste container to E-98s quarters.

B) Call the resource center to arrange a pickup.

C) Call the private contractor to arrange a pickup.

D) Place the red bags outside of quarters for the Dept. Of Sanitation to pick up.

Answer 24

A) Bring the infectious waste container to E-98s quarters.

(CFR-D 3, 12.16)

A - Correct

B - Resource center = CFR-D Depot calls if there’s a missed pickup

C - Private contractor = CFR-D Depot calls to arrange pickup

D - NEVER place red bags outside of quarters.

Question 25

After operating at an EMS run where a person was hit by a car, the members of E-99 are gathering their equipment when they notice that the trauma bag and Halligan tool have blood on them. The officer of E-99 directs his members to place the trauma bag and halligan tool in a red bag until they can be decontaminated. Do you agree with this stament?

A) Agree

B) Disagree

Answer 25

B) Disagree

(CFR-D 3, 12.16 Note)

• Red bags = ONLY put disposable wastes inside (throw away)
• Halligan and trauma bag need to be DECONNED (not thrown away)

Question 26

Which point below made during a study group meeting is not correct?

A) Company Officers at roll call, shall have members check the quantity of supplies on hand. A record of this inspection shall be made in the roll call entry.

B) If a members PPE or work duty clothing is contaminated with blood, blood products, or other bodily fluids they may take them home or to a commercial laundry facility for cleaning.

C) If a Motorola portable radio/HT becomes contaminated with blood or other bodily fluid, it shall be decontaminated in quarters. These radios may be completely immersed in fluid.

D) Tech services will distribute bleach packets. These packets are mixed with 1 gallon of water for an effective disinfection solution. Mixtures remaining after 24 hours will be disposed of in the slop sink.

Answer 26

B) If a members PPE or work duty clothing is contaminated with blood, blood products, or other bodily fluids they may take them home or to a commercial laundry facility for cleaning. (INCORRECT)

(CFR-D 3, 13.1.4)

• DO NOT take home PPE or work duty uniforms to wash if
  contaminated. (They must be sent out for Decon)

Question 27

During a CFR-D refresher class at Fort Totten, tuberculosis and rabies were being discussed. A sharp student should respectfully correct the instructor in which point made about these topics?

A) Tuberculosis is an airborne disease that is spread through the air when a person with active tuberculosis coughs and releases tuberculosis into the air.

B) Tuberculosis is most easily transmitted in crowded, congested, and poorly ventilated areas. It is very difficult to acquire tuberculosis in locations such as restrooms, subways and stores.

C) Rabies is an acute viral infection of the central nervous system that effects mammals. The virus can live a few hours outside the body in saliva and body fluids.

D) During BISP at hospitals, shelters, or prisons, where the risk of tuberculosis is high, it is necessary to enter all rooms as a visual inspection is not sufficient to detect fire prevention violations.

Answer 27

D) During BISP at hospitals, shelters, or prisons, where the risk of tuberculosis is high, it is necessary to enter all rooms as a visual inspection is not sufficient to detect fire prevention violations (INCORRECT)

(CFR-D 3, ADD 1)

• IT IS NOT NECESSARY to enter all rooms on these inspections. Wear
  an N95 and peek in to visually inspect.

Question 28

E-287 responded to a patient with difficulty breathing. They placed him on supplemental oxygen. The patients son shows you a valid DNR and requests that your members cease all care. You would be most correct to?

A) Have your members continuing giving proper care.

B) Verify the validity of the DNR before discontinuing all patient care.

C) Stop all patient care and give the DNR to EMS.

D) Special call an EMS supervisor to verify the DNR.

Answer 28

A) Have your members continuing giving proper care.

(CFR 2, 6.2.1)

• Continue to give appropriate care BUT NOT CPR.

Question 29

A PCR should be filled out in all but which of the following situations?

A) A ladder company that stabilized a patient’s neck while assisting an EMS ambulance.

B) Anytime a CFR-D Engine is 10-84 on an EMS run

C) Verbal alarm where the CFR-D unit initiated history taking

D) Patient care is provided by a CFR-D firefighter at an all hands fire.

Answer 29

B) Anytime a CFR-D Engine is 10-84 on an EMS run (INCORRECT)

(CFRD 5, 1.2.2)

• Patient contact or patient care = PCR
• Patient contact = visualized or approached a patient.
  Communicated with or took a patient’s history
• Just because you are 10-84 at an EMS run, you do not have to fill out
  a PCR if there was no patient contact or care given. (Ex: 10-91)

Question 30

Which is not correct about what is done with the various parts of the PCR?

A) Part 1 is forwarded to OMA via the local EMS division.

B) Part 2 stays in quarters and must be secured by the officer

C) Part 3 is for the hospital and, if completed, should be given to the EMS unit at the scene.

