Chapter 11 | Scene Size-Up

Question 1

List:

steps of scene size-up

6 points

Answer 1

1. BSI: put on PPE
2. scene safety: is the scene safe?
3. nature of call: what is the NOI/MOI?
4. number of patients: how many people to treat?
5. additional resources available: who can be called for backup?
6. C-spine precautions: does patient likely have spinal injury?

Question 2

List:

scene safety considerations

4 points (who you look out for)

Answer 2

• your safety
• partner/rescuer safety
• bystanders safety
• patient safety

Question 3

Define:

NOI and MOI

(acronyms)

Answer 3

• NOI: nature of illness
• MOI: mechanism of injury

Question 4

Fill in the blank:

A severe fall for an adult is more than [BLANK] feet.

Answer 4

A severe fall for an adult is more than 20 feet.

Question 5

Fill in the blank:

A severe fall for an child is more than [BLANK] feet.

Answer 5

A severe fall for an child is more than 10 feet.

2-3 times their height

Question 6

Define:

penetrating trauma

Answer 6

MOI at specific point of contact that pierces skin and creates open wound

Question 7

Define:

low-velocity penetrating trauma

Answer 7

penetrating injury with damage limited to area penetrated

(i.e. knife injury)

Question 8

Define:

medium-/high-velocity penetrating trauma

Answer 8

penetrating injury that may be anywhere in body

examples:

• handgun bullet wound would be medium-velocity penetrating trauma
• rifle bullet wound would be high-velocity penetrating trauma

Question 9

Define:

blunt-force trauma

Answer 9

injury caused by a blow that strikes body but does not penetrate skin or other body tissues

Question 10

Define:

nature of illness

Answer 10

nature of call relating to conditions patient is facing

essentially same as patient’s chief complaint

Question 11

Fill in the blank:

You should begin your scene size-up as [BLANK].

(when?)

Answer 11

You should begin your scene size-up as you approach the scene in the ambulance.

Question 12

List:

bones/structures to assess for injury when caring for a patient who landed a 10-foot fall on feet

3 points

Answer 12

• femur
• pelvis
• ankles

Question 13

List:

potential hazards at the scene of an MVC

3 points

Answer 13

• hazardous materials
• electrocution
• other emergency vehicles

(MVC is motor vehicle collision)

Question 14

Choose:

Which of the following situations will not require additional resources at the scene?

A: a patient with emphysema who is on oxygen therapy at home

B: a call for a sick person at home during which an odor of natural gas is detected

C: a 300-pound woman complaining of back pain

D: a call to a manufacturing plant where a worker has his hand caught in a machine

Answer 14

A

Question 15

Choose:

You have just arrived on the scene of a motor vehicle collision in which a compact car was struck from behind by a delivery truck. The driver of the delivery truck is standing outside his vehicle talking to police when you arrive, but the driver of the car is still seated in the driver’s seat. You have noted moderate damage to the rear of the car.

For which of the following injuries should you have the highest level of suspicion?

A: fractures of lower extremities

B: chest injury

C: neck injury

D: abdominal injury

Answer 15

C

Question 16

Answer:

You and your partner respond to a residence for a fall. You arrive to find a group of approximately 30 adults surrounding a middle-aged man who appears to be unconscious. A police car pulls in behind you.

What should you do first?

Answer 16

wait for the police officer to assess the safety of the scene

Question 17

Answer:

As you are assessing a 32-year-old asthmatic woman who has called EMS due to difficulty breathing, her husband enters the home through a back door and shouts, “Get your hands off her; she doesn’t need your help. She needs to be taught a lesson about her smart mouth.”

What is the best course of immediate action?

Answer 17

request police backup immediately and consider leaving the scene

Question 18

Answer:

As you approach the scene of a motorcycle accident, you see an EMR trying to stop the bleeding on the patient’s left arm. You notice that the EMR has blood covering the front of his shirt and running down his arms.

What Standard Precautions are needed?

Answer 18

• gloves
• gown
• face mask with eye shield

Question 19

Answer:

You and your partner are en route to a motor vehicle crash involving a tanker truck on a rural road. Dispatch informs you that fluid is leaking from the truck, that there are several bystanders passed out on the ground near the cab of the truck, and that a caller has reported the code that appears on a placard attached to the tanker truck.

What should you do first?

Answer 19

consult the Emergency Response Guidebook on placard meanings

Question 20

Choose:

You are on the scene of an explosion at a suspected methamphetamine manufacturing operation. You and your partner are the first to arrive and note two middle-aged men and a woman on the front lawn with burns and cuts on their faces and arms. The fire department is en route.

Which of the following resources should be the least important to be requested by the EMT during the scene size-up?

A: law enforcement

B: one or two additional ambulances

C: hazardous material clean-up crew

D: gas company

Answer 20

C

A is wrong because law enforcement must preserve evidence and deescalate risk of violence

B is wrong because other ambulances will be needed for what is most likely an MCI

D is wrong because the gas company must disconnect all natural gas lines in the event of a fire to prevent greater explosion

Question 21

Answer:

Your patient fell out of a tree while putting the roof on a tree house. A 15-foot ladder is required to enter the tree house and there is enough room for an adult to stand up inside.

