CFRD MANUAL Flashcards
E96 arrives at a CFRD response where they find a 64 year old male in a doctor’s office who is lying on the floor and not breathing. A PA is currently performing ventilation on the patient but the patient’s wife presents members with a valid DNR Order. In this situation the members would be most correct to?
A) Advise the PA to continue resuscitation because once CPR has begun it must be continued.
B) Be aware that a doctor may direct that the DNR Order be disregarded.
C) If confrontation appears likely, request the response of an OLMC Physician
D) If a foreign body is causing choking, make no attempt to remove the foreign object and if breathing has stopped, do not assist in ventilation.
ANSWER: B) Be aware that a doctor may direct that the DNR Order be disregarded.
A - CPR may be discontinued if presented with valid DNR.
C - Request EMS OFFICER and CALL OLMC
D - Relief of choking by removing a foreign body IS APPROPRIATE, but if breathing has stopped, ventilation shall NOT be assisted.
(CFRD Manual 2 - Addendum 1)
Engine 298 arrives at a CFRD response for an 88 year old male in cardiac arrest. On arrival, they are told by a family member that the patient has an official DNR order. In this situation, it would be correct to think which of the following?
A) An out of hospital DNR is valid in NY State only if it is recorded on a NYS Department of Health form and has NOT expired. These forms must be updated every 90 days.
B) A DNR bracelet with a caduceus and the words “Do Not Resuscitate” is considered a valid DNR order, even if a written order is not located. It shall be assumed that a valid written DNR order exists.
C) A MOLST form that has a DNR order written within the document is not acceptable in the pre-hospital care setting.
D) A hospital or nursing home DNRs remain valid even if the patient has been moved to a different hospital or nursing home than which the form was issued from.
ANSWER: B) A DNR bracelet with a caduceus and the words “Do Not Resuscitate” is considered a valid DNR order, even if a written order is not located. It shall be assumed that a valid written DNR order exists.
A - Out of Hospital = CAN EXPIRE (Still good)
C - MOLST IS ACCEPTABLE in pre-hospital care setting
D - NOT VALID if patient is MOVED / Date must be current
(CFRD 2 - Addendum 1 3.2)
Completing a PCR is an important responsibility when responding to CFR runs. Which choice below is a response where the officer DOES NOT have to complete a Patient Care Report?
A) Engine 1 arrives at an EMS run, makes their way into the apartment and discovers an individual displaying signs of rigor-mortis.
B) Engine 2 arrives at an EMS run simultaneously with a BLS unit and makes their way into the apartment to verify the presence of a patient.
C) Engine 3 arrives at an EMS run near the corner bodega and discovers an uncooperative, intoxicated male who eventually leaves the scene.
D) Engine 4 arrives at an EMS run, attempts to assess an EDP displaying altered mental status who refuses medical aid.
ANSWER: B) Engine 2 arrives at an EMS run simultaneously with a BLS unit and makes their way into the apartment to verify the presence of a patient. (DOES NOT HAVE TO COMPLETE A PCR)
(CFR-D MANUAL CHAPTER 2)
A – Yes - They CFR unit must complete a PCR even if the patient is DOA to document that the company properly examined the patient to confirm that the patient exhibited the criteria for obvious death. (4.4)
B – No – A PCR is NOT REQUIRED when a CFR company is on scene at any assignment unless patient care is provided.
C – Yes – When a patient refuses medical aid, a PCR must be completed (4.9.1)
D – Yes– Request PD assistance and remain on scene until the arrival of EMS. Complete a PCR report
During which of the following scenarios is the Engine Company operating within department guidelines while on CFR-D responses?
A) ESU is operating at a pedestrian struck when Engine 1 arrives at the location. After a brief exchange, no assistance is needed from the company, so the officer enters 10-91 and goes 10-8 prior to the arrival of EMS.
B) ESU is operating at a man-under when Engine 2 arrives at the location. After a brief exchange, assistance is required so the Engine officer assumes medical authority until the arrival of EMS.
C) ESU arrives at a car accident after the arrival of Engine 3. After a brief exchange, the ESU EMT’s insist on assuming patient care. The Engine Officer refuses and retains medical authority until the arrival of EMS.