D) If part 3 is not given to the EMS unit on scene, it is forwarded with part 1.

Answer 30

A) Part 1 is forwarded to OMA via the local EMS division. (INCORRECT)

(CFRD 5, 1.1)

• PART 1 FORWARDED THROUGH THE BAG.

Question 31

After using the AED for a cardiac arrest the officer must ensure that the incident is properly documented. Which is incorrect?

A) The original PCR is faxed to OMA by the end of the tour.

B) A copy of the PCR and the AED module are exchanged for a new module at the Battalion CFRD Depot.

C) The serial number of the module should be recorded on the PCR

D) If the AED was not applied to a cardiac arrest patient, the circumstances must be explained on the PCR.

Answer 31

A) The original PCR is faxed to OMA by the end of the tour. (INCORRECT)

(CFRD 5, 2.1)

• The original PCR is faxed to OMA IMMEDIATELY UPON RETURN TO
  QUARTERS.

Question 32

Which is an incorrect entry on a PCR?

A) For the “Vehicle ID” the engine company number shall be preceded by the number “5”

B) If unable to obtain the patients name, “unknown” should be written in the name box.

C) The patients age is not required if the Date of Birth is documented.

D) A minimum of one set of vital signs is required for adult patients unless they are in cardiac arrest or DOA.

E) Only the names and certification numbers of the CFRD members who provided patient care are required. The name of the member completing the PCR must be circled.

Answer 32

C) The patients age is not required if the Date of Birth is documented. (INCORRECT)

(CFRD 5, 4.1.4)

• STILL NEED to enter patient’s age.

Question 33

Of the following points listed below regarding the FDNY and the CFRD program, which is the point that is written correctly?

A) All CFR-D companies are to carry a minimum of (2) blankets on the apparatus at all times. CFRD blankets are white with FDNY printed on them in blue letters.

B) A defibrillator that displays a flashing red hourglass in the upper right hand corner is operational and ready for use.

C) Expired defibrillator electrodes (pads) are to be used before non expired pads and within 30 days of the expiration date.

D) CFR-D companies shall ensure that the suction unit batteries are charged at the start of every tour.

Answer 33

A) All CFR-D companies are to carry a minimum of (2) blankets on the apparatus at all times. CFRD blankets are white with FDNY printed on them in blue letters.

(CFRD 4, 2.6.3)

B - Flashing BLACK hourglass (defibrillator operational/ready for use)

C - Expired pads ARE NOT to be used

D - CFRD units shall keep suction units on constant charge through a
connection to the apparatus electrical system.

Question 34

You are a CFRD engine that has just responded to 4 CFRD runs. Which situation does not require a PCR?

A) 10-84 & ESU has initiated care and they state no assistance is necessary.

B) Patient has valid DNR and no care was performed.

C) Patient is RMA (refusing medical attention)

D) Patient is DOA with rigor mortis

Answer 34

A) 10-84 & ESU has initiated care and they state no assistance is necessary.

(CFRD 2, 4.13 Note)

• CFRD unit must complete pre-hospital care report even if patient is
  DOA to document that the company properly examined the patient to
  confirm that the patient exhibited criteria for obvious death.

Question 35

Once on scene, a CFRD unit will transmit 10-99 for the following reasons except for which one?

A) Vehicle extrication

B) Multiple patients

C) Reported cardiac / respiratory arrest

D) Request for ETA for ambulance and EMS reports no units are available.

Answer 35

C) Reported cardiac / respiratory arrest

(CFRD 2, 3.19)

* 10-99:
  CONFIRMED cardiac arrest
  Multiple patients
  Vehicle extrication
  Request for ambulance and EMS reports no units available.

Question 36

At the start of the tour your Engine company firefighters are checking their CFRD equipment. Which symbol on the AED would mean it’s ready for use?

A) Emits a chirping sound

B) Solid red “X”

C) Flashing red “X”

D) Flashing black hourglass

Answer 36

D) Flashing black hourglass

CFRD 4, 1.9

Question 37

E-24 is dispatched to an EMS run for a major injury to a child. The child has fallen off his skateboard and broken his arm. The child’s parents refuse to give you permission to treat their child. You determine that his injury is non life threatening and that a delay in treatment would not jeopardize the child’s life. You would be correct to take which action?

A) Carefully explain the reasons for the treatment, what intervention is necessary to correct the problem and the consequences if the injury is not treated.

B) Notify dispatcher of events and have them notify PD.

C) Contact EMS lieutenant on call if there is a phone available

D) Do not leave scene before PD arrives.

Answer 37

A) Carefully explain the reasons for the treatment, what intervention is necessary to correct the problem and the consequences if the injury is not treated.

