CH 11 Scene Size Up

Question 1

Scene Size-Up

Answer 1

Steps taken when approaching the scene of an emergency call: Checking scene safety taking standard precautions, noting the mechanism of injury or nature of the patient’s illness, determining the number of patients and deciding what, if any, additional resources to call for

Question 2

Danger Zone

Answer 2

The area around the wreckage of a vehicle collision or other incident within which special safety precautions should be taken

Question 3

Examples of Danger Zones

Answer 3

Downed Power Lines Vehicles on Fire Hazardous Materials Threatened by Fire Spilled Fuel Hazardous Materials

Question 4

Danger Zone when there are no apparent hazards:

Answer 4

Consider the DZ to extend at least 50’ (15.2M) in all directions from the wreckage). The ambulance needs to be staged away from broken glass and other debris, the ambulance cannot impede emergency service personnel who must work in or around the wreckage. When using flares to protect the scene, make sure the person igniting them has been trained in the proper technique

Question 5

Danger Zone where there has been fuel spilled:

Answer 5

Danger zone extended to minimum of 100’ (30.4M) in all directions from the wreckage and fuel. Park upwind. Note wind direction. You want the ambulance out of the path of dense smoke if fuel ignites. If fuel is flowing away from the wreckage, park uphill as well as upwind from the wreck. Do NOT use flares in areas that fuel has been spilled. Avoid gutters, ditches, and gullies that can carry the fuel towards the ambulance. Use traffic cones during the day and triangles at night.

Question 6

Danger Zone when vehicle is on fire

Answer 6

Danger zone 100’ (30.4M) in all directions even if the fire seems small and limited to engine compartment. If fire does reach the fuel tank, an explosion could easily damage an ambulance parked any closer

Question 7

Danger zone where wires are down

Answer 7

Danger zone the area in which people may be in contact with energized wires if the wires pivot around their points of attachment. Even though you may have to carry equipment and stretchers for a considerable distance, the ambulance should be parked at least one full span of wires away from the poles to which the broken wires are attached

Question 8

Danger zone where hazardous material is involved

Answer 8

The ERG needs to be consulted for stand off distances

Question 9

Mechanism of Injury

Answer 9

A force or forces that may have caused injury

Question 10

Penetrating Trauma

Answer 10

Injury caused by an object that passes through the skin or other body tissues

Question 11

Blunt Force Trauma

Answer 11

Injury caused by a blow that does not penetrate the skin or other body tissues

Question 12

Index of Suspicion

Answer 12

Awareness that there may be injuries

Question 13

Nature of the illness

Answer 13

What is medically wrong with the patient

Question 14

When looking at the Nature of the Illness you can look at:

Answer 14

The patient Family Members or Bystanders The scene To get information on the nature of the illness

Question 15

Nature of Illness - Patient provided

Answer 15

When conscious and oriented, patients will be a prime source of information about their condition throughout the assessment process

Question 16

Nature of Illness - Family members or Bystanders

Answer 16

These are people who can provide you with information especially when dealing with an unconscious patient. Additionally, if the patient is conscious, but their mental status is compromised, these other sources can be put in there in order to be able to piece the information to put a full picture together for your patient

Question 17

Nature of Illness - The scene

Answer 17

As you are sizing up the scene for safety, you can also make notes of other factors that may be clues to the patients condition. You may see medications in the patients room, living conditions that are unsanitary, or dangerous are all things that you are able to make note of in order to give a report on later and be able to give a more clear picture of when you give your patient report

Question 18

Scene Safety Scenario: Which of the following would be be a NEW and UNEXPECTED FACTOR that CHANGED the nature of of the scene following your arrival? 1. Power lines come down as you are providing care to patients 2. You see downed lines as you are driving up to the scene 3. Dispatch warns you to expect downed power lines 4. After you begin transport the power goes out across the neighborhood

Answer 18

1. Power lines come down as you are providing care to patients This would be a new and unexpected factor that CHANGED the nature of the scene and required sizing up. 2. Seeing downed lines as you drive up is part of ARRIVING on the scene, 3. A warning from dispatch prior to entering the scene is PRE-ARRIVAL 4. A power outage after you begin transport occurs after you LEAVE the scene

Question 19

Scene Size up: 1. is ongoing throughout every call 2. ends with arrival on the scene 3. ends with identification of MOI or NOI 4. extends of initial identification of hazards

Answer 19

1. Is ongoing throughout every call Scene size-up is not confined to the first part of the assessment process. These considerations should continue throughout the call, because emergencies are dynamic, always-changing events

Question 20

You arrive on scene and see smoke, approaching onlookers, an overturned vehicle, a broken utility pole, shards of glass on the street, and a fire hydrant. The element that signals nothing hazardous is: 1. the utility pole 2. the smoke 3. the approaching onlookers 4. the fire hydrant

Answer 20

4. the fire hydrant Smoke, approaching onlookers, and a broken utility pole are all signs of potential hazards. A fire hydrant is there to help in emergencies and is not in itself a sign of any hazard or emergency

Question 21

Your ambulance has been dispatched to a multiple-car motor vehicle crash. Dispatch has alerted you that fire and rescue units are enroute. As you approach the scene, you should 1. look and listen for other emergency units approaching from side streets 2. don personal protective equipment 3. remove your seatbelt to allow easy exit of the ambulance 4. review the trauma triage criteria