D) ESU arrives at the scene of a Cardiac Arrest after the arrival of Engine 4 and despite not having a SAED, insists on assuming patient care. The Engine officer agrees and turns over patient care to the ESU EMT’s prior to the arrival of EMS.
ANSWER: A) ESU is operating at a pedestrian struck when Engine 1 arrives at the location. After a brief exchange, no assistance is needed from the company, so the officer enters 10-91 and goes 10-8 prior to the arrival of EMS.
(CFRD CHAPTER 2)
B – If assistance is required, ESU EMT’s shall have medical authority at the scene until the arrival of an ambulance.
C – If the ESU EMT’s assumes the role of higher level pre-hospital care provider and assumes responsibility for patient care, the company shall release the patient to ESU.
D – If ESU is NOT equipped with a SAED, the CFRD unit shall retain patient care responsibilities as per the regional coordination of Pre-hospital resources protocols.
You are a covering Lt. on duty and firefighter Moss walks into the office looking to withdraw from the CFRD program. He is a 19-year veteran of the department. You quickly look up his eligibility and the criteria to withdraw and make the following statements. Which one is CORRECT?
A) He is a first-grade firefighter appointed in 2000 and can therefore opt out.
B) There are 20 firefighters assigned to the company (including 4 on long term medical leave and 4 others on long term light duty) and can therefore opt out.
C) His certification expires in 60 days, in time to submit a written request to the Chief of Operations and can therefore opt out.
D) He has to notify a regularly assigned officer of his intentions to withdraw.
ANSWER: A) He is a first-grade firefighter appointed in 2000 and can therefore opt out.
(CFR-D CHAPTER 1)
B – FOURTEEN 14 or more CFR-D qualified firefighters not including members who do not have full duty status
C – Forwards a written request to the Chief of Operations at least NINETY (90) days prior to the expiration of his or her CFR-D certification.
D – Has to notify the COMPANY COMMANDER
All CFR-D equipment shall be inspected during Roll Call. Which of the following statements is correct concerning CFR-D equipment?
A) CFR-D companies shall not keep suction units on a constant charge as this will deplete the life of the battery
B) A Defibrillator that displays a flashing green hourglass in the upper right hand corner is operational and ready for use
C) A Defibrillator that displays a flashing or solid red X and/or emits a chirping sound indicates that the defibrillator is not ready for use and should be exchanged at the CFR-D Depot
D) Expired pads are not to be used. Officers on duty in any unit with expired electrodes (Pads) shall notify Tech Services for replacement
ANSWER: C) A Defibrillator that displays a flashing or solid red X and/or emits a chirping sound indicates that the defibrillator is not ready for use and should be exchanged at the CFR-D Depot
(CFR-D Manual ch 4 - 1.9.1)
- Flashing or solid RED X = no good
A - Keep suction units on CONSTANT CHARGE through a connection to the apparatus electrical system
B - Flashing BLACK hourglass = ready for use
D - Any expired pads are to be exchanged at the CFR-D DEPOT. Depot Officers shall notify Tech Services for replacement.
Members operating on CRF-D runs should protect themselves by using proper BSI. Which of the following bodily fluids is considered to be potentially infectious for bloodborne pathogens?
A) Semen
B) Nasal secretions
C) Feces
D) Vomit
ANSWER: A) Semen
(CFR_D Manual Ch 3 Infection control program 7.2, 7.3)
- The following bodily fluids are not considered at risk of transmitting bloodborne diseases unless contaminated with blood; however they do transmit other diseases and should be avoided saliva, nasal secretions, urine, sweat, feces, tears, vomit
Engine 98 responded to a CFR run where CPR had to be performed. Which action taken by the officer at the conclusion of the run was CORRECT?
A) No shocks were indicated by the AED after application so it was not necessary for the company to exchange the AED module.
B) The original PCR (part 1) was turned in to the CFR depot along with the AED module upon completion of the assignment.
C) The AED was not applied during the cardiac arrest so the details of what prevented the application were indicated in the comments section of the PCR.
D) The AED was not applied so the officer immediately faxed and forwarded part 1 of the PCR to OMA upon return to quarters.
C) The AED was not applied during the cardiac arrest so the details of what prevented the application were indicated in the comments section of the PCR.