(CFRD 2, 6.1.1)

B - Notify EMS (not PD)

C - Contact Telemetry

D - Do not leave scene before EMS arrives

Question 38

Which information if not necessary to relay to the dispatcher when requesting an ambulance?

A) CUPS status

B) Pulse and respiratory rate

C) Number of patients

D) Chief complaint

Answer 38

C) Number of patients

(CFRD 2, 3,11)

When requesting an ambulance, companies must provide:
“Chris And Charlie Can Play Rugby”

C - CUPS status
A - Age
C - Chief complaint
C - CPR initiated or not
P & R - Pulse and respiratory rate

• Patients sex is NOT needed

Question 39

It is 0900 and you are the lieutenant of E-100. Your are assigning CFRD responsibilities and immediately after you finish, an “EMS patient unconscious” run comes in. You arrive to find a patient in cardiac arrest. The “Airway” firefighter begins ventilations. The “Checker” begins compressions and your “Documenter” firefighter hook up and operates the Defibrillator. After a few minutes of working on the patient, you revive him. You now notice a cut to the patients head and call for the trauma bag. Which firefighter should have brought it?

A) Airway

B) Boss

C) Checker

D) Defib / Documenter

Answer 39

C) Checker

CFRD 2 2.13

Question 40

You are working in an Engine company and respond to an EMS run. The patient can’t speak, there are no bystanders that know who she is, and she has no ID. How do you fill out the PCR (pre-hospital care report)?

A) Leave the name section blank

B) Fill in “unknown female”

C) Fill in “Jane Doe”

D) Fill in “99999”

Answer 40

B) Fill in “unknown female”

CFRD 5, 4.4.1 B

Question 41

Which patient would not need to be packaged while your CFRD members are treating life hazards?

A) A patient receiving CPR

B) An u responsive patient with no gag reflex

C) Patient is responsive but cannot follow commands

D) Patient is in shock

Answer 41

D) Patient is in shock

(CFRD 2, 3.12)

• If the patient is CRITICAL or UNSTABLE, packaging efforts must
  begin immediately while treating life threats. Immobilize to a
  spineboard if indicated.
• If the patient is POTENTIALLY UNSTABLE or STABLE, perform the
  appropriate focused physical exam for the patient.

Critical - Patients either receiving CPR
Respiratory arrest or requiring and receiving life-sustaining
ventilatory/circulatory support.

Unstable - Poor general impression
Unresponsive with no gag or cough reflexes
Responsive but unable to follow commands
Difficulty breathing

Potentially
Unstable - Pale skin or other signs of poor perfusion (shock)
Complicated childbirth
Uncontrolled bleeding
Severe pain in any area of the body
Severe chest pain (esp. with a systolic BP

Question 42

You are returning to quarters after a CFR-D run where you expended your supplies and do not have the minimum amount of supplies specified by the CFRD manual. Who do you advise as to your CFRD status?

A) Borough dispatch and Battalion that you are O.O.S for CFRD and notify Battalion only when you are back in service for CFRD.

B) Borough dispatch only that you are O.O.S for CFRD and again when you are back in service for CFRD.

C) Battalion only that you are O.O.S for CFRD and fire duty.

D) Borough dispatch and Battalion that you are O.O.S for CFRD and notify Dispatch only when you are back in service for CFRD.

Answer 42

D) Borough dispatch and Battalion that you are O.O.S for CFRD and notify Dispatch only when you are back in service for CFRD.

(CFRD 2, 3.16)

Question 43

You are responding to a nursing home as a CFRD unit for a report of an elderly patient in cardiac arrest with no pulse. You know which of the following procedures to be incorrect?

A) On arrival the patient is unconscious but not in cardiac or respiratory arrest. Nursing home staff provide you with a valid NYS out of hospital DNR and you administer supplemental oxygen.

B) Patient is wearing a DNR bracelet, is in cardiac arrest, but there is no copy of the DNR in sight so you do not start CPR.

C) On arrival the patient is in cardiac arrest. Nursing home staff gives you an out of hospital NYS DNR with a doctors signature, but the date is not current, so you start CPR on the patient.

D) Patient is in cardiac arrest and has a living will that states the patient wishes not to be resuscitated so you start CPR.

Answer 43

C) On arrival the patient is in cardiac arrest. Nursing home staff gives you an out of hospital NYS DNR with a doctors signature, but the date is not current, so you start CPR on the patient. (INCORRECT)

(CFRD 2, 6.2.1)

• DNR order NEED NOT HAVE a current date.

Question 44

Lt. Crocker and the crew of E-3 go 10-84 at EMS box 2376 for a male down o the corner. NYPD ESU EMTs have already initiated patient care. Lt. Crocker ascertains fro ESU if they need assistance from his CFRD unit, with ESU stating that they do not. Listed below are the actions taken by Lt. Crocker and his crew, with which one being wrong?