To what type of medical center should your patient be transported?

Answer 21

a trauma center

the fall was likely over 20 feet (severe)

Question 22

Choose:

You are dispatched to a local bar for the report of an unresponsive female patient found in the bathroom. As you approach the scene, you notice a large crowd outside the front door holding beer bottles. The group has pulled the patient outside. As you approach the scene, people from the group start yelling, “Do something! She’s not breathing.”

What is your greatest concern regarding this scene?

A: the crowd stating the patient is not breathing

B: the fact that the patient has been moved from where she was found

C: the possibility that the patient may be intoxicated

D: the large crowd that has been drinking and is now yelling at you

Answer 22

D

Question 23

Choose:

Your patient, a 29-year-old female, was the front seat passenger in a vehicle that was struck in the passenger’s side door by another vehicle that ran a red light.

Which of the following is most likely to have occurred?

A: the patient’s body was pushed forcefully out from under her head, causing injury to the cervical spine

B: the patient took the “down and under” pathway, causing trauma to her lower extremities

C: the patient took the “up and over” pathway, striking her head on the windshield

D: the patient impacted the steering wheel with her chest, causing a fracture of the sternum

Answer 23

A

Question 24

Answer:

In the event of a chlorine gas leak at a public swimming pool, an EMT should consult the [BLANK].

Answer 24

In the event of a chlorine gas leak at a public swimming pool, an EMT should consult the Emergency Response Guidebook.

(because of hazardous materials on scene)

Question 25

Answer:

You and your partner respond to a residence for a fall. You arrive to find a group of approximately 30 adults surrounding a middle-aged man who appears to be unconscious. A police car pulls in behind you.

What should you do first?

Answer 25

wait for the police officer to assess the safety of the scene

Question 26

Fill in the blank:

An unusual lack of activity at the scene may signal [BLANK].

Answer 26

An unusual lack of activity at the scene may signal impending violence against the EMT.

Question 27

Answer:

You are called to a motor vehicle collision where the car is on fire.

How do you ensure safety?

Answer 27

remain a safe distance from the car until the fire is out

Question 28

List:

collisions of an MVC

3 points (transfers of energy)

Answer 28

1. vehicle-to-vehicle collision
2. body-to-vehicle collision
3. organ-to-body collision

(MVC is motor vehicle collision)

Question 29

Answer:

What should be your first suspicion when noticing multiple patients experiencing the same symptoms?

Answer 29

environmental factors

(CO exposure in home or shock from electrical conduction on wet grass)

Question 30

Answer:

What should you do when you observe an object that might be used to commit violence?

(i.e. a gun)

Answer 30

place your partner or yourself between the patient and the object in order to prevent the patient’s access to that object

Question 31

Choose:

You are assessing a patient who fell off a ladder. He is conscious and alert and complaining of pain to his right side and shortness of breath.

This is known as:

A. The chief complaint

B. The nature of illness

C. A sign

D. The mechanism of injury

Answer 31

A

Question 32

Choose:

Which of the following is not an appropriate action when you near the scene of a traffic collision?

A. Look and listen for other EMS units as you near intersections.

B. Look for signs of collision-related power outages.

C. Observe traffic flow to anticipate blockage at the scene.

D. Attempt to park your vehicle downhill from the scene.

Answer 32

D

Question 33

Choose:

You have been dispatched to a multiple-car collision on the interstate. When you are in sight of the collision scene, you should watch for the signals of police officers and other emergency service personnel because:

A. they may have information about hazards or the location of injured persons.

B. the first ones on the scene are considered to be in charge.

C. federal law requires you to follow the command of other responders.

D. they are considered the medical-care experts on the scene.

Answer 33

A

Question 34

Fill in the blank:

When there are no apparent hazards at a traffic incident scene, consider the danger zone to extend at least [BLANK] feet in all directions from the wreckage.

Answer 34

consider the danger zone to extend at least 50 feet in all directions from the wreckage.

50 feet for no apparent hazards

100 feet for enflamed collision vehicle

Question 35

Fill in the blank:

When a collision vehicle is on fire, consider the danger zone to extend at least [BLANK] feet in all directions, even if the fire appears small and limited to the engine compartment.

Answer 35

consider the danger zone to extend at least 100 feet in all directions

50 feet for no apparent hazards

100 feet for enflamed collision vehicle

Question 36

Choose:

Standard Precautions should be taken with all patients.

The key element of Standard Precautions is to:

A. always wear all the protective clothing.

B. always have personal protective equipment readily available.

C. place equipment on the patient as well as the rescuer.

D. determine which body fluids pose a danger to the EMT.

Answer 36

B

Question 37

Choose:

Certain injuries are common to particular situations.

Injuries to bones and joints are usually associated with:

A: fights and drug usage

B: fires and explosions

C: falls and vehicle collisions

D: bullet wounds

Answer 37

B

Question 38

Fill in the blank:

The law of inertia states that [BLANK].

Answer 38

The law of inertia states that a object/body in motion will remain in motion unless acted upon by an outside force.