(CFRD – CHAPTER 5 – DOCUMENTATION 2.1.3)
A – The AED will be exchanged for a blank one and the CFR depot will immediately forward the module and PCR copy directly to OMA. (2.1.2)
B – A COPY of the original PCR turned into CFR Depot along with the AED (2.1.1)
D – When the company APPLIES AND TURNS ON THEIR AED during a cardiac arrest resuscitation attempt, the original shall be immediately faxed and forwarded to OMA upon return to quarters. (2.1)
Engine 99 responded to a CFRD run. On board were two trained firefighters, an untrained ECC and untrained officer. Which action taken at the scene of the medical emergency was INCORRECT?
A) Because they were short certified members, the Officer had an uncertified member complete the PCR.
B) A verbal report was made to the EMS Crew upon their arrival including the patient assessment, vital signs and patient care provided.
C) The response involved a car accident so the officer also completed a NYFIRS report.
D) Part 3 of the completed PCR was given to the EMS crew prior to the company leaving the scene.
ANSWER: A) Because they were short certified members, the Officer had an uncertified member complete the PCR. (INCORRECT)
(CFRD – DOCUMENTATION CHAPTER 5 1.3)
- A CFRD certified member shall be assigned to complete the PCR.
C – In addition to completing a PCR, all appropriate NYFIRS reports shall be completed
D – Part 3 of the PCR should be given to the EMS crew.
Upon arrival at a CFR response, you find an unresponsive young man exhibiting symptoms of possible fentanyl exposure. In addition, at the victim’s location there are signs of possible fentanyl use. You would be correct to take all of the following actions except?
A) Ensure members utilize appropriate PPE to avoid dermal contact, inhalation and ingestion of the suspect substance. If possible, these members should don their appropriate PPE prior to, or immediately after, initiating medical treatment.
B) Treatment should never take place in the area of suspected exposure. Removal of the patient from the area and removal of product from the patient’s skin and clothing is paramount.
C) Do not eat, drink, smoke, or use the bathroom while working in an area with known or suspected fentanyl.
D) Do not touch the eyes, mouth, and nose after touching any surface potentially contaminated with fentanyl.
ANSWER: A) Ensure members utilize appropriate PPE to avoid dermal contact, inhalation and ingestion of the suspect substance. If possible, these members should don their appropriate PPE prior to, or immediately after, initiating medical treatment. (INCORRECT)
(HM 18 1-2.2, 4)
- Ensure members utilize appropriate PPE to avoid dermal contact, inhalation and ingestion of the suspect substance.
- Members shall ALWAYS don appropriate PPE PRIOR TO initiating any medical treatment.
Engine Officers are often presented with situations on CFRD runs where a decision has to made regarding administering CPR or withholding it based on paperwork presented by family members. If valid, which is the only document that would prevent members from performing CPR on a pre-hospitalized patient in Cardiac Arrest?
A) Health Care Proxy
B) Living Will
C) Power of Attorney
D) Out of Hospital DNR Order
ANSWER: D) Out of Hospital DNR Order
(CFRD CHAPTER 2 ADDENDUM 1 3.6)
- A, B, C are NOT recognized in the pre-hospital environment. (3.6, 3.7, 3.8)
D – Correct – Out of Hospital DNR’s are valid even if they have not been updated (every 90 days). They do not expire. Must be recorded on a NYS DOH standard form (DOH-3474).
In the era of mass shootings and Emergency Response Groups, Hemostatic agent dressings for hemorrhage control are an important new addition to our CFR equipment. While discussing accountability at roll call, the senior firefighter made the following statements. Which is the only one that was CORRECT?
A) Restock is on a one for one exchange basis.
B) Each company will carry 6 dressings.
C) Engine, Ladder, and Squad Companies carry the dressings.
D) When depot restock is necessary, company officers shall request the restock directly from tech services.
ANSWER: A) Restock is on a one for one exchange basis
(CFRD – CHAPTER 4 ADDENDUM 2 5.1)
B – Each Engine and Squad will carry FIVE (5) dressings.
C – ENGINE and SQUAD companies carry the dressings
D – Requests are made via EMAIL to the Pharmacy
Paperwork is reviewing a completed PCR prior to submission and made the following observations. Which action taken next to correct the errors was CORRECT?
A) A written error was observed. It was corrected by placing a single line through the incorrect entry and writing in the correction directly above it.
B) A wrong bubble was filled in. It was corrected by placing an X through it and fully darkening in the correct bubble.