A) Lt. Crocker entered 10-91 and went 10-8 via MDT and left the scene.

B) E-3 Nozzle is an active paramedic for Jamaica Hospital EMS, therefore he took over as the higher level of certification on scene.

C) As E-3 didn’t perform any patient care, a PCR was not completed.

D) Lt. Crocker entered a 10-91 and went 10-8 on the MDT and remained on scene to observe.

Answer 44

B) E-3 Nozzle is an active paramedic for Jamaica Hospital EMS, therefore he took over as the higher level of certification on scene. (INCORRECT)

(CFRD 2, 4.13)

• Members shall operate solely upon their department certification level
• PCR not required when a CFRD company is 10-84 at any CFRD
  assignment unless patient care is provided.
• A unit going 10-8 can leave or remain on scene to observe

Question 45

Of the points listed below regarding legal guidelines from the state health departments policy for providing pre-hospital care to minors and responding to DNR orders, which point would you know not to be correctly written?

A) When a minor is found to be suffering from a life threatening injury or illness, immediate medical intervention must be provided regardless of whether the parent is available or refuses to give consent.

B) When a CFRD unit suspects child abuse, the circumstances of the suspected abuse shall be reported to the NYPD on scene.

C) If a CFRD unit is presented with a signed NYS DOH DNR order, the unit shall follow it unless it has been revoked verbally or in writing.

D) A nursing home does not have to utilize the NYS out of hospital DNR form.

Answer 45

B) When a CFRD unit suspects child abuse, the circumstances of the suspected abuse shall be reported to the NYPD on scene.

(CFRD 2, 6.1.1)

• Report child abuse to EMS PERSONNEL on scene and take a mark in
  the company journal upon return to quarters including the names of
  those notified and their unit designation.

Question 46

Documentation and record keeping is an important aspect of an FDNY unit responding to or operating at a CFRD incident. Listed below you will find 4 statements regarding documentation pertaining to the PCR that FDNY units utilize everyday in the field. Which is the incorrect statement?

A) A PCR is not required when a CFRD company is on scene (10-84) at any CFRD assignment unless patient care is provided.

B) The CFRD company officer is responsible for the accuracy, completeness and legibility of the PCR and shall assign a CFRD certified member to complete the PCR.

C) Circle the name of the member providing patient care on the PCR.

D) At any scene not requiring a PCR or a NYFIRS report, the company officer has the option of completing an unusual occurrence report.

Answer 46

C) Circle the name of the member providing patient care on the PCR (INCORRECT)

(CFRD 5, 4.19)

• Circle the name of the MEMBER COMPLETING THE PCR.

Question 47

Regarding decontamination procedures, a company officer should be aware of all of the following except?

A) The company officer will determine if the minor cleaning (decontamination) procedure can be used on the items in question.

B) Equipment and clothing with minor contamination of blood or other body fluids should be spot cleaned as soon as practical using a mixture of one part bleach to 99 parts water.

C) The member preparing the disinfection mixture should empty the packet of bleach into the container first, and then fill it with water.

D) The use of stronger (more than 99 to 1) mixtures has no advantage in killing bacteria and viruses and may deteriorate equipment.

E) Mixtures remaining at the end of a tour should be disposed of in the slop sink. Officers shall ensure that a new solution is prepared each tour.

Answer 47

E) Mixtures remaining at the end of a tour should be disposed of in the slop sink. Officers shall ensure that a new solution is prepared each tour. (INCORRECT)

(CFRD 3, 15.2)

• Mixtures remaining after a TWENTY FOUR (24) HOUR PERIOD should
  be disposed of in the slop sink.

Question 48

All of the following items may be completely immersed in the decontamination mixture in the slop sink except?

A) Boots

B) Helmet

C) Motorola portable radios / Handie Talkies

D) Non Motorola portable radios / Handie Talkies

Answer 48

D) Non Motorola portable radios / Handie Talkies (INCORRECT)

(CFRD 3, 15.3.7)

• These are NOT deconned in quarters.
  Double clear bag them for SOC.

Question 49

If a firefighters work duty uniform or firefighting PPE becomes contaminated with large amounts of bodily fluids, it would be incorrect to think?

A) SOC should be notified for the need for temporary replacement equipment.

B) All items requiring decon should be bagged in double red bags.

C) The bagged items shall be placed on the apparatus in an appropriate location to preserve the bag integrity and transported to quarters.

D) The bagged items, marked with the members name, assigned unit, and type of contaminant, shall be placed in a light traffic location on the apparatus floor pending collection by SOC.

Answer 49

B) All items requiring decon should be bagged in double red bags. (INCORRECT)

(CFRD 3, 15.7)

• DOUBLE CLEAR BAGS.