Answer 21

1. look and listen for other emergency vehicles as you approach the scene 2. Although personal protective equipment and 4. the trauma triage criteria are important, the immediate risk is being struck by an oncoming vehicle. You should always consider safety first 3. You should never remove your seat belt in a moving vehicle

Question 22

You pull up on a MVA. Vehicle vs a utility pole, you notice that there is gasoline leaking from the car. What is another potential hazard that you would expect/need to take into account in this situation? 1. Penetrating trauma 2. Fumes 3. Blunt-force trauma 4. Organ collision

Answer 22

2. Fumes This is another hazard that you should expect/take into consideration as a hazard. During your assessment you may find that patients involved have sustained: 1. Penetrating trauma 3. Blunt force trauma 4. Organ collision However, all of the above are types of injuries, not hazards on the scene

Question 23

Which of the following would represent the next best location for parking if you could not park upwind, or uphill from the scene of a gasoline spill? 1. Behind a barrier 2. In a drainage ditch 3. Downwind from the spill 4. Downhill from the spill

Answer 23

1. Behind a barrier If liquid is flowing, park behind a barrier if possible. Parking downhill or downwind would put you, your crew and your ambulance at risk for exposure to the liquid or fumes. Drainage ditches also pose the risk of exposing you to runoff from the spill

Question 24

You are called to an area that you and/or your partner know to be dangerous (can be from experience, or briefings). There are frequent incidents of violent incidents of violent crime in that area. When you arrive, you see no bystanders, you see the patient who is an elderly male, he is experiencing respiratory problems, he also appears to be alone with the exception of his granddaughter, who is also the RP. The scene is quiet. What most indicates potential danger? 1. The patient is alone except for his granddaughter 2. There are no bystanders 3. The scene is quiet 4. You know the neighborhood is dangerous

Answer 24

4. You know the neighborhood is dangerous You and your partner have prior knowledge of violence in the neighborhood you are responding to, and so you know that there is a potential for dangerous situation(s) to occur

Question 25

Your patient is a known black belt martial arts instructor, you have been dispatched for a welfare check due to his being in the middle of the street attacking cars. When is it safe to approach him? 1. After he has calmed down 2. After dispatched has cleared you 3. After another crew arrives 4. After the police have subdued him

Answer 25

4. After the police have subdued him You are facing an emotionally unstable patient who can be a significant threat if his anger is directed toward you. You should NOT approach him, even with another crew, without law enforcement present. Once police have the patient subdued, it is safe to approach him

Question 26

A 68 y/o F complains of respiratory distress. She says she has been sick for 3 days, she has a HX of COPD. You note that she is coughing forcefully into napkin. Which of the following would be the most appropriate personal appropriate protective equipment for use on this scene? 1. Mask and eye protection 2. Gloves and Eye Protection 3. Gloves and gown 4. Gloves, Eye Protection, and Mask

Answer 26

4. Gloves, Eye Protection and Mask This patient is exhibiting sx of respiratory illness. You should employ droplet protection in the form of gloves, eye protection and a mask. The mask would protect against direct inhalation of droplets, the eye protection would protect the mucous membrane of the eyes, and the gloves would prevent secondary infection from contact with infected surfaces

Question 27

In a rollover collision, expect which of the following: 1. skeletal and internal injuries 2. any type of serious injury pattern 3. spinal injuries 4. head and neck injuries

Answer 27

2. Any type of serious injury pattern Rollover collisions can be the most serious because of the potential for multiple impacts. Rollover collisions frequently cause ejection of anyone who is not wearing a seat belt. Expect any type of serious injury pattern.

Question 28

You have been dispatched to a call for an assault, that is all of the information. What is the initial response you will take as you approach the scene with the information provided?

Answer 28

Based on the information provided, it being an assault, you are going to stage, waiting for law enforcement to secure the scene

Question 29

When you are finally cleared to come into the scene. As you start to head in, you are informed that your patient has suffered a gunshot wound. What types of damage would you expect to find? 1. Cavitation and projectile damage 2. Pressure-related damage and cavitation 3. Blunt-force trauma and penetrating 4. Cavitation and blunt force trauma

Answer 29

1. Cavitation and projectile damage In a bullet injury, you would expect to find cavitation, or pressure-related damage from the bullet, and projectile damage directly from the projectile

Question 30

You have been dispatched to a MVA, your patient is in the drivers side of the vehicle and you noticed that there was no airbag deployment. What would be your first concern? 1. The airbag may still deploy, injuring you or your patient 2. The patient may have chest injuries he is not aware of. 3. You should immediately fir a cervical collar 4. The patient may have a head injury

Answer 30

1. The airbag may still deploy, injuring you as well as your patient.

Question 31

You have been dispatched to a MVA, the MVA was a head-on collision. One injury pattern you would expect to find is 1. rollover 2. cavitation 3. down and under 4. projectile damage

Answer 31

3. Down and Under

Question 32

For a trauma to qualify as penetrating trauma, it must be an injury that passes through the skin or other body tissues and that is caused by: 1. a projectile 2. a person 3. an object 4. a blunt object

Answer 32

3. an object

Question 33

You were dispatched to treat a​ 41-year-old woman with unknown bleeding. You introduce yourself to the patient and identify that the bleeding was caused by a stab wound. The patient says that the perpetrator has left the premises. You should​ next: 1. identify the weapon 2. request law enforcement 3. leave the scene 4. begin the primary assessment

Answer 33

2. request law enforcement