C) The time recorded on the PCR was 1430 hrs. It was corrected to read 2:30 PM. Time is not expressed in Military time.
D) Errors are not permitted on the legal document. The officer discarded the form and completed another one.
ANSWER: A) A written error was observed. It was corrected by placing a single line through the incorrect entry and writing in the correction directly above it.
(CFRD CHAPTER 5 – DOCUMENTATION 3.4)
A – Single line through the words to be corrected/omitted and write the accurate information above the word to be corrected.
B – Single line through the error and fill in the correct action.
C – All times recorded on the PCR are in MILITARY TIME.
D – Not Stated - Errors are to be corrected as instructed in section
Which of the following is INCORRECT regarding MCI Bags?
A) All units have been issued MCI Bags.
B) MCI bags shall only be used when the highest-ranking officer operating at an MCI determines the number of patients requiring hemorrhage control exceeds the standard hemorrhage control equipment available on the responding units.
C) Once the bag has been opened, the officer must contact the dispatcher for an immediate notification to the OMA on-call medical director.
D) Any company that does not have an MCI Bag will be placed out of service until a replacement is procured.
ANSWER: D) Any company that does not have an MCI Bag will be placed out of service until a replacement is procured. (INCORRECT)
(CFRD CHAPTER 4 ADDENDUM 1 - 3.2)
- Units DO NOT require an MCI bag to be in service.
Documentation is one of the most important aspects of a CFRD response. Which of the following choices represents the CORRECT handling of a PCR following a CFRD response?
A) In all cases, the proper page(s) of the form must be forwarded through the bag by the end of the tour.
B) Part three of the form is the Research copy and is forwarded to the Office of Medical Affairs.
C) Part two of the form is the Hospital Patient Record Copy and is to be given to the patient prior to transporting.
D) Part One of the form is the Original and is to be retained at Quarters and must be secured by the company officer in the company files at all times.
ANSWER: A) In all cases, the proper page(s) of the form must be forwarded through the bag by the end of the tour.
(CFRD CHAPTER 5 – DOCUMENTATION 1.1.3)
A – Must be forwarded through bag by the end of the tour.
B – Part 3 is the Hospital Patient Record Copy which is given to the EMS UNIT operating at the scene.
C – Part 2 is the Research Copy retained at Quarters.
D – Part 1 is the original and is to be forwarded to the Office of Medical Affairs through the bag.
Which member of a CFR-D Engine company is responsible for completing the Pre-Hospital Care Report (PCR)?
A) The FF responsible for ventilation during CPR
B) The FF responsible for compressions during CPR
C) The Officer
D) The FF responsible for operating the Defibrillator during CPR.
ANSWER: D) The FF responsible for operating the Defibrillator during CPR.
(CFRD - Chapter 2 - 2.1.4)
- The “D” FF is responsible for Defib and Documentation
Which of the following actions taken by the officer was MOST CORRECT?
A) The officer notified the dispatcher they were out of service and again at the change of tours when they were in service for CFR runs.
B) The officer notified the Battalion they were out of service for CFR runs.
C) The officer notified the Division they were out of service for CFR runs.
D) The officer entered the event in the company and office record journals.
ANSWER: B) The officer notified the Battalion they were out of service for CFR runs.
(CFR CHAPTER 2 1.8)
A – At 0900 and 1800, unit status defaults to normal CFR status
C – Companies only notify the Division when they are completely out of service. (REGS CH 30)
D – The event is ONLY entered in the company journal.
You are the new Lt. on duty and following roll call, several members come into the office to ask you questions about the CFR training policy. Which of the following statements below is CORRECT?
A) Full and Light Duty firefighters and officers are permitted to attend the CFR Cycle or the CFR refresher course.
B) Firefighters and officers are allowed to use Self-mutuals to attend the training.
C) Members unable to attend a weekly session will be dropped from the program and must return during the next cycle.
D) Members who successfully opt out of the program will be given one opportunity to reinstate by attending a refresher course.
ANSWER: C) Members unable to attend a weekly session will be dropped from the program and must return during the next cycle.
(CFR-D CHAPTER 1 - 4.1.5 C)
A – ONLY Full Duty members shall attend the CFRD cycle or refresher.
B – Self mutual are NOT allowed except for covering officers.