Question 50

Regarding the storage and use of bleach, it would be incorrect to state that?

A) Bleach shall not be mixed with hydrogen peroxide, ammonia, or any other cleansing agent.

B) Members over exposed to bleach should be moved to fresh air.

C) Members who have made contact with bleach shall immediately flush their skin or eyes with running water for at least 5 minutes.

D) BHS or the Medical Officer on emergency duty should be notified by the Officer on duty when bleach overexposure occurs.

Answer 50

C) Members who have made contact with bleach shall immediately flush their skin or eyes with running water for at least 5 minutes. (INCORRECT)

(CFRD 3, 15.14.1)

• At least FIFTEEN (15) MINUTES.

Question 51

The single most effective method of reducing disease transmission is?

A) Frequent, adequate hand washing

B) Use of masks

C) Getting promoted to lieutenant

D) Transmitting a 10-91

Answer 51

A) Frequent, adequate hand washing.

Question 52

An Engine company lieutenant has just returned from a CFRD incident where patient care was provided to a victim complaining of chest pains. In regard to the pre hospital care report (PCR) the officer would be incorrect if he were to perform which action?

A) Forward part 1 through the bag to the Office of Medical Affairs (OMA) by the end of the tour.

B) File part 2, the Research Copy in a file at quarters.

C) Part 3 was given to the EMS unit operating at the scene

D) If part 3 was not given to EMS, it shall be retained in quarters with part 2.

Answer 52

D) If part 3 was not given to EMS, it shall be retained in quarters with part 2. (INCORRECT)

(CFRD 5, 1.1)

• If not given to EMS, forward part 3 ALONG WITH part 1 through the
  bag to the OFFICE OF MEDICAL AFFAIRS (OMA)

Question 53

During a recent day tour the following CFRD procedures were performed on a patient at an automobile accident by members of E-7. Their esteemed lieutenant was correct when he chose only to document which procedure on the patients PCR?

A) NYPD ESU stabilized the patients neck and spine

B) A private ambulance, EMS certified, administered oxygen

C) Members of E-7 performed defibrillation

D) NYC EMS removed the patient to an ambulance for transport.

Answer 53

C) Members of E-7 performed defibrillation

(CFRD 5, 1.2.2)

• Officer required to ONLY DOCUMENT PATIENT CARE PROVIDED
  BY HIS CFRD UNIT.

Question 54

The officer on duty is responsible for filling out the patients PCR. If the officer is not CFRD certified, only then shall he assign a CFRD certified member to complete the PCR. Do you agree or disagree with this statement?

A) Agree

B) Disagree

Answer 54

B) Disagree

(CFRD 5, 1.2)

• FIREFIGHTER WILL FILL OUT THE PCR.
  Officer is responsible for its accuracy.

Question 55

Members of E-11 have just returned to quarters after utilizing their AED on a patient in cardiac arrest (10-37-2). When the unit returned to quarters, the officer performed the following actions. Which one is not entirely correct?

A) Upon return to quarters the original PCR (part 1) was immediately faxed and forwarded to OMA.

B) A copy of the original PCR (part 1) was turned into the CFRD depot along with the AED module upon completion of assignment.

C) The AED module was exchanged for a blank one. The serial number of the used module was documented on the PCR.

D) The officer of E-11 forwarded the copy of the PCR and the used module directly to OMA.

Answer 55

D) The officer of E-11 forwarded the copy of the PCR and the used module directly to OMA. (INCORRECT)

(CFRD 5, 2.1)

• AED is turned in to the CFRD depot.
  The DEPOT OFFICER will turn the AED over to OMA.

Question 56

The hazardous waste disposal (red bag) policy for CFRD companies is listed below. Which choice is incorrect?

A) CFRD companies shall drop off red bag waste at their CFRD depot.

B) Citywide pickups for red bag waste shall be at CFRD depots

C) CFRD depot officers shall initially contact the Resource Center to have the depots red bags picked up for proper disposal.

D) No tools, masks, or equipment shall be transported in red bags. Red bags are for disposable or infectious waste items only.

Answer 56

C) CFRD depot officers shall initially contact the Resource Center to have the depots red bags picked up for proper disposal. (INCORRECT)

(CFRD 3, 12.16)

• INITIALLY CONTACT SOLID WASTE TECHNOLOGIES.
  If they miss a pickup, then contact the Resource Center.

Question 57

Once on the scene, a CFRD unit must transmit a signal 10-99 in the following instances. Which is the most correct answer?

A) Confirmed cardiac/respiratory arrest (CPR/defibrillation)

B) Any situation where the company will be operating for 20 min or more (vehicle extrication, multiple patients)

C) Any CFRD response where in response to a request for an ETA for EMS from the company on scene, EMS reports a unit has been dispatched.

D) All of the above

Answer 57

A) Confirmed cardiac/respiratory arrest (CPR/defibrillation)

(CFRD 2. 3.19)

B - When units are operating for THIRTY (30) MIN or more

C - When EMS reports NO UNITS AVAILABLE

Question 58

During a study group, a group of lieutenants were discussing CFRD staffing among other things. Which statement made during this study group was incorrect?

A) In order to be in service as a CFRD unit, there shall be a minimum of 2 firefighters and at least 1 officer with current CFRD certification.

B) Fire companies will provide CFRD level care for all patients until the arrival of an EMS u it or other certified ambulance agency, with a higher level provider, and when assistance is no longer needed, will go back in service.

C) Company commanders shall assign CFRD certified members to groups to ensure the greatest likelihood that at least (2) CFRD qualified firefighters will report for duty on any given tour.

D) Company officers of CFRD units shall ensure that (2) CFRD firefighters will be working each tour. Officer shall notify their respective battalion for needed details prior to the start of the tour.

Answer 58

A) In order to be in service as a CFRD unit, there shall be a minimum of 2 firefighters and at least 1 officer with current CFRD certification. (INCORRECT)

(CFRD 2, 1.5)

• In order to be in service as a CFRD unit, there shall be a minimum of
  TWO CFRD TRAINED MEMBERS. This could be one firefighter and
  one officer.
• You must start the tour with at least 2 trained FIREFIGHTERS. If
  during the tour, due to medical leave etc. the company can still be a
  CFRD unit if there is a minimum of one trained firefighter and one
  trained officer.

Question 59

At the start of each tour, the officer shall make out a riding list that includes each members CFRD assignment along wit his or her firefighting assignment and riding position. Which CFRD assign,ent listed below is not entirely correct?

A) The firefighter designated as the “A” Airway firefighter is responsible for manually stabilizing the patients spine (if trauma is suspected) while opening the airway, maintaining the airway, and administering oxygen as needed. This firefighter should carry the oxygen bag.

B) The officer in charge is designated as the “B” Boss. The officer should carry a hand light and portable radio. The Boss is also responsible for completing the PCR.

C) The “C” Checker firefighter is responsible for conducting patient assessment and performing any hands on care. In response to a cardiac arrest, this firefighter checks the pulse and begins compressions and shall carry the trauma bag.

D) The “E” Equipment firefighter should initially remain with the apparatus and held carry any additional equipment needed. This would be the 5th firefighter if a CFRD company is riding with 5 firefighters.

Answer 59

B) The officer in charge is designated as the “B” Boss. The officer should carry a hand light and portable radio. The Boss is also responsible for completing the PCR. (INCORRECT)

(CFRD 2.1)

• “D” Defibrillator firefighter is responsible for completing the PCR.

Question 60

Individuals may identify themselves as patients or may be identified to the company as such by family, friends, or bystanders. Once an individual has been identified as a patient, the company has the duty to evaluate, render the appropriate care, and generate a PCR. An individual is considered a patient if:

1. Individual is sick
2. Individual is injured
3. Individual was exposed to a situation or condition that could have
   the potential to cause injury.

A) 1 & 2 B) 1 & 3 C) 2 & 3 D) None E) All

Answer 60

E) All

CFRD 2, 3.9.1

Question 61

E-99 arrives at the scene of an EMS run and finds a patient who is having difficulty breathing. The members of E-99 should be guided by which choice below?

A) When requesting an ambulance provide the CUPS status, sex, chief complaint, if CPR has been initiated, and the pulse and respiratory rate. Since this patient is potentially unstable, perform the appropriate focused physical exam for the patient.

B) When requesting an ambulance, provide the CUPS status, age,machinery complaint, if CPR has been initiated and the pulse and respiratory rate. Since this patient is unstable, perform the appropriate focused physical exam for the patient.

Answer 61

B) When requesting an ambulance, provide the CUPS status, age,machinery complaint, if CPR has been initiated and the pulse and respiratory rate. Since this patient is unstable, perform the appropriate focused physical exam for the patient.

(CFRD 2, 3.13)

“CHRIS AND CHARLIE CAN PLAY RUGBY”

1. CUPS status
2. Age
3. CPR initiated
4. Chief complaint
5. Pulse
6. Respiratory rate

Question 62

E-99 has just operated at a CFRD run where a patient had a broken ankle after getting hit by a car. The patient was put on a backboard, a cervical collar was placed on the patient and dressings were used to cover lacerations on the patients leg. None of the firefighters, their PPE, or their equipment was contaminated at this incident. The firefighters will have to restock the equipment that was left with the patient and the supplies that were expended. In this situation, the officer of E-99 would be correct to?