D – Members who opt out shall NOT be permitted to participate in the program in the future.
Engine 99 just got flagged down for a CFRD run and needs to request an ambulance. The officer reports a 55-year old female who is complaining of chest pain with a pulse rate of 80 and respiratory rate of 20. Which piece of information relayed to the dispatcher is unnecessary (INCORRECT)?
A) Chief Complaint
B) Sex
C) Pulse and Respiratory rate
D) Age
ANSWER: B) Sex (INCORRECT)
(CFRD CHAPTER 2)
- Sex is not required when requesting an ambulance – Chief Complaint, CUPS status, CPR Initiated, Age, Pulse and Respiratory rate.
“Chris and Charlie Can Play Rugby” (Info to dispatcher)
C - CUPS status
A - Age
C - Chief complaint
C - CPR initiated
P - Pulse
R - Respiratory rate
Engine 199 responds to an EMS run where they discover a child suffering from non life-threatening injuries as a result of suspected child abuse. The parents refuse to allow the company to provide medical care to the minor. Which of the following actions taken next is CORRECT?
A) The officer had the ECC notify the dispatcher to have the fire marshals respond because they suspected child abuse.
B) The officer had the members treat the minor despite the parents’ objections.
C) A phone was available, so the officer contacted FDNY/EMS telemetry directly and implemented their recommendations (if any) while awaiting EMS arrival.
D) Patient care was not provided, but because child abuse was suspected, the officer had a PCR completed for EMS upon their arrival.
ANSWER: C) A phone was available, so the officer contacted FDNY/EMS telemetry directly and implemented their recommendations (if any) while awaiting EMS arrival.
(CFRD – CHAPTER 2 SECTION 6)
A – As required under New York State Social Services’ Law, if there is a reasonable cause to suspect that a child has suffered, or will suffer, abuse of maltreatment as a result of the acts or omissions of a child’s parent or guardian, members are mandated to file a report. To facilitate this report, immediately request the response of the Police Department, an FDNY EMS supervisor, and an ambulance through the dispatcher. The ambulance crew will be responsible for filing the mandated report.
B – Care must be provided for LIFE THREATENING injury or illness.
D – A PCR is NOT required when a CFRD unit is on scene at any assignment unless patient care is provided.
CFRD assignments/designations shall be handed out at roll call. If the nozzle firefighter is the Airway, the Officer the Boss, the back-up the Checker, & the Control firefighter operates the Defibrillator, which member is responsible for completing the PCR?
A) Officer
B) Nozzle
C) Back-up
D) Control
ANSWER: D) Control
(CFRD CHAPTER 2)
- Defib/Documentor is responsible for completing PCR
The Department-issued Prehospital Care Report (PCR) is a three-part form and contains protected health information, which by law is confidential. Which of the following is an inaccurate statement in regard to documentation and recordkeeping of a Prehospital Care Report?
A) Receiving a patient history from the patient is considered contact and a PCR is required
B) Part One, the original, is to be forwarded to the Office of Medical Affairs through the bag by the end of each tour
C) Part two is the Research Copy and is to be retained at Quarters and must be secured by the Company Officer in the Company files at all times
D) Part Three is the Hospital Patient Record Copy and if completed, is be given to the EMS Unit operating at the scene. If Part Three is not given to the EMS Unit, it shall be secured at Quarters with part Two in the Company files.
ANSWER: D) Part Three is the Hospital Patient Record Copy and if completed, is be given to the EMS Unit operating at the scene. If Part Three is not given to the EMS Unit, it shall be secured at Quarters with part Two in the Company files. (INCORRECT)
(CFR-D Manual Chapter 5 Documentation)
- If Part Three is not given to the EMS Unit, it shall be forwarded with the original to OMA.
When requesting an ambulance, Companies MUST provide all of the following information to the dispatcher for relay to EMD with the exception of ______.
A) CUPS status
B) Sex
C) Chief complaint
D) Pulse AND respiratory rate
ANSWER: B) Sex (INCORRECT)
(CFR-D Manual Chapter 2 sec 3.11.2)
- Sex is not required when requesting an ambulance – Chief Complaint, CUPS status, CPR Initiated, Age, Pulse and Respiratory rate.