A) Place E-99 out of service for both fire duty and CFRD runs.

B) Stay in service for both fire and CFRD runs but immediately return to quarters to replace equipment and supplies.

C) Notify administrative BC and be guided by his instructions.

D) Go back in service for fire duty but advise the dispatcher and the Battalion that E-99 is not available for CFRD responses.

Answer 62

D) Go back in service for fire duty but advise the dispatcher and the Battalion that E-99 is not available for CFRD responses.

(CFRD 2, 3.16.1)

• Go out of service for fire duty and EMS runs ONLY IF DECON IS
  REQUIRED.

Question 63

E-100 is responding to an EMS run for a report of a child who is choking. As they are responding they are flagged down by a group of people who are standing around an elderly male who appears to be unconscious and is lying on the ground. One of the civilians states that they think the elderly man had a heart attack. In this situation, the officer of E-100 would be correct to?

A) Continue to the original run since it is for a choking victim but immediately notify the dispatcher of the second incident so that appropriate resources are dispatched.

B) Make every attempt to make patient contact with the unconscious elderly male and notify the dispatcher. If contact is made with the 2nd patient, the company shall not leave the scene until relieved by EMS.

Answer 63

B) Make every attempt to make patient contact with the unconscious elderly male and notify the dispatcher. If contact is made with the 2nd patient, the company shall not leave the scene until relieved by EMS.

(CFRD 2, 3.18)

Question 64

If a patient’s whereabouts are unknown, the responding company will make every effort to ascertain the location of said individual. If after a complete search of the area in question, no patient is found, there is a procedure that should be followed. Listed below are the three steps of this procedure. Which is the correct order for these steps?

1. If after rechecking the information provided, no patient is found, the
   officer in charge shall verify the information with the dispatcher.
2. After re-verification of the dispatch information, the responding
   company shall attempt to contact neighbors, building
   superintendent, and/or security personnel.
3. The officer in charge shall review the response printout for additional
   information as to incident location, cross street, dwelling or unit
   number, and any other pertinent information provided by EMD or 911
   comment section of the printout.

A) 1, 2, 3 B) 2, 1, 3 C) 3, 2, 1 D) 3, 1, 2

Answer 64

D) 3, 1, 2

(CFRD 2, 4.7)

1. The officer in charge shall review the response printout for additional
   information as to incident location, cross street, dwelling or unit
   number, and any other pertinent information provided by EMD or 911
   comment section of the printout.
2. If after rechecking the information provided, no patient is found, the
   officer in charge shall verify the information with the dispatcher.
3. After re-verification of the dispatch information, the responding
   company shall attempt to contact neighbors, building
   superintendent, and/or security personnel

Question 65

Lt. Smith made the following for points during company drill on the topic of CFRD. Which is the only correct point?

A) If a patient is exhibiting altered mental status or appearing to be an emotionally disturbed person (EDP) declines to accept treatment, the officer in charge should request police assistance and remain on the scene until the police arrive.

B) When a patient refuses medical aid, a PCR must be completed. If a patient insists on leaving the scene, the officer in charge shall notify the dispatcher and the unit shall go back in service after the patient has left.

C) If after arrival at the scene of an EMS run where a patient has rigor mortis, obvious death, dependent lividity, decomposition, or a valid DNR order, a PCR will not be required.

D) Once on the scene a CFRD unit must transmit a signal 10-99 when the company officer determines that the company will likely remain on the scene for 20 min or more.

Answer 65

B) When a patient refuses medical aid, a PCR must be completed. If a patient insists on leaving the scene, the officer in charge shall notify the dispatcher and the unit shall go back in service after the patient has left.

(CFRD 2, 4.10)

A - Officer requests police for EDP and remain on scene until arrival of
EMS. (Not police)

B - Correct

C - PCR IS REQUIRED FOR DOAs.

D - 10-99 when units will be operating for more than THIRTY (30) min.

Question 66

E-99 is operating at an EMS run for a person who is having chest pains. After operating for approximately 5 minutes, an NYPD ESU unit arrives on scene. The ESU cops are both EMTs and state that they wish to take over patient care. The officer of E-99 would be correct to take which action below?

A) Do not release the patient to the ESU cops under any circumstances.

B) Only release the patient to the ESU cops if an FDNY EMS supervisor gives approval.

C) Release the patient to the ESU cops if the ESU cops have a SAED (semi-automatic external defibrillator).

D) Release the patient to ESU in all cases as they are trained to a higher level of care.

Answer 66

C) Release the patient to the ESU cops if the ESU cops have a SAED (semi-automatic external defibrillator)

(CFRD 2, 4.13)

• ESU has higher level training that a CFRD unit.
  You can release patient care to them ONLY if they have a defibrillator.