“Chris and Charlie Can Play Rugby” (Info to dispatcher)
C - CUPS status
A - Age
C - Chief complaint
C - CPR initiated
P - Pulse
R - Respiratory rate
If unable to obtain a male patient’s name on a CFR run, the correct description of the patient shall be written on the PCR as follows ________.
A) John Doe
B) Unknown Male
C) FDNY Bus designation (ex- 46B)
D) Leave the name section blank
ANSWER: B) Unknown Male
(CFR ch 5 sec 4.4.1 B)
- If unable to obtain a name, a description of the patient’s gender preceded by ‘Unknown’ shall be written in these boxes (e.g., Unknown Male). This area shall never be left blank and ‘JANE/JOHN DOE’ shall NOT be used.
CFR-D Units must begin each tour with __ certified Firefighters. In the event that during a tour the minimum CFR-D staffing reduces to __ Firefighter(s) and 1 Officer, the Company shall remain available for CFR-D response.
A) 2,1
B) 3,2
C) 3,1
D) 4,2
ANSWER: A) 2,1
CFR Ch 2 sec 1.8 Note
To make corrections on the PCR, members shall place a single line through the word(s) to be omitted or corrected and write the accurate information above the word(s) to be corrected. When correcting a darkened circle, _______________.
A) place a single line through the error and fill in the correct section. The initials of the member making the correction shall be placed above the single line.
B) place a double line through the error and fill in the correct section. The initials of the member making the correction shall be placed above the single line.
C) place a single line through the error and fill in the correct section. Initials next to the error are no longer necessary.
D) place a double line through the error and fill in the correct section. Initials next to the error are no longer necessary.
ANSWER: A) place a single line through the error and fill in the correct section. The initials of the member making the correction shall be placed above the single line.
(CFR Ch 5 sec 3.4)
E248 responds to an EMS run for an unconscious male. Lt Ryan E248 is the Incident Commander. A volunteer ambulance is first on the scene with 2 paramedics followed shortly by FDNY EMS with 2 EMT’s. BC Morris from the local fire battalion stops on scene to deliver the bag and stays until E248 gives the 10-37-3. Who is in charge of patient care at this scene?
A) Volunteer ambulance paramedics
B) FDNY EMT’s
C) Lt Ryan E248
D) BC Morris
ANSWER: A) Volunteer ambulance paramedics
(CFR Ch 2 sec 8.4)
- The ranking Fire Suppression officer shall consult with and be guided by the highest level pre-hospital emergency medical provider at the scene for patient care decisions.
- Don’t confuse this with…
Regardless of which EMS agency first establishes patient contact, FDNY EMS shall be responsible for coordination of pre-hospital resources in situations involving:
- 4.1 Multiple Casualty Incidents (MCIs);
- 4.2 Unscheduled MEDEVAC transports;
- 4.3 Hazardous materials situations requiring decontamination;
- 4.4 Fires/crimes in progress; or
- 4.5 Unusual public health or safety emergencies.
The NYC Department of Health recently issued a health alert for the Measles. Which piece of information below, is inaccurate when considering this viral infection?
A) Individuals are contagious from four days before the onset of rash, through the forth day after the rash appears.
B) Signs and symptoms appear around 10-14 days after exposure to the virus.
C) In cases where measles is a consideration, CFR units shall don respiratory protection in the form of an Air Purifying Respirator (APR).
D) Some of the symptoms of measles include: high fever, white spots in the mouth, and a rash that tends to begin on the face and spreads down the arms and trunk toward the lower extremities.
ANSWER: C) In cases where measles is a consideration, CFR units shall don respiratory protection in the form of an Air Purifying Respirator (APR). (INCORRECT)
(CFR-D Manual, Chapter 6, OMA Dir. 2019-05)
- Don an N95 surgical mask.
- Although donning an APR would protect you, the bulletin says SHALL don N95.
When requesting an ambulance, CFR-D Companies must provide certain information to the dispatcher for relay to EMD. Which of the following is not an example of what should be transmitted?
A) Pulse
B) CUPS Status
C) Age
D) Blood Pressure
ANSWER: D) Blood Pressure (INCORRECT)
(CFR-D Manual Ch 2 sec 3.11)
“Chris And Charlie Can Play Rugby”
C - CUPS Status
A - Age
C - Chief Complaint
C - CPR initiated
P - Pulse
R - Respiratory rate