Question 67

According to the CFRD manual the only vehicle used to transport patients shall be NYS-certified ambulances.

A) Agree

B) Disagree

Answer 67

A) Agree

CFRD 2, 11.3.34

Question 68

When operating at incidents where minors are involved there have been situations where the parents of minors have refused to give permission to firefighters to treat the minor. All of the following choices are correct except which one regarding the treatment of minors at CFRD incidents?

A) Where a minor is found to be suffering from a life threatening illness or injury, immediate medical intervention must be provided, regardless of whether the parent/guardian is available or refuses to give treatment.

B) If a parent/guardian refuses to give permission for medical treatment for their minors, treatment should nonetheless be provided whenever the minor is suffering from a life threatening injury or illness and it is apparent that a delay in treatment, even if minimal, would jeopardize the minors life.

C) When a CFRD unit suspects child abuse, the circumstances of the suspected abuse shall be reported to the police department. The officer in charge shall make an entry in the company journal upon return to quarters including the names of the police officers notified.

D) If an illness/injury is non urgent in nature, treatment should still be provided to a minor unless the parent/guardian refuses to allow treatment. If permission to treat the minor is not given by the parent/guardian, members should carefully explain the reasons for treatment, notify the dispatcher and have the, notify EMS, and call FDNY EMS telemetry.

Answer 68

C) When a CFRD unit suspects child abuse, the circumstances of the suspected abuse shall be reported to the police department. The officer in charge shall make an entry in the company journal upon return to quarters including the names of the police officers notified. (INCORRECT)

(CFRD 2, 6.1.1)

• Child abuse = report to EMS and make an entry in the company
  journal including names of the EMS PERSONNEL AND
  THEIR UNIT.

Question 69

Do not resuscitate orders are described by the NYS DOH in the pre-hospital setting as an individual’s right to decline any or all life saving measures to be implemented to sustain life when all respiratory or cardiac activity ceases. Which choice below is the only incorrect point regarding DNRs?

A) A DNR order is only an order not to perform cardio-pulmonary resuscitation (compressions and artificial ventilation for a patient in cardiac arrest)

B) A DNR order is not a reason to withhold other treatments, such as supplemental oxygen.

C) If a signed order is presented, the CFRD unit should follow it unless it has been revoked in writing only.

D) The order must be a copy of the NYS Out Of Hospital DNR form. The attending physician must sign and date the form.

Answer 69

C) If a signed order is presented, the CFRD unit should follow it unless it has been revoked in writing only. (INCORRECT)

(CFRD 2, 6.2.1)

• Signed order should be followed unless it has been revoked in writing
  or VERBALLY.

Question 70

DNRs issued by nursing homes do not have to be on a specific form and each facility may have their own variation. A nursing home does not have to utilize the NYS Out Of Hospital DNR form. If presented with a DNR form from a nursing home facility, members should know that the minimum requirement is?

A) Current date of issuance

B) Patients signature

C) Nursing home facilities official seal

D) Physicians signature

Answer 70

D) Physicians signature

CFRD 2, 6.2.3

Question 71

E-99 and L-100 are operating at an auto accident where 3 cars are involved on a quiet residential street in Staten Island. Lieutenant Hernandez is working in E-99 and Captain Carter is working in L-100. There is no BC assigned to this box since it is not a highway incident. EMS Deputy Chief Orasco who is an EMT Lieutenant is also on the scene along with one FDNY BLS Ambulance (EMTs) and one ALS Ambulance (paramedics) from a volunteer ambulance corp. in the neighborhood. At this incident ______________ is/are in charge of all patient care matters and _____________ is the IC.

A) DC Orasco / DC Orasco

B) The Paramedics / Lt. Hernandez

C) The FDNY EMTs / Captain Carter

D) The paramedics / Captain Carter

Answer 71

D) The paramedics / Captain Carter

(CFRD 2, 8.2)

• Fire officer is guided by the highest level of pre-hospital care medical
  provider on scene (the paramedics in this situation)
• Whenever units of the Bureau of Fire Operations and the Emergency
  Medical Service are operating at an incident, the RANKING FIRE
  OFFICER ON SCENE IS THE INCIDENT COMMANDER.

Question 72

Members shall comply with all orders and directions of the IC concerning the safety of operating personnel. However, a pre-hospital care provider receiving an order believed to be detrimental to the patients condition, contrary to good patient care, or in violation of medical protocols or agency policy shall inform the IC of such and continue providing appropriate patient care. If the IC persists in giving such orders, the pre-hospital care provider is required to prepare a report and forward, through the appropriate channels, a written statement to?

A) Office of Medical Affairs

B) The Chief of EMS

C) The Division Commander

D) The Chief Of Operations

Answer 72

A) Office of Medical Affairs

CFRD 2, 8.7